An Innovative Brief Psychodynamic Psychotherapy: Commentary on Busch and Milrod

Busch and Milrod's presentation summarizes the brief psychodynamic psychotherapy of a patient suffering from an anxiety disorder with panic attacks, depression, and significant separation anxiety. It is a case from a treatment study using Panic Focused Psychodynamic Psychotherapy-eXtended Range, a specific psychodynamic psychotherapy for patients with separation anxiety and anxiety disorders developed by Milrod, Busch, and colleagues. (Milrod et al. 2007; Busch et al. 2012). This particular case was selected from a sample of treatment nonresponders with anxiety disorders and separation anxiety on the basis of having had three previous treatments to which he did not respond, and now was successfully treated with the present treatment in a 21-session trial.

This treatment uses sophisticated dynamic concepts regarding separation and attachment, particularly unconscious conflicts around rage toward ambivalently loved attachment objects, and the related fear of self-assertion and independence because of their aggressive and vengeful implications. The theory of technique applied to this case involved identifying and addressing the patient's core separation-related fantasies, including a sense of catastrophic danger surrounding separation, a sense of helplessness, and the feeling that attachment objects are fragile and can