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Minerva Psichiatrica 2002 December;43(4):287-94

Copyright © 2002 EDIZIONI MINERVA MEDICA

language: Italian

Sisyphus and integrated therapy

Mungo S.


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The story of the integration between biological and psychological therapies in the treatment of mental disturbances runs right through the history of psychiatry, becoming particularly significant in the 60s when the spread of psychodrugs radically modified the evolution and prognosis of mental diseases. After an initial coup de foudre lasting until the mid-70s, a dramatic breakdown occurred. The diffident reconciliation between psychotherapists and psychopharmacologists that was a feature of the next decade seemed to be more the product of a generalised cultural modification which spread the concepts of dialogue, assimilation and complexity, than of an autochthonous integration of different theories and techniques. Within the specific context of mood disturbances, antithetical positions are encountered which range from discouraging every association of psychotherapy with pharmacological treatment, judged to be useless or damaging, to the more recent re-assessments of psychological treatments, at least in cases of greater management complexity. Another very particular situation is represented by bipolar disturbances where the introduction of equilibrators seems to have swept away every need for psychotherapeutic treatment and where we continue to see unexplainable recidivation. The biotechnological supremacy of aseptic drugs such as the stabilisers is, in fact, stymied by a series of situations in which the emotional-affective instability which remains in pharmacological treatment is no longer biologically modifiable but can only be understood and elaborated within a therapeutic relationship where, once again, the ineluctability of the renewal of psychiatric work recalls the fatigues of Sisyphus.

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