Psychoanalytic Character Diagnosis
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Questions and Answers

What does the Psychodynamic Diagnostic Manual aim to address?

  • Replace classical psychoanalytic theories.
  • Fill in gaps left by previous theories. (correct)
  • Offer a method for empirical measurement.
  • Provide a comprehensive treatment framework.

    • How did classical psychoanalytic theory primarily approach personality in the era of Freud's original drive theory?

  • Through understanding defense mechanisms.
  • In terms of cognitive functioning.
  • Based on fixation and developmental phases. (correct)
  • By analyzing relational models.

    • Which of the following theories added to Freud's original drive theory by focusing on defense mechanisms?

  • Cognitive theory.
  • Behaviorism.
  • Ego psychology. (correct)
  • Attachment theory.

    • What is a key aspect of personality as understood by relational models in psychoanalysis?

    <p>Understanding through interpersonal relationships.</p> Signup and view all the answers

    Which of the following is NOT mentioned as a formulation that enriches understanding of personality?

    <p>Behavioral theory.</p> Signup and view all the answers

    What is a common misconception about the two approaches in classical psychoanalytic theory?

    <p>They can coexist and enhance understanding.</p> Signup and view all the answers

    What aspect of personality does the Shedler-Westen Assessment Procedure (SWAP) measure?

    <p>Inner capacities of the whole person.</p> Signup and view all the answers

    Which of the following statements about psychoanalytic character diagnosis is true?

    <p>It considers multiple paradigms in interpretation.</p> Signup and view all the answers

    What has current psychoanalytic writing emphasized regarding borderline dynamics?

    <p>The importance of childhood trauma</p> Signup and view all the answers

    Which anxiety is most prevalent for individuals in the psychotic range?

    <p>Fear of annihilation</p> Signup and view all the answers

    What is a common theme that individuals with borderline personality organization focus on?

    <p>Separation-individuation</p> Signup and view all the answers

    Which instrument is mentioned as being used for diagnosing borderline character structure?

    <p>Structural Interview for Personality Organization</p> Signup and view all the answers

    What is a significant factor that differs across individuals with borderline conditions?

    <p>The causes of their conditions</p> Signup and view all the answers

    What characterizes anxiety in neurotic individuals?

    <p>Fear involves unconscious conflict</p> Signup and view all the answers

    What has influenced the paradigm shift in understanding personality organization?

    <p>Empirical findings in attachment and trauma</p> Signup and view all the answers

    Which system is activated in individuals experiencing separation anxiety?

    <p>Panic system</p> Signup and view all the answers

    What aspect of therapy do neurotic-level clients generally seek to improve?

    <p>Conflicts between desires and obstacles</p> Signup and view all the answers

    What does Freud suggest is the primary goal of therapy for neurotic-level clients?

    <p>Removal of inhibitions against love and work</p> Signup and view all the answers

    How do therapists generally feel when working with neurotic-level clients?

    <p>As though they are allies against a common problem</p> Signup and view all the answers

    Which statement best describes the behavioral adaptations of neurotic-level individuals as discussed?

    <p>They often are unaware of certain behavioral patterns being problematic.</p> Signup and view all the answers

    How does the situation differ between neurotic-level and psychotic-level individuals?

    <p>Neurotic-level individuals are often more organized and stable.</p> Signup and view all the answers

    Which development stage is notably referenced in the context of neurotic-level individuals?

    <p>Basic trust and basic autonomy</p> Signup and view all the answers

    What might a therapist expect regarding countertransference when working with neurotic-level clients?

    <p>It tends to feel manageable, whether positive or negative.</p> Signup and view all the answers

    What can be said about the behaviors of a deeply disturbed patient at the psychotic level?

    <p>They can swing from pleasant discussions to violent outbursts.</p> Signup and view all the answers

    What is a prominent emotional issue that borderline patients face?

    <p>Difficulty with affect tolerance and regulation</p> Signup and view all the answers

    How does identity confusion differ between borderline and psychotic individuals?

    <p>Borderline patients may have identity confusion but maintain awareness of their existence.</p> Signup and view all the answers

    What differentiates borderline patients from psychotic individuals in terms of their reaction to identity questions?

    <p>Psychotic individuals are less likely to engage with the questions about their identity due to fear.</p> Signup and view all the answers

    What was Kernberg's recommendation regarding the assessment of patients for differential diagnosis?

    <p>Evaluate the 'adequacy of reality testing' of the individual.</p> Signup and view all the answers

    What does the term 'primitive defenses' refer to in the context of borderline and psychotic individuals?

    <p>Basic and often maladaptive ways of coping with anxiety</p> Signup and view all the answers

    Focus solely on the patient's emotional expressiveness.

    <p>They can demonstrate some appreciation of reality despite their symptoms.</p> Signup and view all the answers

    Which approach did Kernberg suggest for investigating a patient's self-presentation?

    <p>Gently commenting on some peculiar aspect of their self-presentation.</p> Signup and view all the answers

    Which feature is commonly found in both borderline and psychotic individuals?

    <p>Difficulty with reality testing</p> Signup and view all the answers

    What might psychotic individuals feel towards their therapist who offers more than diagnosis and medication?

    <p>Deference and gratitude</p> Signup and view all the answers

    Which emotional response is commonly felt by therapists when working with psychotic patients as opposed to neurotic patients?

    <p>Subjective omnipotence and deep empathy</p> Signup and view all the answers

    What is a concern therapists face when working with psychotic patients regarding their emotional dependence?

    <p>They impose a heavy psychological responsibility on the therapist</p> Signup and view all the answers

    How do psychotic individuals typically respond to a therapist's sincerity?

    <p>They appreciate it and forgive mistakes</p> Signup and view all the answers

    What behavior might therapists expect from psychotic patients due to their desperation for respect?

    <p>Gratitude and deference</p> Signup and view all the answers

    What risk is associated with the affectionate response therapists feel toward psychotic patients?

    <p>Overidentification with the patient</p> Signup and view all the answers

    How are psychotic individuals compared to infants by therapists in terms of emotional needs?

    <p>They require nurturing but are not yet oppositional</p> Signup and view all the answers

    What aspect of psychotic patients can evoke a sense of positivity in therapists?

    <p>Their idealized perception of the therapist</p> Signup and view all the answers

    Study Notes

    Psychoanalytic Character Diagnosis: Classical Approaches

    • Classical psychoanalytic theory viewed personality through two lenses: fixation at early developmental stages and characteristic defense styles.
    • Ego psychology added to drive theory by focusing on how individuals develop adaptive and defensive patterns.
    • Relational models (British object relations, American interpersonal psychoanalysis, self psychology) enrich the understanding of character organization.
    • The author's understanding of personality is also informed by Jungian archetypes, Murray's personology, Tomkins's script theory, control-mastery theory, and empirical research (attachment, cognitive and affective neuroscience).

    Diagnostic Paradigms in Psychoanalysis

    • The author utilizes multiple, potentially contradictory, psychoanalytic paradigms in diagnosis.
    • Empirical findings on infant development, attachment, and trauma have challenged the notion of fixation at normative developmental phases.
    • Despite varied etiologies, a consensus exists on the clinical manifestations of borderline personality organization.
    • Structured interviews (e.g., Kernberg's structural interview, STIPO) aid in the diagnosis of borderline character structure.

    Developmental Levels of Personality Organization

    • Individuals vulnerable to psychosis may be preoccupied with early symbiotic phase issues (trust).
    • Borderline personality organization is characterized by a focus on separation-individuation themes.
    • Neurotic structures involve more internalized conflicts (Oedipal).
    • Central anxieties differ across levels: fear of annihilation (psychotic), separation anxiety (borderline), unconscious conflict (neurotic). These anxieties relate to activation of specific brain systems (FEAR, PANIC).

    Characteristics of Neurotic-Level Personality Structure

    • Neurotic individuals have generally successfully navigated Erikson's first two stages (basic trust, autonomy).
    • They seek therapy due to conflicts between desires and perceived self-imposed obstacles.
    • The therapeutic alliance is typically strong, with therapist and patient united against problematic aspects of the patient's personality.
    • Countertransference is usually manageable, neither overwhelmingly positive nor negative.

    Characteristics of Psychotic-Level Personality Structure

    • Psychotic individuals exhibit internal desperation and disorganization.
    • They may lack a strong sense of separate existence.
    • Therapists may experience positive countertransference (omnipotence, protectiveness, empathy).
    • Psychotic patients may be appreciative of sincerity, educational efforts, and normalization of their preoccupations.
    • The countertransference resembles maternal feelings toward infants.

    Characteristics of Borderline-Level Personality Structure

    • Borderline patients struggle with affect tolerance and regulation, often expressing anger where others might feel other emotions.
    • Their sense of self is inconsistent but not marked by the existential terror of psychotic individuals.
    • They are more likely to react with hostility to questions about identity.
    • Borderline individuals, despite symptoms, demonstrate an understanding of reality (adequate reality testing).
    • To differentiate borderline from psychotic, assessing their appreciation of conventional reality is key (e.g., by commenting on unusual behaviors).

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    Related Documents

    Psychoanalytic Diagnosis: Understanding Personality Structure

    Description

    Explore the classical and contemporary approaches to psychoanalytic character diagnosis. This quiz delves into the development of personality, the defense mechanisms, and the integration of various psychoanalytic theories, including those of Jung and contemporary empirical research. Test your knowledge on the diagnostic paradigms within psychoanalysis and how they shape our understanding of personality.

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