W50 – Assessing Attachment and Emotional Patterns to Tailor Biopsychosocial Treatment of Treatment-Refractory Psychiatric Patients

W50 – Assessing Attachment and Emotional Patterns to Tailor Biopsychosocial Treatment of Treatment-Refractory Psychiatric Patients

Saturday, Oct. 29
15:45 – 16:45 (1 hr)
Meeting Room: Linden (Mezzanine)
Allan Abbass*, MD, FRCPC

CanMEDS Roles:

  1. Communicator
  2. Medical Expert
  3. Collaborator

At the end of this session, participants will be able to: 1) Identify three pathways of unconscious anxiety and three categories of major defense; 2) Describe processes to assess anxiety/defense pathways related to past attachment; and 3) Describe some considerations and tailor pharmacotherapy and psychotherapy to patient attachment patterns.

Non-remission is the most common outcome of first- and second-line treatments of the spectrum of psychiatric disorders. Patient emotional, relational, and physiological patterns that relate to attachment interruptions can all contribute to treatment resistance. Patients have specific patterns of physiologic emotional response depending on their attachment history. Assessing and understanding these different pathways can help tailor pharmacotherapy and psychotherapy in an integrated frame while protecting the therapeutic relationship. Rates of remission can be improved by combining these two. In this workshop, video recordings of patient assessments will be used to complement theory to help clinicians identify categories of patients based on physiological responses that can assist in the medication and psychotherapeutic treatment of diverse psychiatric patients.

References:

  1. Abbass A. Reaching through Resistance: Advanced Psychotherapy Techniques. Kansas City (MO): Seven Leaves Press; 2015.
  2. Town JM, Abbass A, Stride C, et al. A randomised controlled trial of intensive short-term dynamic psychotherapy for treatment resistant depression: the Halifax Depression Study. J Affect Disord 2017;214:15–25.