You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
Our bioself-psychological model of panic disorder (for a complete description of the clinical features and diagnostic criteria of panic disorder see DSM-IV [American Psychiatric Association, 1994]) combines two major and seemingly opposing perspectives concerning this condition. On the one hand, we use the pioneering work of biological psychiatrists, such as Klein (1964, 1981; Klein et al., 1985), Quitkin et al. (1972), Shear (1988), Telch (1988), Swinson and Kuch (1990), and Klerman et al. (1993), all of whom have provided convincing empirical evidence about the biological (neurological and biochemical) basis of panic disorder. More specifically, we incorporate Klein's distinction between anxiety and panic as two distinct dysphoric affect states that appear to be involved in generalized anxiety disorder and panic disorder, respectively. This biologically based distinction is consistent with and supportive of our self-psychological distinction between what we term “diffusion anxiety” and other types of anxious self-states.
In an analogous fashion, our approach to analytic therapy with the panic-disordered patient extrapolates from a biologically grounded approach to the treatment of this type of patient. Klein, as well as others, discovered that these patients respond to a specific psychopharmacological regimen that is distinct from that typically used in the treatment of patients suffering from generalized anxiety disorder. Our concept of the containing function of the selfobject transference parallels the biological findings concerning the psychopharmacological specificity of the drug regimen used in treating panic disorder.