Psychoanalytic Diagnosis: Understanding Personality Structure in the Clinical Process Second Edition

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.

Excellent overview of personality types, mostly focused on the pathologies associated with them. The introduction is an invaluable guide to key strains of psychoanalytic thought. The book is a bit academic, yes, but this is to some extent necessary to explain the subject matter in precise terms. It's written for therapists, but I'd recommend it to anyone who has done read some pop psychology and wants to go deeper.

This is an excellent resource because Dr. McWilliams knows how to place diagnostics within a socio-cultural framework and can therefore provide a more thorough and insightful analysis of personality disorders, those who diagnose them and those who suffer from them. She is not one of those clinicians who attempts to detach in a pseudo-scientific manner, but rather constantly reminds the reader of the DYNAMICS between therapist and patient.I have read various books on these issues, and some authors known as experts in the field (Kernberg, Millon) are tedious to read because of their jargon. They have much in common with the DSM which takes a "cold," clinical approach by listing symptoms. McWilliams provides a great deal of insight by contextualizing these issues; J. Reid Meloy is also excellent.Highly recommended: one of the most accessible, comprehensive and scholarly books I have read on the challenging and fascinating subject of personality disorders.

This was my favorite text last semester. I absolutely loved this book. It gives a very thorough understanding of personality disorders and what causes some people to behave the way that they do. You would have a much better understanding of the personality disorders and how to counsel certain groups of people as opposed to others. I love how the book gives information on what to look for in certain personality types and then how to counsel certain personality types and what might work and what might not work. It gives a much more in depth understanding of the different personality disorders than the DSM.

This book offers practical application of cutting edge diagnostic methods in depth psychology. It takes diagnostic approaches back from the hands of those who prefer the medical model and returns it to counselors and therapists treating the psyche and soul of people.

Fan-friggin-tastic. Read it

A hard read at first although Very informative.

Item was listed as used but was brand new.