Psychodynamic Psychotherapy A Clinical Manual

Deborah Cabaniss is Professor of Clinical Psychiatry, Director of Psychotherapy Training, and Associate Director of Residency Training in the Columbia University Department of Psychiatry. Dr. Cabaniss, who is also Director of the Virginia Apgar Academy of Medical Educators at the Columbia University College of Physicians and Surgeons, is a recipient of Columbia University’s Presidential Award for Outstanding Teaching. She has published extensively on topics related to psychiatric and psychoanalytic education, and is a Training and Supervising Analyst at the Columbia University Center for Psychoanalytic Training and Research.

Carolyn J. Douglas is Associate Clinical Professor of Psychiatry at Columbia University College of Physicians and Surgeons, and Adjunct Associate Professor of Clinical Psychiatry at Weill Medical College of Cornell University. Dr. Douglas is the author of several publications on teaching supportive psychotherapy to psychiatric residents, the psychotherapy selection process, and psychodynamic psychotherapy.

Anna R. Schwartz is Assistant Clinical Professor of Psychiatry at the Columbia University College of Physicians and Surgeons, and Director of the Psychodynamic Psychotherapy Program at the Columbia University Center for Psychoanalytic Training and Research. Dr. Schwartz is also a former recipient of the Irma Bland Teaching Award from the American Psychiatric Association.

Sabrina Cherry is Associate Clinical Professor of Psychiatry at Columbia University College of Physicians and Surgeons and currently practices psychiatry and psychoanalysis in New York City. Dr. Cherry is also a Training and Supervising Analyst and active teacher of psychoanalytic candidates at Columbia Center for Psychoanalytic Training and Research.

Preface xi

Acknowledgments xiii

Use of This Manual xv

About the CompanionWebsite xvii

Introduction xix

PART ONE What Is Psychodynamic Psychotherapy? 1

1 The Treatment for a Mind in Motion 3

2 How Does Psychodynamic Psychotherapy Work? 8

PART TWO Assessment 15

3 Creating a Safe Place and Conducting an Assessment 17

4 Assessing Domains of Function 27

5 The Initial Formulation 47

6 Indications for Psychodynamic Psychotherapy 57

PART THREE Beginning the Treatment 69

7 Informed Consent and Collaborative Goal Setting 71

8 Setting the Frame and Establishing Boundaries 80

9 Developing a Therapeutic Alliance 94

10 Technical Neutrality 103

11 Conducting a Psychotherapy Session 111

12 Our Patients’ Feelings about Us and Our Feelings about Our Patients 120

13 Empathic Listening 129

14 Looking for Meaning 138

15 Medication and Therapy 142

PART FOUR Listen/Reflect/Intervene 151

16 Learning to Listen 153

17 Learning to Reflect 159

18 Learning to Intervene 169

PART FIVE Conducting a Psychodynamic Psychotherapy: Technique 201

19 Affect 205

20 Free Association and Resistance 219

21 Transference 234

22 Countertransference 254

23 Unconscious Conflict and Defense 266

24 Dreams 283

Review Activity for Part Five: The “Microprocess Moment” – Understanding a Moment in Therapy 296

PART SIX Meeting Therapeutic Goals 299

25 Improving Self-Perceptions and Self-Esteem Regulation 301

26 Improving Relationships with Others 311

27 Improving Adapting to Stress 319

28 Improving Cognitive Function 327

PART SEVEN Working Through and Ending 341

29 Working Through 343

30 Ending 352

Review Activity for Parts Six and Seven: “The Macroprocess Summary” – Understanding How Things Change in Treatment 365

31 Continuing to Learn 370

Appendix 1 How to Use Psychodynamic Psychotherapy: A Clinical Manual – A Guide for Educators 375

Appendix 2 Template for Assessment of the Microprocess Moment and Video Review 384

Appendix 3 The Post-Evaluation Psychodynamic Psychotherapy Educational Resource – The “PEPPER” 385

Recommended Reading 388

Index 401

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