Customer Reviews

Psychoanalytic Diagnosis: Understanding Personality Structure in the Clinical Process

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This book is without a doubt the finest psychoanalytic text I have come across. If you desire only one psychoanalytic work in your library, make it this one. Ms. McWilliam's book is beautifully and clearly written, intelligent, informative, and affords both a useful overview of most concepts that any practitioner (or interested layperson) might need, AND the history and development of whatever she discusses. She is smart, does not take herself or the field too seriously, and explains things better than nearly anyone else writing in the field. BUY THIS BOOK!

In conjunction with Kernberg's Severe Personality Disorders and the quickie DSM-IV, this is an excellent (albeit, of course, involved) resource for even the layperson who desires to gain a deeper understanding of human beings. Not everyone is material for therapy, yet all of us may employ any number of the conditions and defense mechanisms outlined in the book, to SOME degree. It is, of course, the extreme, debilitating examples that can really bring such dynamics to a brighter light for analysis. Thus, I have been able to subtly apply some of these ideas in my everyday relationships, in terms of my understanding and processing of them.

In "Psychoanalytic Diagnosis", I find particularly helpful the brief, theoretical mapping of the defense mechanism buffet as presently known to man, laid across a few chapters in order of primary and secondary usage. Of course, much of the ideology presented is speculative ~ but interesting, nonetheless.

I also appreciate the occasional, juxtaposed variety of interpretational approaches offered for individual phenomenon. Given the organic and sometimes elusive nature of our subject matter, this presentation of several angles of the same behavior can prove to be beneficially revealing.

In sum, it is exploring these "extreme" case studies that offers insight into the universal structure of the human soul ... beneficial for anyone seeking such knowledge, and desiring to understand and improve their relationships.

For more info on transferences between client and therapist - (which, despite the book's perspective, the dynamics of such need not be limited to the psychotherapist's couch, but potentially *any* relationship (as deemed relevant)) - I recommend the Kernberg work initially cited.

This text should be a staple item in the library of any aspiring dynamic therapist. Lucidly written and well-organized.

If only every textbook was so well written and insightful. I would reccommend it to anyone studying psychology. It should be required reading for anyone pursuing the field of psychotherapy. I savored every last word.

This book offers a welcome and much needed alternative to the dogma-bound DSM used in psychiatry and psychology. It gives a theory-driven alternative that is elegant and can be applied to virtually any of the interpersonal and emotional problems mental health practitioners treat. McWilliams' use of a continuum of characterology, ranging from flexible to symptomatic to persistent to severe makes intuitive sense. The categories she describes will be familiar to anyone with a clinical background and again are resonant with common experience.

Two concerns: her use of "Borderline" is inconsistent throughout the book, used at times to denote a range between neurotic and psychotic and other times as a type, as in BPD. She inaccurately claims that the DSM uses BPD as a degree rather than type, when in fact it one of the several "clusters" of personality disorders, each distinct in presentation. My suggestion is to go with her psychological approach and eliminate the vague word "Borderline" altogether. Replace it with characterological and take Vaillant's advice to forget the "kitchen sink" BPD.

The other concern regards the Dissociative type of pathology. McWilliams ignores her own elegant heuristic when presenting these difficulties. She loses track of the neurotic-characterological-psychotic spectrum in which this type of pathology can present. A close reading of this section of the book suggests revisions for the next edition, which I hope will be forthcoming, as this is a wonderful text to use with students learning about so-called abnormal psychology.

Her opening comments on page 7 tell you why this is a must read for health care providers and caregivers and family members alike.

"For many people, including some therapists, diagnosis is a dirty word. We have all seen the misuse of the psychodiagnostic formulations: The complex person gets flippantly oversimplified by the interviewer who is anxious about uncertainty; the anguished person gets linguistically distanced by the clinician who cannot bear to feel the pain; the torublesome person gets punished with a pathologizing label. Racism, sexism, heterosexism, classism, and numerous other prejudices can be (and have been) handlity fortified by nosology."

"All kinds of evil can be wreaked in the name of worthy ideals---love, patrotism,Christianity, whatever--through no fault of the original vision but because of its perversion." "Does the careful, nonabusive appplication of psychodiagnostic concepts increase a client's chances of being helped."

She then sets out to show what doesn't work and what does and how health car providers can better care for their clients needs and in doing so help the client to become a functioning and happier person.

A dear friend Ira in New Jersey, sent this book to me and it has been a godsend. Our birth mother was institutionalized in the 50's for Schizophrenis and in the 90's the issue of MPD/DID became a personal concern. Because of the advise Dr McWilliams offered I and many others have discovered psychotherapists who knew what to do and in doing their job well have helped us live full, compassionate and whole lives.

This book is clear, concise, and extremely well written. It gives an excellent overview of all of the psychoanalytic theories, development, and defenses which lays a solid foundation for the different types of personalities. Most importantly she gives a clear understanding of how an individuals personality structure should inform the therapist's focus and intervention. This is an excellent book!

Psychoanalytic Diagnosis is one of my favorite books. In a very thorough and systematic way, Nancy McWilliams provides the reader with insights on several forms of character pathology - and does so from each of the four major schools of analytic thought (classical drive, ego, object relational, and self psychological perspectives). Typical countertransferential pulls and helpful guidelines for the conduct of therapy with each of the character types is also included. This is a great book, and I return to it often in my own clinical work.

I've been in psychotherapeutic training for several years now and this is perhaps my favorite book. Dr. McWilliams has brought together both useful information and a sense of the humanity of patients in a book that provides an orientation for work as well as some quite practical do's and don't. I recognized myself in her descriptions, but benefitted from her compassion at the same time. It is a "primer" but it holds wisdom that I return to time and again.