I share my personal journey toward retirement, grappling with feelings of loss, relevance, and legacy, and finding renewed purpose through teaching yoga and learning kirtan. I review core findings about happiness from the Harvard Study of Adult Development, emphasizing that meaningful social connections are central to a good life and healthy aging. Despite having moments of self-doubt and inevitable experiences of loss, I highlight the lasting impact of even small acts of human connection, underscoring the profound importance of social relationships and shared humanity in giving life meaning.

For decades, diplomats and psychoanalysts have applied psychoanalytic theories to international relations. Their collaborations have led to the creation of Track II diplomacy, defined as unofficial meetings among people with access to policymakers. Track II diplomacy illuminates psychological barriers to negotiations by clarifying negotiators' defense mechanisms and communication styles. Track II diplomacy assumes a desire to negotiate, but differences in expectations among negotiating parties can interrupt negotiations. This Perspective suggests that conceptualizing interruptions through the psychoanalytic impasse can introduce novel ways to resume negotiations. I draw on experiences with India-Pakistan Track II diplomacy.

Some patients, especially those encountered early in one's career, become emblazoned in memory. Such was the case for this author with Rudy. His is a moving story by virtue of who he was and what happened to him. From him, I learned of the potential for deeply mutative work with medically ill patients, even in the context of infrequent meetings. I learned how and why in supportive, dynamically oriented therapy, there are times when bending the frame is essential. Rudy taught me-and my students-how important the "art" of medicine is and about the potential for "healing" even in the absence of cure. His story conveys the deep psychological impact of childhood illness and demonstrates the potential to reverse some of that impact when illness is encountered once again in adulthood. The theme of the "music" of the consulting room provides an organizing metaphor for the dialectic of spontaneous, emotionally engaged responsiveness and disciplined restraint that optimally characterizes dynamic psychotherapeutic work.

Introduction: This study investigated the relationship between illness anxiety and interpersonal guilt as conceived in control-mastery theory. Additionally, we explored how illness anxiety symptoms relate to general anxiety, depression, alexithymia, autonomic nervous system reactivity, personality functioning impairment, sociodemographic factors, and childhood experiences. Methods: A sample of 201 participants completed measures of illness anxiety (Health Anxiety Questionnaire), interpersonal guilt (Interpersonal Guilt Rating Scale-20s), anxiety (State-Trait Anxiety Inventory), depression (Beck Depression Inventory-II), alexithymia (Toronto Alexithymia Scale-20), personality dysfunction (Level of Personality Functioning-Brief Form 2.0), and autonomic nervous reactivity (Body Perception Questionnaire-22). Sociodemographic and childhood traumas and adverse experiences data were collected via an ad hoc questionnaire. Results:. Individuals with worried and autonomy-limiting caregivers reported higher levels of illness anxiety. Correlation analyses revealed significant positive associations with illness anxiety and all the variables measured. As expected, partial correlation demonstrated that separation/disloyalty guilt and burdening guilt are the most associated with illness anxiety symptoms. Unexpectedly, however, survivor guilt lost significance when controlling for other types of guilt. Hierarchical multiple regression identified anxiety as the strongest overall predictor of illness anxiety, followed by separation/disloyalty guilt and bodily reactivity indices. Discussion:. This study suggests that interpersonal guilt may be a key component in sustaining illness anxiety symptoms in anxious people. In particular, the interplay between anxiety, separation/disloyalty guilt, and autonomic overreactivity appears to contribute to illness anxiety concerns and behaviors. Working on these aspects may be essential for positive long-term outcomes of psychotherapy.

In transference-focused psychotherapy (TFP), an evidence-based treatment for patients with borderline personality disorder (BPD), the attention paid to establishing and tracking goals is both organizing and distinctive. The objective of this article is to describe TFP's unusual emphasis on first elucidating and then focusing on a patient's concrete, measurable personal goals. We review the critical distinction between the patient's goals and the therapist's goals. We also provide pertinent examples of material related to goals in TFP. The examination of the role of goals in the treatment of patients with BPD has significant salience given accumulating data that suggests that symptom remission does not reliably lead to enhanced functioning (sustained work/study performance, stable relations with a partner or parents) in this patient population.

Introduction: This study explored the relationship between different types of interpersonal guilt as conceived according to control-mastery theory and emotion dysregulation, mentalization, frustration intolerance, and body appreciation. Methods: We recruited 200 participants to whom we administered the Interpersonal Guilt Rating Scale-20, the Difficulties in Emotion Regulation Scale-Short Form, the Reflective Functioning Questionnaire-8, the Frustration Discomfort Scale, the Body Appreciation Scale-2, and a sociodemographic schedule. Results: The data revealed that self-hate and burdening guilt were positively associated with emotion dysregulation and negatively associated with body appreciation. Frustration intolerance correlated with burdening guilt, while mentalization impairments were linked to self-hate. Both constructs also positively correlated with separation/disloyalty guilt. Discussion: The findings of this study underline the association between several guilt-related pathogenic beliefs and relevant psychopathological factors such as emotional dysregulation, mentalization difficulties, frustration intolerance, and body dissatisfaction. Among the pathogenic beliefs investigated, a particular role is played by the belief that one is bad, inadequate, and undeserving; the belief that one's own emotions, needs, and way of being is a burden to other people; and the beliefs that separating physically or psychologically from important others may hurt them. The clinical implications of these finds are discussed.

Introduction: Psychodynamic psychotherapy is an effective treatment for borderline personality disorder (BPD), but few specific curricula for psychiatric residents currently exist. The authors developed an online learning module to teach psychodynamic psychotherapy for BPD to psychiatry residents, based on the following educational methods: the ADDIE (analysis, design, development, implementation, evaluation) design process, the Morrison, Ross, and Kemp instructional design model, and the 4C/ID (four-components instructional design) model. Methods: Indonesian residents, psychiatrists, and psychotherapy teaching staff participated in a needs analysis to identify the competencies, subject content, and learning methods that the module should address, through focus group discussions and Delphi survey methodology. The module then underwent content validation. Results: The psychodynamic psychotherapy for BPD learning module was designed as a 12-session online training program. The module addresses three main subjects: phenomenology and pathogenesis of BPD, basic principles of psychodynamic psychotherapy, and the practice of psychodynamic psychotherapy with patients with BPD. It is taught through lectures, case discussions, video discussions, psychodynamic formulation learning assignments, and a review of residents' process notes of psychodynamic psychotherapy sessions. Discussion: Implementation of this module could enhance residents' competency to treat BPD with psychodynamic psychotherapy and fill the current gaps in the field of psychotherapy education, especially in areas of the world with limited access to expert faculty.

The request for hastened death by patients with psychiatric disorders poses a professional conundrum for psychiatrists. Issues of transference and countertransference loom large in such situations. Primitive defense mechanisms, particularly projective identification need to be addressed in understanding the request.