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Tijdschrift voor Psychiatrie 42 (2000) 7, 459 - 467

Essay

Psychotherapy and its future in the psychiatric field: An attempt for integration of new insights

M.G.J. Schmeets, A.C. van Reekum

Psychotherapy and its effectiveness are under attack. It seems that psychiatry gradually turns its back on it. Recent developments in many fields of research, among which genetics, however, seem to give significant support for the preservation of psychotherapy. The neurosciences attempt to make the primary attachment operative, because it proves to be of great influence on the brain's function and structure. An important task within the dyad caretaker-infant (the primary relationship) is the mutual affect regulation, by means of mutual harmonisation. In turn it appears that the affect regulation also has influence on the brain's function and structure. Information from the primary relationship, including its affective component, becomes stored in what is called the procedural memory. It leads to general ways of being and social intercourse, which determine the way the individual forms relationships for life. Recent research in psychotherapy postulates that changes in these procedural, unconscious, implicit schemes form an important effective psychotherapeutic factor, whether you are a behavioural therapist or a psychoanalyst. So psychotherapy ought to be revaluated within the psychiatric field.

keywords attachment, infantresearch, neurosciences, psychotherapy