I went to medical school and did my psychiatric residency at Weill Cornell in the Upper East Side of Manhattan. Weill Cornell has traditionally emphasized psychoanalytic thinking in addition to medical psychiatry. Instead of seeing patients as a checklist of symptoms adding up to a diagnosis, the psychoanalytic approach tries to see why the patient is having distress, or not functioning well, as an outcome their personal history. Symptoms and personality traits can originate out of trying to adapt to past psychological or interpersonal conflicts but may have outlasted their usefulness.
Because of my interest in this comprehensive model of the mind, I did psychoanalytic training at the New York Psychoanalytic Institute & Society. With experience, I have found that the best treatment comes out of meeting each patient’s needs with an individually tailored approach. How much a psychoanalytic approach is part of a treatment plan is variable. It can be the treatment of choice. But, sometimes supportive, motivational or cognitive psychotherapies are more practical. Biological psychiatry has developed many important and tolerable therapies, including medication, that should be carefully considered for the appropriate conditions. Integrating these different treatment modalities is a job for the practitioner and the patient to do together for the best possible outcome. We see some patients who already have their own psychotherapist who has been professional and effective for them. We are willing to consider, with some exceptions, collaborations with outside providers. We also see patients who prefer to only do psychopharmacology or only do psychotherapy.
I believe in offering effective and practical short-term treatments to patients, with the goal of significant improvement of the immediate presenting problems. When that is achieved, we assess whether longer term issues contributed to the development of the initial presenting problems. If so, then longer term intensive treatment is offered as an option to prevent recurrence and improve overall fulfillment. Patients always can opt for less frequent follow-up with the goal of maintaining recovery.
-Brian A. Aslami, M.D.
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