Complex Problems in Psychodynamic Psychotherapy

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Complex Problems in Psychodynamic Psychotherapy Psychodynamics in Under-Medication of Pain in HIV/AIDS 1 Early Childhood Trauma, PTSD, and Non-Adherence in HIV/AIDS 2 The Difficult-to-Treat Patient 3 Psychodynamic Psychopharmacology in the Care of Treatment-Resistant Patients 4 Mary Ann Cohen, M.D. 1,2 Elizabeth Haase, M.D. Thomas Kalman, M.D. David Mintz, M.D. 3, 4 Silvia W. Olarte, M.D. 3 Eric Plakun, M.D. 3 J.J. Rasimas, M.D., Ph.D. 4 Erminia Scarcella, M.D. Jane Simon, M.D.

Mary Ann Cohen, M.D. macohen@nyc.rr.com Dr. Mary Ann Cohen is Clinical Professor of Psychiatry at the Mount Sinai School of Medicine. Board certified in adult psychiatry, addiction psychiatry, geriatric psychiatry, and psychosomatic medicine, Dr. Cohen is an award-winning psychiatrist and a leader in the fields of psychosomatic medicine and AIDS psychiatry. Clinical Practice Dr. Cohen is in the full time private practice of psychodynamic psychotherapy, psychosomatic medicine, geriatric psychiatry utilizing individual, couple, and family therapy. She has served on or directed psychosomatic medicine services at two municipal hospitals for 23 years and AIDS psychiatry services at an AIDS nursing home and at the Mount Sinai Medical Center for 12 years. In each of these settings, Dr. Cohen has created health care environments to meet the needs of patients and their communities and innovated programs to identify and diminish disparities and discrimination in health care settings. She has integrated psychoanalytic principles into patient care, medical board governance, and bioethics committees. Research Research interests include the prevalence of substance use, suicide attempts, and capacity consultations, the use of restraints in general care and their association with increased lengths of stay, prevalence of distress in persons with AIDS, and the association of suicide attempts and HIVassociated neurocognitive disorders. Grand Rounds Presentations Decisional Capacity: Autonomy and the Patient s Right to Self-Determination Grand Rounds, Montrose Veterans Administration Hospital, Montrose, New York, January 27, 2010 Psychodynamics of Under medication for Pain in Severe and Complex Medical illness - Grand Rounds, McMaster University, Ontario, Canada, November 3, 2010

Elizabeth Haase, MD Suite 620, 119 West 57th Street New York, NY 10019 ekh7@columbia.edu Dr. Haase completed her medical degree at Yale University and her residency at Columbia University Medical Center. She remained at Columbia University to complete a fellowship in consultation-liaison psychiatry and a certificate in psychoanalysis. These trainings inform her approach to patients, teaching and writing, which is characterized by a thorough explication of both biological and psychodynamic contributions to a given clinical presentation. She serves on the Committee for Human Sexuality for the Group for the Advancement of Psychiatry and the Editorial Board of the Journal of Dynamic Psychiatry, both under Drs. Jennifer Downey and Richard Friedman, and will be working this year on the program committee for a new center devoted to the interdisciplinary study of the mind under Dr. Edward Nersessian. The recipient of two teaching awards, Dr. Haase teaches courses on psychosexual development, advanced psychoanalytic theory, and human pain through the Columbia University residency training program and Chinese American Psychoanalytic Alliance, where she is consistently rated one of the most clear and relevant teachers. Recent presentations include a panel on internet dating for B'nai Brith New York and a workshop on sexuality for a local religious community. The author of several papers and chapters, Dr. Haase's current writing interests include theories of perversion, the relationship between mood states and romantic love, and the psychology of shame. Presentations: Pain Management for the Psychiatric Resident Psychosexual Development from Birth to Middle Age Romantic Love in the Bipolar Patient Personality Disorders in the Headache or Medical Patient Any of the theory lectures: Obsessional Neurosis, Hysterical Personalities, Schizoid Personalities, Narcissistic Personalities, Borderline Personalities, Ego Psychologists from Anna Freud to Heinz Hartman, The Work of: Melanie Klein, Wilfred Bion, WRD Fairbairn, Otto Kernberg, Margaret Mahler, Heinz Kohut, Donald Winnicott, Attachment Theory, Relational Theory, Dreamwork, Female Sexual Development, Perversions and Perverse Character Structure, Sadomasochism

Thomas Kalman, M.S., M.D. TKmd49@gmail.com Dr. Kalman is Clinical Associate Professor of Psychiatry, Weill Medical College of Cornell University, and Adjunct Associate Professor of Psychiatry, NY Medical College. He has maintained a private practice in general psychiatry and psychoanalysis for over thirty years, integrating different techniques and understandings along with a primarily psychodynamic orientation. Dr. Kalman s current areas of interest and research involve split-treatment arrangements and the problem of inadequate communication between professionals treating the same individual. Other recently presented and published work involves problematic Internet use, specifically pornography. Dr. Kalman s other graduate degree is in health care administration, and he remains interested in health care delivery, economics, and policy. Recent publications and presentations Clinical Encounters with Internet Pornography. Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry: 36:593-618, 2008 Kalman TP and Goldstein, MA, Satisfaction of Manhattan psychiatrists with private practice. Assessing the impact of managed care. Journal of Psychotherapy Practice and Research; 7:250-8, 1998 Clinical Encounters with Internet Pornography, Grand Rounds, Dept. of Psychiatry, Weill-Cornell Medical College, New York, NY, October 2008; Personality Disorders Conference, NY Presbyterian Hospital, Westchester Division, White Plains, NY, June 2009 Do Psychotherapists speak to Psychopharmacologists about their Mutual Patients? Grand Rounds, Dept. of Psychiatry, Metropolitan Hospital Center, New York, NY, April, 2010; Dept. of Psychiatry, Queens Hospital Center, Jamaica, NY, October 2010; Sheppard Pratt Hospital, Baltimore, MD, October 2010; Westchester County Medical Center/New York Medical College, February 2011 Can we talk? Do Psychotherapists speak to Psychopharmacologists? Paper presentation, Annual meeting of The American Psychiatric Association, New Orleans, LA, 2010

David Mintz, M.D. Director of Psychiatric Education The Austen Riggs Center 25 Main Street / P.O. Box 962 Stockbridge, MA 01262 phone: (413) 931-5315 fax: (413) 298-4020 David.Mintz@AustenRiggs.net David Mintz, M.D., is a graduate of the Cambridge Hospital/Austen Riggs Center Combined Residency Program and completed a Fellowship in Psychodynamic Psychotherapy at Austen Riggs, where he is Director of Psychiatric Education. His primary interests involve psychosocial factors in psychopharmacology, particularly in relation to treatment-resistance and treatment outcome, psychodynamic aspects of medical education and developmental processes involved in becoming a psychiatrist. He is on the Education Committee of the American Academy of Psychoanalysis and Dynamic Psychiatry and the Medical Student Education Committee of the American Psychoanalytic Association. Recent Presentations: Recovery From Childhood Psychiatric Treatment AAPDP Annual Meeting, Honolulu, HI, May 13, 2011. A Psychodynamic Approach to Treatment Resistant Mood Disorders: Breaking Through Complex Comorbid Treatment Resistance by Focusing On Axis II "APA Annual Meeting, Honolulu, HI, May 17, 2011. Psychiatry Grand Rounds: Meaning and Medication: Psychodynamic Approaches to the Treatment Resistant Patient, Yale, New Haven, CT, July 22, 2011. Recent Publications: Mintz D., Teaching the Prescriber Role: The Psychodynamics of Psychopharmacology. Academic Psychiatry, 2005, Vol 29(2): 187-194. Mintz D., Psychodynamic Trojan Horses: Using Psychopharmacology to Teach Psychodynamics. Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry, 2006, 34(1): 151-161. Mintz D & Belnap BA., What is Psychodynamic Psychopharmacology: An Approach to Pharmacologic Treatment Resistance. Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry, 2006, 34(4): 581-601.

Silvia W. Olarte, M.D. Phone: 212 249 6246 Email: swolarte@aol.com Dr. Olarte is an APA Distinguished Fellow and a Fellow of the AAPDP. She is Clinical Professor of Psychiatry and training and supervising psychoanalyst at the Psychoanalytic Institute at New York Medical College. She has been president of the Association of Women Psychiatrists and of the American Academy of Psychoanalysis and Dynamic Psychiatry. She practices psychodynamic psychiatry in New York City. She devoted much of her earlier career to serving the Latino deprived population in New York City at Metropolitan Hospital where she was Outpatient Department Director and s Acting Director of Psychiatry. At the APA, among others, she has served on the Committee of International Medical Graduates, the Committee on Hispanics and the Committee on Women, chaired the task force on Educating Psychiatrists on Ethical Issues and the former Council on National Affairs. She has been the recipient of the APA George Tarjan Award and the APA Alexandra Symonds Award, the APA Special Presidential Commendation and the AAPDP Presidential Award. She has published over 30 articles and presented, discussed, or chaired numerous presentations on women s issues, ethical issues, boundaries violations, psychodynamic treatment of deprived populations, and changes in psychodynamic practices. Recent Presentations: Dynamic Psychiatry in the United States (WPA Congress, Buenos Aires 2011 and Chulalongkorn University Medical School Thailand 2012) The Psychiatrist as Internist of the Mind (AAPDP, Philadelphia 2012) The Impact of Culture on Gender, Clinical Implications (AAPDP, New York, 2004) Leadership and Minority Women, Transcultural Experiences (World Congress Women's Mental Health, Washington, 2004) Boundary Violation, Clinical and Ethical Consequences (Fifth World Congress on Depression, Mendoza, Argentina, 2003) Women Psychiatrists; Personal and Career Choices: Implications for the future. (APA, Philadelphia 2012)

Eric M. Plakun, M.D. eric.plakun@austenriggs.net Dr. Plakun is Director of Admissions and Professional Relations at the Austen Riggs Center in Stockbridge, MA. He has been a Clinical Instructor in Psychiatry at Harvard Medical School for over 20 years. He is the editor of New Perspectives on Narcissism (American Psychiatric Press, 1990) and Treatment Resistance and Patient Authority: The Austen Riggs Reader (Norton Professional Books, 2011) and author of more than forty papers and book chapters on the diagnosis, treatment, and outcome of patients with borderline and other personality disorders, suicidal and selfdestructive behavior, and treatment resistant disorders. He is a Distinguished Life Fellow of the American Psychiatric Association, past Chair of its Committee on Psychotherapy by Psychiatrists, and a Psychoanalytic Fellow of the American Academy of Psychoanalysis and Dynamic Psychiatry, where he is a former member of its Executive Council. In 2004 he was appointed Academy representative to the APA Assembly, where he chairs the Assembly Allied Organization Liaisons Committee and serves on the Assembly Executive Committee. He is a Fellow of the American College of Psychiatrists, an Honorary Fellow of the American College of Psychoanalysts, and a member of the editorial board of Psychodynamic Psychiatry. He has appeared on the CBS show 60 Minutes, where he was interviewed by Mike Wallace as an expert in forensic psychiatry. Recent Presentations: Concepts Psychiatry Needs from Psychoanalysis A Psychodynamic Approach to Treatment Resistant Mood Disorders with Axis II Comorbidity Psychotherapy with Suicidal Borderlines The Y Model An integrated, evidence based approach to teaching psychotherapy

J.J. Rasimas, M.D., Ph.D. Staff Clinician, National Institutes of Health NIMH Experimental Therapeutics and Pathophysiology Branch 10-CRC, Room 7-5541 10 Center Drive, MSC 1282 Bethesda, MD 20892-1282 Office: (301) 496-1063 Fax: (301) 402-9360 Mobile:(301) 605-3231 rasimasj@mail.nih.gov Dr. Rasimas he attended the University of Scranton and graduated summa cum laude with degrees in biochemistry, mathematics, and philosophy. He completed the Medical Scientist Training Program at Penn State University, earning a Ph.D. in Chemical Biology (2002) and M.D. (2003). Upon graduation from the Penn State College of Medicine, Dr. Rasimas was honored for excellence in both psychiatry and medical toxicology. He matriculated to psychiatry residency training at the Mayo Clinic in Rochester, Minnesota. Dr. Rasimas received the National Institute of Mental Health (NIMH) Outstanding Resident Award in 2005 and was recognized by the American College of Psychiatrists with the Laughlin Fellowship in 2007. He is a member of a number of academic honor societies as well as the Association for the Advancement of Philosophy and Psychiatry. He has studied psychotherapy at the Minnesota Psychoanalytic Society and Institute and the Washington School of Psychiatry. Dr. Rasimas was a clinical fellow at the NIMH, training in consultation-liaison psychiatry, bioethics, and clinical research. He has served as a staff psychiatrist for Hershey Medical Center and remains an Associate Professor of Psychiatry and Emergency Medicine for the Penn State College of Medicine, there. He completed a medical toxicology fellowship, obtained board certification in Addiction Medicine, and then returned to NIMH to join the Intramural Research Program. Dr. Rasimas is pursuing an academic medical career at the interface of psychosomatic medicine, medical toxicology, and psychodynamic psychotherapy. His primary areas of clinical interest are pharmacotherapeutics, neuropsychiatric toxicity, psychoanalysis, and the phenomenology of suicide.

Erminia Scarcella, M.D., DFAPA Email: ermsca@verizon.net Web: www.erminiascarcellamd.com Web: ItalianPhysicians.com Dr. Scarcella received her medical degree from the University of Rome, specializing in neurology and psychiatry and received additional training in psychiatry at the George Washington University and St. Elizabeth Hospital. She is Assistant Clinical Professor at George Washington University, Designated Physician of the Embassy of Italy and President of Jung Society of Washington DC. She is a Distinguished Fellow of the American Psychiatric Association and a member and past Trustee of the American Academy of Psychoanalysis and Dynamic Psychiatry. She is in full-time private practice of psychiatry and psychoanalysis in Washington, D.C. She serves on the Board of the Consortium for Psychoanalytic Research and is past President of American Society of Psychoanalytic Physicians. She is active in the Washington Psychiatric Society and was Founder of the Embassy Disaster Preparedness, a humanitarian project designed to assist international victims of disasters. She is a recipient of the APA Bruno Lima Award. Presentations: "The Red Book of C.G. Jung," National Association for the Advancement of Psychoanalysis, New York "The Red Book of C.G. Jung,: Association for Psychoanalytic Physicians, Washington, D.C. "Psychodynamic Case Formulation Washington, D.C, Howard University A Case Presentation Illustrating the Jungian Clinical Approach, Focusing in Archetypes, Collective Unconscious and Multigenerational Family Dysfunction, AAPDP and OPIFER conference, Genoa, Italy; The Red Book of C.G. Jung ; The Philadelphia Jungian Professional Club Description of Professional Formation in Analytic Psychology of C.G. Jung, AAPDP and OPIFER conference, Rome, Italy

Jane Simon, M.D. 145 Central Park West, Suite 1A New York, NY 10023 Office Telephone: 212-877-3566 Js145@msn.com; jsimon145@gmail.com Website: www.drsimonsays.blogspot.com Dr. Simon is a board certified psychiatrist, trained in adult, adolescent and child psychiatry. She has been in private practice in New York City for more than thirty years. She is Clinical Associate Professor of Psychiatry, St. Lukes -Roosevelt Medical Center of Columbia University and supervises residents in the adult and the child and adolescent residency programs. She is a Diplomate of the American Board of Psychiatry and Neurology, a Life Fellow of the American Psychiatric Association, a member of the American Academy of Child and Adolescent Psychiatry, member and trustee of the of the AAPDP, and serves on the editorial board of Psychodynamic Psychotherapy and on the editorial board of the Journal of Religion and Health. Topics of her professional articles include thoughts on September 11 and soul death and a chapter, Stepping Stones in a Full Life, in The Inner Life of Women s Spirituality (Ed. by C. A. Rayburn and Comas-Diaz, Connecticut: Praeger, 2008). She has presented papers at AAPDP meetings and a Grand Rounds on soul death at the Roosevelt Hospital in New York City. Her poems have been published in literary journals and a small volume of poetry, Incisions. Written in collaboration with the cartoonist, Jim Whiting, The Cabala of the Animals presents life lessons and moral values (in prose and poetry) of what we can learn from our animal friends (May, 2012). She writes a weekly blog, www.drsimonsays.blogspot.com, which has elicited favorable comments. These blogs written for the layperson integrate her thoughts and experiences and could be adapted to a professional audience.