CL 731: DISORDERS OF ADULTHOOD I
Spring 2010
Michele Rivette, LMSW, ACSW, BCD
Michele.Rivette@yahoo.com
(734) 930-2200
This course focuses on psychoanalytic personality theory and implications for clinical practice; the major classifications of mental disorders of adulthood; moving from a medical model to a more psychodynamic model of diagnosis and clinical case formulation; and treatment approaches from classical, object relations and self psychology perspectives. The CL 731 course builds on the students’ previous courses in psychodynamic theory and clinical process and technique.
Goals:
1. Establish a psychodynamic understanding of the etiology of neurotic, psychotic, and character disorders in adulthood.
2. Increase ability to convey diagnostic understanding in both written and oral communication.
3. Understand key components of a comprehensive psychodynamic case formulation that includes diagnoses, bio-psycho-social history, and initial recommendations for treatment.
4. Identify treatment techniques associated with specific disorders.
5. Augment understanding of the dynamic and shifting relationships among theory, diagnosis, treatment and the contribution of the historical context.
Evaluation
Written work will be evaluated on quality of writing, complexity, independence of thought, and ability to express ideas authentically and honestly. Plagiarism of any kind will not be tolerated, and ideas belonging to others (including the internet) must be cited using APA guidelines.
Overall class grades will be based on the following: Quality of class participation: 25%, Assignment #1: 25%; Assignment #2: 50%
Written assignments will be assessed as follows:
An “A” paper should reflect a high degree of understanding, and demonstrate creativity and critical thinking. It demonstrates and ability to integrate and apply theoretical concepts with clinical material or experience. It should also be well-organized, clear, and edited for correct grammar and spelling.
A “B” paper is one which shows a high degree of accuracy in understanding and an above average application of key concepts. It should also be well-organized and edited for correct grammar and spelling.
A “C” paper is one that is written with insufficient depth and demonstrates only an adequate understanding of the material. It is also a grade that can be given because of poor organization of material, lack of clarity, or insufficient editing for spelling and grammar.
An “F” will be given to papers that reflect major conceptual misunderstandings.
Papers must conform to ICSW Style manual.
Class participation includes: Evidence of reading assigned readings and ability to raise questions about the readings and to relate clinical experience to concepts presented in readings. Class attendance is mandatory and emergency absences should be discussed in advance with instructor when possible. For students who miss more than one class, the overall grade for course will be lowered one grade level. Students who miss more than two classes will automatically fail the course (in the case of personal emergency, the student will be asked to withdraw from the course and retake it the following year).
Written Assignments:
Using the character of Jacqueline du Pre’ in the film (based on a true story), Hillary and Jackie, you will have two written assignments.
Assignment I: Pretend that you are Sigmund Freud circa 1920s and Jacqueline du Pre’ comes to visit you. Write a diagnostic assessment of Jackie from Freud’s perspective of the neurotic disorders. Please make the best diagnosis within this category and explain, using the course material, how the theory applies to Jackie. Discuss the etiology and course of the illness. Remember this is a course which connects the theory and the clinical understanding, so be sure to maintain a good balance using the character to illustrate your points. This paper is due before the fourth class meets and should be no more than 5 double-spaced, pages.
Assignment II: Now that you have completed the class readings, pretend that it is a more contemporary time (1980-present) and Jackie comes to see you. Re-consider the case of Jackie from all the diagnostic categories we have discussed. Choose the diagnostic category or categories that you think best fits Jackie; explain why you think so, as you did in the previous paper, and why you are ruling out other categories. This paper is due on the last day of class and should be no more than 12 double-spaced pages.
Required Texts:
McWilliams, N. (1994). Psychoanalytic Character Diagnosis: Understanding Personality Structure in the Clinical Process. New York, NY: Guilford Press.
PDM Task Force. (2006). Psychodynamic Diagnostic Manual. Silver Spring, MD: Alliance of Psychoanalytic Organizations.
Course Outline:
Class 1: Theories of Developmental Levels of Personality Organization and Clinical Implications
McWilliams, N (1994). “Why diagnose?” (pp. 7-18); “Psychoanalytic character diagnosis,” (pp.19-39); and “Developmental levels of personality organization,” (pp 40-66). In Psychoanalytic Character Diagnosis: Understanding Personality Structure in the Clinical Process. Guilford Press.
McWilliams, N (1994). “Clinical implications of developmental levels of organization,” (pp. 67-95). In Psychoanalytic Character Diagnosis: Understanding Personality Structure in the Clinical Process. Guilford Press.
PDM Task Force. (2006). “Personality patterns and disorders – P axis,” (pp. 17-32). Psychodynamic Diagnostic Manual. Silver Spring, MD: Alliance of Psychoanalytic Organizations.
Class 2: Sigmund Freud’s Theories of Mind – Early 20th Century
Brenner, C. (1955). “The psychic apparatus,” (Chapter III-V, pp. 31-125). In An Elementary Textbook of Psychoanalysis, New York, NY: Anchor Books.
Freud, S. (1912). “Types of Onset of Neurosis.” The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume XII (1911-1913): The Case of Schreber, Papers on Technique and Other Works, 227-238. PEP archives.
Recommended, not required:
PDM Task Force [Wallenstein, RS]. (2006). “Psychoanalytically based nosology: Historic origins,” In Psychodynamic Diagnostic Manual, Alliance of Psychoanalytic Organizations (pp. 385-402).
Class 3: Sigmund Freud’s Theories of Mind – Early 20th Century (Continued)
Freud, S. (1926). “Inhibitions, symptoms and anxiety.” The Standard Edition of the Complete Psychological Works of Sigmund Freud, Vol. XX, (pp. 77-172). London: Hogarth Press. PEP Archives.
McWilliams, N. (1994). “Hysterical (histrionic) personalities,” (pp. 301-322); In Psychoanalytic Character Diagnosis: Understanding Personality Structure in the Clinical Process. Guilford Press.
PDM Task Force. (2006). “Phobic (avoidant) personality disorders,” (pp. 54-56); “Anxious personality disorders,” (pp. 56-57); “Hysterical (histrionic) personality disorders,” (pp. 59-62). In Psychodynamic Diagnostic Manual. Silver Spring, MD: Alliance of Psychoanalytic Organizations.
Class 4: Affects, Affect Tolerance, Alexithymia, and Addictive Personalities
*Krystal, H. (1988). “Preface,” (pp. xi-xvii); “Clinical aspects of affect,” (3-20); “Affect tolerance,” (21-37); “Self-representation and the capacity for self-care,” (pp. 170-195). In Integration & Self-Healing: Affect, Trauma, and Alexithymia. Hillsdale, NJ: The Analytic Press, Inc.
PDM Task Force. (2006). “Somatizing personality disorders,” (pp. 47-50); “Addictive/substance use disorders,” (pp. 138-141). In Psychodynamic Diagnostic Manual. Silver Spring, MD: Alliance of Psychoanalytic Organizations.
*Walant, KB. (1995). “Symbiosis revisited,” (pp. 37-71); “Alcoholics Anonymous and transcendence,” (pp. 163-185). In Creating the Capacity for Attachment: Treating Addictions and the Alienated Self. Northvale, NJ: Jason Aronson, Inc.
Class 5: Defensive Processes, Primitive Defenses and Other Components of Mental Functioning
McWilliams, N. (1994). “Primary (primitive) defensive processes,” (pp. 96-116); “Secondary (higher-order) defensive processes,” (pp. 117-144). In Psychoanalytic Character Diagnosis: Understanding Personality Structure in the Clinical Process. Guilford Press.
PDM Task Force. (2006). “Profile of Mental Functioning- M Axis” (pp. 73-90). In Psychodynamic Diagnostic Manual. Silver Spring, MD: Alliance of Psychoanalytic Organizations.
Class 6: Depressive and Masochistic Personalities, and Pathological Mourning
Freud, S. (1917). “Mourning and melancholia.” The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume XIV [1914-1916]: On the History of the Psycho-Analytic Movement, Papers on Metapsychology and Other Works, (pp.237-258). PEP archives.
McWilliams, N. (1994). “Types of character organization,” (pp. 145-149); “Depressive and manic personalities,” (pp. 227-256); “Masochistic (Self-defeating) personalities, (pp. 257-278). In Psychoanalytic Character Diagnosis: Understanding Personality Structure in the Clinical Process. Guilford Press.
PDM Task Force. (2006). “Masochistic (self-defeating) personality disorders,” (pp. 42-44); “Depressive personality disorders,” (pp. 44-47). In Psychodynamic Diagnostic Manual. Silver Spring, MD: Alliance of Psychoanalytic Organizations.
Class 7: Trauma, Dissociative Personalities, Complex Post-Traumatic Stress and Borderline Personality Disorder
*Balint, M. (1964). “The two levels of analytic work,” (pp. 11-17); “The basic fault,” (pp. 18-23). In The Basic Fault: Therapeutic Aspects of Regression. Evanston, IL: Northwestern University Press.
McWilliams, N. (1994). “Dissociative personalities,” (pp. 323-347); “Schizoid personalities,” (pp. 189-204); “Paranoid personalities,” (pp. 205-226). In Psychoanalytic Character Diagnosis: Understanding Personality Structure in the Clinical Process. Guilford Press.
*Krystal, H. (1988). “Trauma and affect,” (pp. 137-169). In Integration & Self-Healing: Affect, Trauma, and Alexithymia. Hillsdale, NJ: The Analytic Press, Inc.
Manfield, P. (1992). Split Self/Split Object: Understanding and Treating Borderline, Narcissistic, and Schizoid Disorders. New York, NY: Jason Aronson.
PDM Task Force. (2006). “Psychic trauma and posttraumatic stress disorders,” (pp. 100-104). In Psychodynamic Diagnostic Manual. Silver Spring, MD: Alliance of Psychoanalytic Organizations.
Class 8: Schizoid, Narcissistic, Paranoid Personality Patterns and Disorders
Kernberg, O. (1970). A psychoanalytic classification of character pathology. Journal of the American Psychoanalytic Association. 18: 800-823. PEP Archives.
McWilliams, N. (1994). “Narcissistic personalities,” (pp. 168-188); “Schizoid personalities,” (pp. 189-204); “Paranoid personalities,” (pp. 205-226). In Psychoanalytic Character Diagnosis: Understanding Personality Structure in the Clinical Process. Guilford Press.
PDM Task Force. (2006). “Schizoid personality disorders,” (pp. 33-34); “Paranoid personality disorders,” (pp. 34-36); “Psychopathic (antisocial) personality disorders,” (pp. 36-37); “Narcissistic personality disorders,” (pp. 38-40); “Dependent personality disorders,” (pp. 50-54). In Psychodynamic Diagnostic Manual. Silver Spring, MD: Alliance of Psychoanalytic Organizations.