Psychoanalytic Case Formulation

Description

What kinds of questions do experienced therapists ask themselves when facing a new client? How can clinical expertise be taught? From the author of the landmark Psychoanalytic Diagnosis, this book takes clinicians step-by- step through developing an understanding of each client's unique psychology and using this information to guide and inform treatment decisions. McWilliams shows that while seasoned practitioners rely upon established diagnostic categories for record-keeping and insurance purposes, their actual clinical concepts and practices reflect more inferential, subjective, and intuitive processes. Interweaving illustrative case examples with theoretical insights and clinically significant research, chapters cover assessment of client temperament, developmental issues, defenses, affects, identifications, relational patterns, self-esteem needs, and pathogenic beliefs. Winner--Gradiva Award, National Association for the Advancement of Psychoanalysis Cover About the Author Preface Acknowledgments Contents Introduction On the Subjective/Empathic Tradition On Being a Therapist and Teaching Psychotherapy at the Turn of the Century Organization Chapter One: The Relationship between Case Formulation and Psychotherapy Basic Premises Goals of Traditional Psychoanalytic Therapy Case Formulation for Therapeutic Rather Than Research Purposes Summary Chapter Two: Orientation to Interviewing My Own Style of Initial Interviewing Concluding Comments Summary Chapter Three: Assessing What Cannot Be Changed Temperament Genetic, Congenital, and Medical Conditions with Direct Psychological Effects Irreversible Consequences of Head Trauma, Illness, and Toxicity Unchangeable Physical Realities Unchangeable Life Circumstances Personal History Summary Chapter Four: Assessing Developmental Issues Some Cautionary and Orienting Comments on Psychoanalytic Developmental Theory Classical and Post-Freudian Developmental Models and Their Clinical Applications Summary Chapter Five: Assessing Defense Clinical versus Research Considerations in Assessment of Defense Characterological versus Situational Defensive Reactions Clinical Implications of Assessing Defense Summary Chapter Six: Assessing Affects Affects in the Transference/Countertransference Field Affect States as Presenting Problems Evaluating the Diagnostic Meaning of Affect Therapeutic Implications of Getting It Right about Affect Summary Chapter Seven: Assessing Identifications Identifications Suggested by Transference Reactions Identification, Incorporation, Introjection, and Intersubjective Influencing Clinical Implications of Understanding Identifications Clinical Possibilities Where Counteridentification Predominates Ethnic, Religious, Racial, Cultural, and Subcultural Identifications Summary Chapter Eight: Assessing Relational Patterns Relational Themes in the Transference Relational Themes outside the Therapy Situation Implications of Relational Patterns for Long-Term versus Short-Term Therapies Summary Chapter Nine: Assessing Self-Esteem The Significance of Understanding Self-Esteem Issues Psychoanalytic Attention to Self-Esteem Clinical Implications of Assessing Self-Esteem Summary Chapter Ten: Assessing Pathogenic Beliefs The Nature and Function of Pathogenic Beliefs Developing Hypotheses about Pathogenic Beliefs Clinical Implications of Understanding Pathogenic Beliefs Summary Concluding Comments Some Final Advice Appendix: Sample Contract References Author Index A B C D E F G H I J K L M N O P R S T V W Y Z Subject Index A B C D E F G H I K L M N O P Q R S T U W Y