Facilitated by

Psychoanalytic diagnosis brings back a rich tradition of viewing patients not as collections of symptoms, but as human beings with their nuanced endowments, histories, fallibilities, defenses, and character structures. After the heyday of psychoanalysis in the 1950s and 1960s, various cultural, political, and economic forces converged, diminishing the prevalence of psychodynamic thinking and practice in this country. These forces included the shaping of clinical psychology into a positivist “science,” cost-containment efforts by insurance companies, the economic interests of the pharmaceutical industry, and the dismissive reaction of some analysts to outcome research (McWilliams, 2011, p. xii), resulting in an increasing emphasis on medications and short-term treatment models. This movement culminated in the 1980 publication of the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), in which mental disorders were described as symptom-based categorical entities or discrete illnesses as opposed to prior conceptualizations of characteristics having broad etiologies and existing on continuums ranging from normal to maladaptive.

Nancy McWilliams’ rejoinder to DSM-III, Psychoanalytic Diagnosis, was published in 1994 and quickly became a classic in the psychoanalytic field. It viewed human beings as complex wholes, and diagnosis as having inferential, dimensional, contextual, and biopsychosocial bases. It summarizes psychoanalytic concepts about character structure, defense mechanisms, and relational styles in understandable language with useful treatment implications. In the second edition of Psychoanalytic Diagnosis, published in 2011, McWilliams integrated information from neuroscience, infant research, contemporary psychoanalytic theories, and empirical research into her formulations.

This study group is appropriate for clinicians with an intermediate level of knowledge about psychoanalytic theory. Group participants will utilize readings, discussion, and case examples to learn about psychoanalytic diagnosis. Participants should obtain the textbook Psychoanalytic Diagnosis, and read the first 4 chapters before the group begins.

J. Christopher Fowler, PhD is Professor of Psychology in Neurosurgery, Houston Methodist Academic Institute; Professor of Psychology in Clinical Psychiatry, Weill Cornell Medical College in New York; and adjunct faculty member at the Center for Psychoanalytic Studies in Houston. He previously was on faculty at two inpatient settings which are or were well known for providing psychoanalytic treatment: (1) Austen Riggs Center in Stockbridge, Massachusetts and (2) Menninger Clinic in Houston. Dr. Fowler is an internationally recognized personality researcher whose publications include articles on the efficacy and interpretation of the Rorschach Inkblot Technique. His other scientific publications are in the areas of suicide, depression, neuroimaging, and treatment outcome. Dr. Fowler is past editor of The Bulletin of the Menninger Clinic.

William Orme, PhD is a clinical psychologist and the Director of Education and Training at Houston Methodist Behavioral Health. He holds an appointment as a Clinical Assistant Professor at McGovern Medical School at UTHealth. He completed his clinical internship and postdoctoral fellowship at Baylor College of Medicine, The Menninger Clinic. His research has focused on topics including mentalization, suicide, personality disorders, religion and spirituality, trauma, and somatization. His clinical experience is in the areas of personality assessment, psychodynamic psychotherapy, mentalization based therapy, and acceptance and commitment therapy. His theoretical orientation has been significantly influenced by his psychodynamic training in graduate school, training at The Menninger Clinic, and involvement in APA’s Division 39 (psychoanalysis). Dr. Orme has previously taught a graduate course on psychoanalytic theory.

Session 1, Jan. 3: Developmental Levels of Personality Organization and Their Implications

Session 2, Jan. 10: Primary and Secondary Defensive Processes 

Session 3, Jan. 17: Antisocial, Narcissistic, and Histrionic Personalities

Session 4, Jan. 24: Schizoid, Paranoid, and Obsessive-Compulsive Personalities

Session 5, Jan. 31: Depressive, Manic and Masochistic Personalities 

Session 6, Feb. 7: Dissociative Personalities and Diagnostic Interview

McWilliams, N. (2020). Psychoanalytic diagnosis, second edition: Understanding personality structure in the clinical process. New York: Guilford Press.

American Psychiatric Association (2022). Diagnostic and statistical manual of mental disorders, fifth edition, text revision: DSM-5-TR. Washington, DC: American Psychiatric Publishers.

Lingiardi, V. & McWilliams, N., Eds. (2017). Psychodynamic diagnostic manual, second edition: PDM-2. New York: Guilford Press.

McWilliams, N. (1999). Psychoanalytic case formulation. New York: Guilford Press.

1302 Waugh Dr. #276, Houston, TX 77019

(713) 429-5810

Visit Website | Email Us

The American Psychoanalytic Association designates this Live Activity for a maximum of 9 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.