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Psychoanalytic Diagnosis : Understanding Personality Structure in the Clinical Process,9780898621990

Psychoanalytic Diagnosis : Understanding Personality Structure in the Clinical Process

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Edition:
1st
ISBN13:

9780898621990

ISBN10:
0898621992
Format:
Hardcover
Pub. Date:
4/15/1994
Publisher(s):
The Guilford Press
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  • Psychoanalytic Diagnosis, Second Edition; Understanding Personality Structure in the Clinical Process
    Psychoanalytic Diagnosis, Second Edition; Understanding Personality Structure in the Clinical Process




Summary

This is the first text to come along in many years that makes psychoanalytic personality theory and its implications for practice accessible to beginning practitioners. The last book of its kind, which was published more than 20 years ago, predated the development of such significant concepts as borderline syndromes, narcissistic pathology, dissociative disorders and self-defeating personality. Contemporary students often react with bewilderment to the language of pioneering analysts like Reich and Fenichel and, since 1980, the various volumes of the Diagnostic and Statistical Manual of Mental Disorders (DSM) have reflected an empirical-descriptive orientation that deliberately eschews psychodynamic assumptions. Consequently, today's therapist in training may have little exposure to the rich clinical and theoretical history behind each disorder mentioned in DSM; to psychoanalytic expertise with widely recognized character patterns not mentioned in DSM, such as depressive and hypomanic psychologies, high-functioning schizoid personalities, and hysterical personalities; or to a comprehensive, theoretically sophisticated rationale that links assessment to treatment. Filling the need for a text that clearly lays out the conceptual heritage that psychoanalytic practitioners take for granted, this important new volume explicates the major clinically important character types and suggests how an appreciation of the patients' individual personality structure should influence the therapist's focus and style of intervention. Dispensing with the dense jargon that often discourages people from learning, Nancy McWilliams writes in a lucid, personal manner that demystifies psychodynamic theory and practice. Innumerable clinical vignettes are presented with humor, candor, and compassion, bringing abstract concepts to life. Comprehensive in scope, Psychoanalytic Diagnosis will be valued by seasoned clinicians and students alike. Psychodynamically oriented readers will find it an excellent introduction to psychoanalytic diagnostic thinking. For those identified with other approaches, it will foster psychoanalytic literacy, providing them with the capacity to better understand the approaches of their analytically oriented colleagues.

Author Biography

Nancy McWilliams, PhD, teaches psychoanalytic theory and therapy at the Graduate School of Applied and Professional Psychology at Rutgers\m-\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, [ital]Psychoanalytic Diagnosis[/ital] 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(1)
A Comment on Terminology
1(3)
A Comment on Tone
4(1)
I CONCEPTUAL ISSUES 5(140)
Why Diagnose?
7(12)
Treatment Planning
8(1)
Prognostic Implications
9(1)
Consumer Protection
10(2)
The Communication of Empathy
12(2)
Forestalling Flights From Treatment
14(1)
Fringe Benefits
15(2)
Limits to the Utility of Diagnosis
17(1)
Suggestions for Further Reading
18(1)
Psychoanalytic Character Diagnosis
19(21)
Classical Freudian Drive Theory
21(4)
Ego Psychology
25(4)
The Object Relations Tradition
29(5)
Self Psychology
34(3)
Other Psychoanalytic Contributions to Personality Assessment
37(1)
Summary
38(1)
Suggestions for Further Reading
38(2)
Developmental Levels of Personality Organization
40(27)
Historical Context: Diagnosing Level of Character Pathology
42(1)
Kraepelinian Diagnosis: Neuroses Versus Psychoses
43(2)
Ego Psychology Diagnostic Categories: Symptom Neurosis, Neurotic Character, and Psychosis
45(4)
Object Relations Diagnosis: Borderline Psychopathology
49(4)
Specific Dimensions of a Neurotic-Borderline-Psychotic Spectrum
53(12)
Summary
65(1)
Suggestions for Further Reading
65(2)
Clinical Implications of Developmental Levels of Organization
67(29)
Psychoanalytic Therapy with Neurotic-Level Patients
69(3)
Psychoanalytic Therapy with Psychotic-Level Patients
72(8)
Psychoanalytic Therapy with Borderline Patients
80(11)
Interaction of Maturational and Typological Dimensions of Character
91(3)
Summary
94(1)
Suggestions for Further Reading
94(2)
Primary (Primitive) Defensive Processes
96(21)
Primitive Withdrawal
100(1)
Denial
101(2)
Omnipotent Control
103(2)
Primitive Idealization (and Devaluation)
105(2)
Projection, Introjection, and Projective Identification
107(5)
Splitting of the Ego
112(2)
Dissociation
114(1)
Summary
115(1)
Suggestions for Further Reading
116(1)
Secondary (Higher-Order) Defensive Processes
117(28)
Repression
118(2)
Regression
120(2)
Isolation
122(1)
Intellectualization
123(1)
Rationalization
124(1)
Moralization
125(2)
Compartmentalization
127(1)
Undoing
127(2)
Turning Against the Self
129(1)
Displacement
130(1)
Reaction Formation
131(2)
Reversal
133(2)
Identification
135(3)
Acting Out
138(2)
Sexualization (Instinctualization)
140(2)
Sublimation
142(2)
Summary
144(1)
Suggestions for Further Reading
144(1)
II TYPES OF CHARACTER ORGANIZATION 145(204)
Rationale for Chapter Organization
145(2)
Character, Character Pathology, and Situational Factors
147(1)
Limits on Personality Change
148(3)
Psychopathic (Antisocial) Personalities
151(17)
Drive, Affect, and Temperament in Psychopathy
152(1)
Defensive and Adaptive Processes in Psychopathy
153(2)
Object Relations in Psychopathy
155(2)
The Psychopathic Self
157(2)
Transference and Countertransference with Psychopathic Patients
159(1)
Therapeutic Implications of the Diagnosis of Psychopathy
160(5)
Differential Diagnosis
165(2)
Summary
167(1)
Suggestions for Further Reading
167(1)
Narcissistic Personalities
168(21)
Drive, Affect, and Temperament in Narcissim
171(2)
Defensive and Adaptive Processes in Narcissim
173(1)
Object Relations in Narcissism
174(3)
The Narcissistic Self
177(1)
Transference and Countertransference with Narcissistic Patients
178(3)
Therapeutic Implications of the Diagnosis of Narcissim
181(3)
Differential Diagnosis
184(3)
Summary
187(1)
Suggestions for Further Reading
188(1)
Schizoid Personalities
189(16)
Drive, Affect, and Temperament in Schizoid Personalities
190(2)
Defensive and Adaptive Processes in Schizoid Personalities
192(1)
Object Relations in Schizoid Conditions
193(2)
The Schizoid Self
195(2)
Transference and Countertransference with Schizoid Patients
197(2)
Therapeutic Implications of the Diagnosis of Schizoid Personality
199(3)
Differential Diagnosis
202(2)
Summary
204(1)
Suggestion for Further Reading
204(1)
Paranoid Personalities
205(22)
Drive, Affect, and Temperament in Paranold Personalities
207(2)
Defensive and Adaptive Processes in Paranoia
209(2)
Object Relations in Paranoia
211(3)
The Paranoid Self
214(2)
Transference and Countertransference with Paranoid Patients
216(1)
Therapeutic Implications of the Diagnosis of Paranoia
217(7)
Differential Diagnosis
224(1)
Summary
225(1)
Suggestions for Further Reading
226(1)
Depressive and Manic Personalities
227(30)
Depressive Personalities
228(1)
Drive, Affect, and Temperament in Depression
229(2)
Defensive and Adaptive Processes in Depression
231(2)
Object Relations in Depression
233(4)
The Depressive Self
237(2)
Transference and Countertransference with Depressive Patients
239(2)
Therapeutic Implications of the Diagnosis of Depression
241(5)
Differential Diagnosis
246(2)
Manic and Hypomanic Personalities
248(1)
Drive, Affet, and Temperament in Mania
248(1)
Defensive and Adaptive Processes in Mania
249(1)
Object Relations in Mania
250(1)
The Manic Self
250(1)
Transference and Countertransference with Manic Patients
251(1)
Therapeutic Implications of the Diagnosis of Mania or Hypomania
251(2)
Differential Diagnosis
253(2)
Summary
255(1)
Suggestions for Further Reading
256(1)
Masochistic (Self-Defeating) Personalities
257(22)
Drive, Affect, and Temperament in Masochism
260(1)
Defensive and Adaptive Processes in Masochism
261(3)
Object Relations in Masochism
264(3)
The Masochistic Self
267(1)
Transference and Countertransference with Masochistic Patients
268(3)
Therapeutic Implications of the Diagnosis of Masochism
271(4)
Differential Diagnosis
275(2)
Summary
277(1)
Suggestions for Further Reading
277(2)
Obsessive and Compulsive Personalities
279(22)
Drive, Affect, and Temperament in Obsessive and Compulsive Personalities
281(2)
Defensive and Adaptive Processes in Obsessive and Compulsive Personalities
283(3)
Object Relations in Obsessive and Compulsive Personalities
286(3)
The Obsessive Compulsive Self
289(3)
Transference and Countertransference with Obsessive and Compulsive Patients
292(2)
Therapeutic Implications of the Diagnosis of Obsessive or Compulsive Personality
294(4)
Differential Diagnosis
298(2)
Summary
300(1)
Suggestions for Further Reading
300(1)
Hysterical (Histrionic) Personalities
301(22)
Drive, Affect, and Temperament in Hysteria
303(1)
Defensive and Adaptive Processes in Hysteria
304(4)
Object Relations in Hysteria
308(2)
The Hysterical Self
310(3)
Transference and Countertransference with Hysterical Patients
313(3)
Therapeutic Implications of the Diagnosis of Hysteria
316(2)
Differential Diagnosis
318(3)
Summary
321(1)
Suggestions for Further Reading
322(1)
Dissociative Personalities
323(26)
Drive, Affect, and Temperament in Dissociative Conditions
328(1)
Defensive and Adaptive Processes in Dissociative Conditions
329(3)
Object Relations in Dissociative Conditions
332(2)
The Dissociative Self
334(2)
Transference and Countertransference with Dissociative Patients
336(2)
Therapeutic Implications of the Diagnosis of a Dissociative Condition
338(4)
Differential Diagnosis
342(4)
Summary
346(1)
Suggestions for Further Reading
346(3)
Appendix: Suggested Diagnostic Interview Format 349(4)
Demographic Data
349(1)
Current Problems and Their Onset
349(1)
Personal History
349(1)
Current Presentation (Mental Status)
350(1)
Concluding Topics
350(1)
Inferences
351(2)
References 353(28)
Author Index 381(5)
Subject Index 386


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