Psychoanalytic Case Formulation

by McWilliams, Nancy

• ISBN13: 9781572304628
• ISBN10: 1572304626
• eBook ISBN(s): 9781606235850
• Edition: 1st
• Format: Hardcover
• Copyright: 1999-03-26
• Publisher: The Guilford Press
• More Book Details

Summary

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.

Author Biography

Nancy McWilliams, PhD, teaches psychoanalytic theory and therapy at the Graduate School of Applied and Professional Psychology at Rutgers--The State University of New Jersey. A senior analyst with the Institute for Psychoanalysis and Psychotherapy of New Jersey and the National Psychological Association for Psychoanalysis, she has a private practice in psychodynamic therapy and supervision in Flemington, New Jersey. Her previous book, Psychoanalytic Diagnosis has become a standard text in many training programs for psychoanalysts, both in the United States and abroad. She has also authored articles and book chapters on personality, psychotherapy, psychodiagnosis, sexuality, feminism, and contemporary psychopathologies.

Table of Contents

Introduction	1	(199)
On the Subjective/Empathic Tradition	2	(2)
On Being a Therapist and Teaching Psychotherapy at the Turn of the Century	4	(3)
Organization	7	(2)
The Relationship between Case Formulation and Psychotherapy	9	(20)
Basic Premises	11	(1)
Goals of Traditional Psychoanalytic Therapy	12	(13)
Case Formulation for Therapeutic Rather Than Research Purposes	25	(3)
Summary	28	(1)
Orientation to Interviewing	29	(19)
My Own Style of Initial Interviewing	30	(15)
Concluding Comments	45	(2)
Summary	47	(1)
Assessing What Cannot Be Changed	48	(17)
Temperament	49	(3)
Genetic, Congenital, and Medical Conditions with Direct Psychological Effects	52	(1)
Irreversible Consequences of Head Trauma, Illness, and Toxicity	53	(3)
Unchangeable Physical Realities	56	(2)
Unchangeable Life Circumstances	58	(3)
Personal History	61	(2)
Summary	63	(2)
Assessing Developmental Issues	65	(20)
Some Cautionary and Orienting Comments on Psychoanalytic Developmental Theory	66	(7)
Classical and Post-Freudian Developmental Models and Their Clinical Applications	73	(10)
Summary	83	(2)
Assessing Defense	85	(17)
Clinical versus Research Considerations in Assessment of Defense	87	(3)
Characterological versus Situational Defensive Reactions	90	(2)
Clinical Implications of Assessing Defense	92	(9)
Summary	101	(1)
Assessing Affects	102	(20)
Affects in the Transference/Countertransference Field	105	(3)
Affect States as Presenting Problems	108	(2)
Evaluating the Diagnostic Meaning of Affect	110	(6)
Therapeutic Implications of Getting It Right about Affect	116	(5)
Summary	121	(1)
Assessing Identifications	122	(17)
Identifications Suggested by Transference Reactions	123	(1)
Identification, Incorporation, Introjection, and Intersubjective Influencing	124	(5)
Clinical Implications of Understanding Identifications	129	(3)
Clinical Possibilities Where Counteridentification Predominates	132	(3)
Ethnic, Religious, Racial, Cultural, and Subcultural Identifications	135	(3)
Summary	138	(1)
Assessing Relational Patterns	139	(19)
Relational Themes in the Transference	143	(9)
Relational Themes outside the Therapy Situation	152	(3)
Implications of Relational Patterns for Long-Term versus Short-Term Therapies	155	(1)
Summary	156	(2)
Assessing Self-Esteem	158	(22)
The Significance of Understanding Self-Esteem Issues	158	(3)
Psychoanalytic Attention to Self-Esteem	161	(5)
Clinical Implications of Assessing Self-Esteem	166	(13)
Summary	179	(1)
Assessing Pathogenic Beliefs	180	(20)
The Nature and Function of Pathogenic Beliefs	181	(5)
Developing Hypotheses about Pathogenic Beliefs	186	(4)
Clinical Implications of Understanding Pathogenic Beliefs	190	(9)
Summary	199	(1)
Concluding Comments	200	(10)
Some Final Advice	208	(2)
Appendix: Sample Contract	210	(2)
References	212	(19)
Author Index	231	(4)
Subject Index	235