ABSTRACT

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common psychiatric diagnoses given in childhood. The recommended treatment is medication in combination with behavioural intervention, and psychoanalytic treatments are rarely recommended or sought. However, in recent decades, there has been an increase in psychoanalytic interest in ADHD, conceptualising it as a complex, biopsychosocial phenomenon requiring a multimodal approach, and suggesting that psychoanalytic psychotherapy can be helpfully and effectively combined with medication in treatment. This study aimed to empirically investigate this practice, by interviewing psychoanalytic child psychotherapists about their experiences of treating children medicated for ADHD. Semi-structured interviews were carried out with six child psychotherapists. The data were analysed qualitatively, using thematic analysis and discourse analysis. Participants presented psychotherapy and medication as theoretically compatible and complementary, but expressed uncertainty about and resistance to the use of medication alongside psychotherapy in practice. Interviewees adopted positions of compliance, avoidance and resistance to the practice of combining medication and psychotherapy, understood as negotiations of the powerful medical discourse of ADHD. While the literature emphasises the potential for psychopharmacological and psychoanalytic approaches to be mutually enriching, this study highlights the challenges of adopting a multi-perspective approach in this contested field.

摘要

注意缺陷多动障碍 (ADHD) 是儿童时期最常见的精神疾病诊断之一。推荐的治疗是药物结合行为干预，很少推荐或寻求精神分析治疗。然而，近几十年来，人们对 ADHD 的精神分析兴趣有所增加，将其概念化为一种复杂的、需要多模式方法的生物心理社会现象，并表明精神分析心理治疗可以有效地与药物治疗相结合。本研究旨在通过采访精神分析儿童心理治疗师，了解他们治疗患有多动症的儿童的经验，对这种做法进行实证调查。对六名儿童心理治疗师进行了半结构化访谈。使用主题分析和话语分析对数据进行定性分析。参与者认为心理治疗和药物治疗在理论上是相容和互补的，但对在实践中同时使用药物治疗和心理治疗表示不确定和抵制。受访者对药物和心理治疗相结合的做法采取顺从、回避和抵制的立场，理解为多动症强大医学话语的谈判。虽然文献强调了精神药理学和精神分析方法相互丰富的潜力，但本研究强调了在这个有争议的领域采用多视角方法的挑战。参与者认为心理治疗和药物治疗在理论上是相容和互补的，但对在实践中同时使用药物治疗和心理治疗表示不确定和抵制。受访者对药物和心理治疗相结合的做法采取顺从、回避和抵制的立场，理解为多动症强大医学话语的谈判。虽然文献强调了精神药理学和精神分析方法相互丰富的潜力，但本研究强调了在这个有争议的领域采用多视角方法的挑战。参与者认为心理治疗和药物治疗在理论上是相容和互补的，但对在实践中同时使用药物治疗和心理治疗表示不确定和抵制。受访者对药物和心理治疗相结合的做法采取顺从、回避和抵制的立场，理解为多动症强大医学话语的谈判。虽然文献强调了精神药理学和精神分析方法相互丰富的潜力，但本研究强调了在这个有争议的领域采用多视角方法的挑战。避免和抵制药物和心理治疗相结合的做法，被理解为多动症强大医学话语的谈判。虽然文献强调了精神药理学和精神分析方法相互丰富的潜力，但本研究强调了在这个有争议的领域采用多视角方法的挑战。避免和抵制药物和心理治疗相结合的做法，被理解为多动症强大医学话语的谈判。虽然文献强调了精神药理学和精神分析方法相互丰富的潜力，但本研究强调了在这个有争议的领域采用多视角方法的挑战。