Psychodynamic Psychiatry, the Biopsychosocial Model, and the Difficult Patient.

This article defines psychodynamic psychiatry as the intersection between general psychiatry and psychoanalysis as a theory of mind. Psychodynamic psychiatry is built on a biopsychosocial model for understanding and treating mental disorders. Currently, a narrower biomedical model is in ascendancy, but it has not lived up to its promise and is not supported by emerging science as robustly as is the biopsychosocial model. The "difficult patient" emerges in part from the limits of our treatment models and treatment methods. Concepts like projective identification and enactment help us to understand our own contributions to our experience of a patient as difficult.