Gordon E. Warme

The current level of psychodynamic knowledge of candidates for the Canadian certification examination in psychiatry.

Candidates at the certification examination in psychiatry of the Royal College of Physicians and Surgeons of Canada are noted by the author to have a lesser degree of psychodynamic sophistication than might be expected of psychiatric specialists. To test this hypothesis a number of sample questions were administered to examinees and their answers suggest that they do indeed perform less well than might have been hoped. It is argued that the examination procedure may be a legitimate instrument for rectifying this situation.

Current issues in child psychiatry: a dialogue with John Bowlby.

A condensed account of Bowlbys work, particularly his advocacy of an ethological approach and of attachment theory, is followed by comments by three child psychiatrists. His work is critically discussed and ranges from questions concerning the theoretical status of Bowlbys work, to concerns about the de-emphasis of constitutional and temperamental factors, and to concerns that current realities render impractical (and perhaps unnecessary) the traditional models of child rearing. Dr. Bowlby responds to each discussant. In this three days at Lake Couchiching, John Bowlby was the most available and charming of guests. He welcomed discussion with delegates in his every free moment, including mealtimes. It was a privilege to have him in dialogue with us.

Passing the oral examination for specialist qualification in psychiatry

This paper summarizes a number of considerations in the areas of technique, structure, diagnosis and formulation for candidates attempting to qualify in the psychiatry oral examination.

Identity theory, functionalism and intentionality: three modes of psychological explanation used in psychiatry.

It is argued that there are three modes of psychological explanation that are available and in wide use, but that the three are often unwittingly confounded. These are, identity theory, functionalism and intentionality. Identity theory explains by viewing psychological events as direct products of design, that is, manifestations of brain events. The stance of functionalism is to study psychological events and those past and current stimuli that evoke them. In other words, functionalism studies the way in which psychological events are programmed. Intentionality approaches psychic events as a product of both conscious and unconscious purposes, beliefs, wishes, reasons and meanings, and concludes that it is of considerable worth to treat persons as intentional systems. It is claimed that the demarcation between these explanatory modes is crucial in psychiatric, and especially psychotherapeutic practice and research.

An essay on contemporary dynamic psychiatry

Psychodynamic theory is less well understood than one would wish, especially because of the centrality of dynamic theories in understanding a host of psychiatric disorders. The key psychodynamic notion is that psychiatric symptoms can be explained as manifestations of an unconscious purpose or strategy. The theoretical term that best encompasses this notion is “intentionality”, a theoretical option that has, in many psychiatric circumstances, the greatest predictive and explanatory powers. Other more or less loosely related dynamic theories are the theory of the Oedipus complex, developmental theory, the theory of transference and the extraclinical theory. New theoretical paradigms are currently competing for explanatory priority, a development which reflects a healthy maturity in psychodynamic science, and which may mean that a new and superordinate theoretical paradigm is about to emerge. At a time of theoretical ferment it is particularly important that the theoretical underpinning of dynamic psychiatry be clearly explicated and the author claims that theoretical role for intentionality.