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Psychodynamic Diagnosis and Treatment of Personality Disorders Individuality and Psychotherapy January 31, 2020 Duquesne University Pittsburgh, PA Nancy McWilliams, PhD, ABPP Graduate School of Applied & Professional Psychology, Rutgers University Ludwig Wittgenstein 1889 - 1951 “The limits of my language are the limits of my world” Disclosure Statement The speaker has nothing to declare and no conflicts of interest. (All royalties from the Psychodynamic Diagnostic Manual (PDM-2) go to a fund to support clinical research.) Psychotherapy outcomes vary according to: 1. Personality factors 2. Relationship factors www.apa.org/about/policy/resolution-psychotherapy.aspx Norcross, J. C. (2011). Psychotherapy relationships that work: Evidence- based responsiveness. New York: Oxford. Wachtel, P. (2010). Beyond “ESTs”: Problematic assumptions in the pursuit of evidence-based practice. Psychoanalytic Psychology, 27(3), 252-272 Norcross, J. C., & Wampold, B. E. (in press). Relationships and responsiveness in the psychological treatment of trauma: The tragedy of the APA Clinical Practice Guideline. Psychotherapy http://dx.doi.org/10.1037/pst0000228 1. Temperament Thomas, A., Chess, S., & Birch, H. G. (1968). Temperament and behavior disorders in children. New York: International Universities Press. Escalona, S. K. (1968). The roots of individuality: Normal patterns of development in infancy. Chicago: Aldine. Kagan, J. (1994). Galen’s prophecy: Temperament in human nature. New York: Basic Books. 2. Attachment Style Bowlby, J. (1969). Attachment and loss: Vol 1: Attachment. New York: Basic Books. Bowlby, J. (1973). Attachment and loss: Vol 2: Separation: Anxiety and anger. New York: Basic Books. Fonagy, P. (2001). Attachment theory and psychoanalysis. New York: Other Press. Holmes, J. (2001). The search for the secure base: Attachment theory and psychotherapy. Philadelphia: Taylor & Francis. Mikulincer, M., & Shaver, P. R. (2007). Attachment in adulthood: Structure, dynamics, and change. New York: Guilford Press. Wallin, D. J. (2007). Attachment in psychotherapy. New York: Guilford Press. Cassidy, J., & Shaver, P. R. (2016) 3. Observed Clinical Patterns Freud, S. (1916). Some character types met with in psychoanalytic work. Standard Edition, 14, 311-333. Reich, W. (1933). Character analysis. New York: Farrar, Straus, & Giroux. Fenichel, O. (1945). The psychoanalytic theory of neurosis. New York: Norton. Shapiro, D. (1965). Neurotic styles. New York: Basic Books. MacKinnon, R. A., & Michels, R. (1971). The psychiatric interview in clinical practice. Philadelphia: Saunders. Kernberg, O. F. (1984). Severe personality disorders: Psychotherapeutic strategies: New Haven, CT: Yale University Press. McWilliams, N. (1994, rev. ed. 2011). Psychoanalytic diagnosis: Understanding personality structure in the clinical process. New York: Guilford. 4. Defensive Organization Freud, A. (1936). The ego and the mechanisms of defense. New York: International Universities Press. Laughlin, H. P. (1970). The ego and its defenses. New York: Jason Aronson. Vaillant, G. E. (1992). Ego mechanisms of defense: A guide for clinicians and researchers. Washington, DC: American Psychiatric Association. Cramer, P. (2006). Protecting the self: Defense mechanisms in action. New York: Guilford. Perry, J. C. (2014). Anomalies and specific functions in the clinical identification of defense mechanisms. Journal of Clinical Psychology, 70, 406‒418. 5. Implicit Cognitions Weiss, J., Sampson, H., & the Mt. Zion Psychotherapy Research Group (1986). The psychoanalytic process: Theory, clinical observations, and empirical research. New York: Guilford. Weiss, J. (1993). How psychotherapy works: Process and technique. New York: Guilford. Beck, J. S. (1995). Cognitive therapy: Basics and beyond. New York: Guilford. Silberschatz, G. (Ed.) (2005). Transformative relationships: The control-mastery theory of psychotherapy. New York: Routledge. 6. Affective Patterns Tomkins, S. S. (1995). Script theory: In E. V. Demos (Ed.), Exploring affect: The selected writings of Silvan Tomkins (pp. 312-388). New York: Cambridge University Press. Panksepp, J. (2004). Affective neuroscience: The foundations of human and animal emotions. New York: Oxford University Press. Anstadt, Th., Merten, J., Ullrich, B., & Krause, R. (1997). Affective dyadic behavior, core conflictual relationship themes and success of treatment. Psychotherapy Research, 7, 397-417. 7. Drive (motivational systems) Solms, M., & Turnbull, O. (2002). The brain and the inner world: An introduction to the neuroscience of subjective experience. New York: Other Press. Fisher, H. (2005). Why we love: The nature and chemistry of romantic love. New York: Henry Holt & Co. Fisher, H. (2010). Why him? Why her? Finding real love by understanding your personality type. New York: Henry Holt & co. Panksepp, J., & Biven, L. (2012). The archeology of mind: Neuroevolutionary origins of human emotions: New York: Norton. Jaak Panksepp 1944-2017 8. Individualistic versus Communal Orientation Jung, C. G., & Baynes, H. G. (1921). Psychological types or the psychology of individuation. London: Kegan Paul. Balint, M. (1945). Friendly expanses—Horrid empty spaces. International Journal of Psycho- Analysis, 36, 225-241. Roland, A. (1988). In search of self in India and Japan: Toward a cross-cultural psychology. Princeton, NJ: Princeton Univ. Press. McGoldrick, M., Giordano, J., & Garcia-Preto (Eds.) ( (2005). Ethnicity and family therapy (3rd ed.). New York: Guilford. Blatt, S. J. (2008). Polarities of experience: Relatedness and self-definition in personality development, psychopathology, and the therapeutic process. Washington, DC: American Psychological Association. Akhtar, S. (Ed.) (2010). Freud and the Far East: Psychoanalytic perspectives on the people and culture of China, Japan, and Korea. Northvale, NJ: Jason Aronson. Tummala-Narra, P. (2016). Psychoanalytic theory and cultural competence in psychotherapy. Washington, DC: American Psychological Association. 9. Internalized Object Relations (Inner Working Models/Schemas) Fairbairn, W. R. D. (1952). An object-relations theory of the personality. New York: Basic Books. “internalized object relations” French, T. (1958). The integration of behavior, vol. 3. The reintegrative process in a psychoanalytic treatment. Chicago: University of Chicago Press. “repetitive structures” Bowlby, J. (1969. Attachment and loss: Vol. 1: Attachment. London: Hogarth. “inner working models” Malan, D. H. (1976). The frontier of brief psychotherapy. New York: Plenum. “nuclear conflicts” Stern, D. N. (1985). The interpersonal world of the infant: A view from psychoanalysis and developmental psychology. New York: Basic Books. “representations of internalizations that have been generalized (RIGs)” Dahl, H. (1988). Frames of mind. In H. Dahl, H. Kachele, & H. Thomae (Eds.). Psychoanalytic process research strategies (pp. 51-66). New York: Springer-Verlag. “fundamental and repetitive emotional structures (FRAMES)” More internalized object relational concepts Aron, L. (1991). Working through the past—working toward the future. Contemporary Psychoanalysis, 27, 81-108. “internal relational models” Tomkins, S. S. (1995). Script theory In E. V. Demos (Ed.), Exploring affect: The selected writings of Silvan Tomkins (pp. 312-388). New York: Cambridge University Press. “nuclear scenes” Bucci, W. (1997). Psychoanalysis and cognitive science. New York: Guilford. “emotion schemas” Luborsky, L., & Crits-Cristoph, P. (1996). Understanding transference (2nd ed.). Washington, DC: American Psychological Association: “core conflictual relationship theme” Lyons-Ruth, K. (1999). The two-person unconscious: Intersubjective dialogue, enactive relational representation, and the emergence of new forms of relational organization. Psychoanalytic Inquiry, 19, 576-617. “implicit relational knowing” Horowitz, M. (1998). Cognitive psychodynamics. New York: Wiley. “personal schemas” Young, J. E., Klosko, J. S., & Weishaar, M. E. (2006). Schema therapy: A practitioner’s guide. New York: Guilford. “individual schemas” 10. Organizing Developmental Issue (“Severity Dimension”) Freud, S. (1905). Three essays on the theory of sexuality. Standard Edition, 7, 135-243. Klein, M. (1935). A contribution to the psychogenesis of manic-depressive states. In Love, guilt and reparation and other works 1921-1945 (pp. 262-289). New York: Free Press. Erikson, E. H. (1950). Childhood and society. New York: Norton. Masterson, J. F. (1976). Psychotherapy of the borderline adult: A developmental approach. New York: Brunner/Mazel. Kernberg, O. F. (1984). Severe personality disorders: Psychotherapeutic strategies. New Haven, CT: Yale University Press. Mahler, M. S., Pine, F., & Bergmann, A. (1985). The psychological birth of the human infant. New York: Basic Books. Steiner, J. (1993). Psychic retreats: Pathological organization in psychotic, neurotic, and borderline conditions. London: Routledge. Bateman, A., & Fonagy, P. (2004). Mentalization-based treatment for borderline personality disorder. New York: Oxford University Press. Empirical support for a severity dimension Sharp, C., Wright, A. G. C., Fowler, J. C., Frueh, B. C., Allen, J. G., Oldham, J., & Clark, L. A. (2015). The structure of personality pathology: Both general (‘g’) and specific (‘s’) factors? Journal of Abnormal Psychology, 124(2), 387-398..
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