Psychoanalytic Diagnosis, Second Edition: Understanding Personality Structure In The Clinical Process
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This acclaimed clinical guide and widely adopted text has filled a key need in the field since its original publication. Nancy McWilliams makes psychoanalytic personality theory and its implications for practice accessible to practitioners of all levels of experience. She explains major character types and demonstrates specific ways that understanding the patient's individual personality structure can influence the therapist's focus and style of intervention. Guidelines are provided for developing a systematic yet flexible diagnostic formulation and using it to inform treatment. Highly readable, the book features a wealth of illustrative clinical examples.   New to This Edition *Reflects the ongoing development of the author's approach over nearly two decades. *Incorporates important advances in attachment theory, neuroscience, and the study of trauma. *Coverage of the contemporary relational movement in psychoanalysis. Winner--Canadian Psychological Association's Goethe Award for Psychoanalytic and Psychodynamic Scholarship

Hardcover: 426 pages

Publisher: The Guilford Press; 2nd edition (July 14, 2011)

Language: English

ISBN-10: 1609184947

ISBN-13: 978-1609184940

Product Dimensions: 1.2 x 6.2 x 9.2 inches

Shipping Weight: 1.4 pounds (View shipping rates and policies)

Average Customer Review: 4.9 out of 5 stars  See all reviews (47 customer reviews)

Best Sellers Rank: #13,724 in Books (See Top 100 in Books) #11 in Books > Medical Books > Psychology > Movements > Psychoanalysis #12 in Books > Health, Fitness & Dieting > Psychology & Counseling > Psychoanalysis #22 in Books > Health, Fitness & Dieting > Mental Health > Personality Disorders

I am a candidate at a psychoanalytic institute and this was one of our first textbooks. I've been told that we return to it over and over in various classes and I can easily see why.McWilliams discusses the various personality structures in an incredibly lucid, concise ways. She talks about:- How to recognize features of each character (depressive, paranoid, narcissistic, hysterical, etc.)- What this person's *inner* experience is like and how it may have come to be that way- What the therapist's experience is like with this patient (the countertransference)- What kind of transference this person is likely to experience with the therapist- What the treatment implications are -- how to approach each case (in general terms)- How to distinguish each character style from various others that it's often confused withEverything is written in an easily readable, almost conversational style. It's rare to say this about a technical textbook, but I found it hard to put it down!! McWilliams shares not only objective material (and cites research and other works) but also her own experience and some highly relevant case vignettes.I am about to reread the book for the second time, and I am very, very thankful that such a clear book exists.

This review is mainly from having used the first edition, but I have looked through the second as well.If I had to choose one book that had the biggest influence on my training, it would be McWilliams' Psychoanalytic Diagnosis.The book neatly, concisely and coherently describes the theoretical underpinnings of the major schools of psychoanalysis. I haven't seen it described as well anywhere else. Those chapters alone are worth the cost of the book. The other valuable part of the book is the descriptions of the major personality pathologies, their origins as well as common transference and countertransference encountered with each. Again, this is invaluable as in most residencies and training programs, these areas are not covered in any great depth. The writing is clear, with case illustrations.I recommend this book for any trainee in psychiatry, social work or psychology who wants to deepen their understanding of patient encounters.

I know some people will reject this book because "Psychoanalytic" is in the title. Others will reject this book because "Diagnosis" is in the title. However, this essential text is highly useful to all practitioners of any theoretical orientation if they can get past the negative stereotyping. The term "Diagnosis" as used in this book is in line with the original definition of the word that is derived from Greek- meaning a distinguishing, to perceive, to know thoroughly. The second part of the book title explains that the point of diagnosing is to know how to help. McWilliams clarifies that, "The main object of this book is to enhance practice..." and that is what this book does extremely well.Nancy McWilliams never looses the person to the diagnosis. "Once I have a good feel for the person, the work is going well, I stop thinking diagnostically and simply immerse myself in the unique relationship that unfolds between me and the client...one can throw away the book and savor individual uniqueness."Her writing style is much like she describes her therapy sessions. She points out the necessity at times, to judiciously self-disclose. Her personal sharing gives the text a soul and you feel you are with a warm and wise teacher. For example when discussing the value of psychoanalysis, McWilliams discloses, "I share this opinion, having benefited all my adult life from a good early classical analysis."Let me share with you an example of her eloquent style that pervades this text: "When any label obscures more than illuminates, practitioners are better off discarding it and relying on common sense and human decency, like the lost sailor who throws away the useless navigational chart and prefers to orient by a few familiar stars." It is writing such as this, which makes this text enjoyable, as it is enlightening.McWilliams' taxonomy is fundamentally based on just two Axes. The first dimension conceptualizes a person's degree of developmental grow or personality organization (neurotic-normal level, borderline level and psychotic level). McWilliams assesses the neurotic, borderline, and psychotic levels of personality structure in terms of favorite defenses, level of identity integration, adequacy of reality testing, the capacity to observe one's pathology, nature or one's primary conflict, and transference and countertransference.She explains that "borderline" is not a distinct personality disorder as introduced by DSM III, but an over-all level of severity. It is a stable instability between the border of neurotic and psychotic ranges, characterized by a lack of identity integration and reliance on primitive defenses without the overall loss of reality testing that is seen with people at the psychotic level.The second axis identifies the type of character or personality patterns (psychopathic, narcissistic, paranoid, depressive, schizoid, etc.). She explains that though this two-axis model is oversimplified, it is useful in synthesizing and streamlining diagnostics for newcomers.McWilliams first looks at how the levels of personality organization are important in the therapeutic process. She states the neurotically organized person is like the boiling pot with the lid on too tight making it the therapist's job to let some steam escape (uncovering-expressive work). However, the psychotically vulnerable individual's pot is boiling over, and it is the therapist's job to turn down the heat and get the lid back on (supportive work).I strongly recommend this recent edition of Psychoanalytic Diagnosis: Understanding Personality Structure in the Clinical Process as a required text for doctoral and post-doctoral students to help them understand and treat patients.

When I get interested in a subject, I like to just dive right in.This book caught my eye so I ordered the Kindle version.Now, I've never taken a psychology class in my life.The only other books I've read dealing with psychology were directly related to playing poker; figuring out what type of player an opponent is and predicting his/her playing decisions by analyzing body language and habitual reactions to various in-game situations (calling/raising/folding).So I have to admit, for about the first five chapters I was having to look up just about every other word.To me, this is actually a good thing, and half the fun. After all, studying a new subject is about learning a new set of words. Everything is vocabulary and vocabulary is everything. You know the words; you know the subject.Once I got past that initial, verbal "boot camp," it was smooth sailing.I love her simple, but not simplistic, way of describing some pretty deep ideas about the way people habitually deal with emotions according to what seemed to work for them growing up.I love the way she breaks it down, with each shade of personality organization, what the biggest fear is, what the primary habitual defenses are, how they see themselves, how they relate to other people, how to approach their treatment, and how each type might get confused with some other type.I also love how she puts a list of suggested further reading at the end of each chapter, not just at the back of the book. I'm really looking forward to my next psych book, which may very well end up being another one of her's.

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