Psychodynamic Psychotherapy - A Clinical Manual
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Psychodynamic psychotherapy offers people a chance to create new ways of thinking and behaving in order to improve the quality of their lives.

This book offers a practical, step-by-step guide to the technique of psychodynamic psychotherapy, with instruction on listening, reflecting, and intervening. It will systematically take the reader from evaluation to termination using straightforward language and carefully annotated examples. Written by experienced educators and based on a tried and tested syllabus, this book provides clinically relevant and accessible aspects of theories of treatment processes. The workbook style exercises in this book allow readers to practice what they learn in each section and more “actively” learn as they read the book.

This book will teach you:

About psychodynamic psychotherapy and some of the ways it is hypothesized to workHow to evaluate patients for psychodynamic psychotherapy, including assessment of ego function and defensesThe essentials for beginning the treatment, including fostering the therapeutic alliance, setting the frame, and setting goalsA systematic way for listening to patients, reflecting on what you've heard, and making choices about how and what to sayHow to apply the Listen/Reflect/Intervene method to the essential elements of psychodynamic techniqueHow these techniques are used to address problems with self esteem, relationships with others, characteristic ways of adapting, and other ego functionsWays in which technique shifts over time

This book presents complex concepts in a clear way that will be approachable for all readers. It is an invaluable guide for psychiatry residents, psychology students, and social work students, but also offers practicing clinicians in these areas a new way to think about psychodynamic psychotherapy. The practical approach and guided exercises make this an exceptional tool for psychotherapy educators teaching all levels of learners.

This book includes a companion website:

with the "Listening Exercise"  for Chapter 16 (Learning to Listen).  This is a short recording that will help the reader to learn about different ways we listen.

Praise for Psychodynamic Psychotherapy: A Clinical Manual

"This book has a more practical, hands-on, active learning approach than existing books on psychodynamic therapy."
Bob Bornstein, co-editor of Principles of Psychotherapy; Adelphi University, NY

"Well-written, concise and crystal clear for any clinician who wishes to understand and practice psychodynamic psychotherapy. Full of real-world clinical vignettes, jargon-free and useful in understanding how to assess, introduce and begin psychotherapy with a patient. Extraordinarily practical with numerous examples of how to listen to and talk with patients while retaining a sophistication about the complexity of the therapeutic interaction. My trainees have said that this book finally allowed them to understand what psychodynamic psychotherapy is all about!"
—Debra Katz, Vice Chair for Education at the University of Kentucky and Director of Psychiatry Residency Training

"This volume offers a comprehensive learning guide for psychodynamic psychotherapy training."
—Robert Glick, Professor, Columbia University


Deborah L. Cabaniss, M.D. is Clinical Professor of Psychiatry at the Columbia University College of Physicians and Surgeons and Director of Psychotherapy Training in the Department of Psychiatry at Columbia University School of Medicine. She has won several teaching awards, including the Edith Sabshin award from the American Psychoanalytic Association. Dr Cabaniss has published numerous articles related to psychoanalytic and psychiatric education and has just finished a term on the editorial board of the Journal of the American Psychoanalytic Association.

Carolyn J. Douglas, M.D. 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. She served for many years as Director of the Residency Training Inpatient Unit at Columbia University Medical Center, and was co-Director of the Columbia Neuropsychiatric Service.   Dr. Douglas is the author of publications on teaching supportive psychotherapy to psychiatric Residents, the psychotherapy selection process, and psychodynamic psychotherapy.

Anna R. Schwartz, M.D. is Assistant Clinical Professor of Psychiatry at the Columbia University College of Physicians and Surgeons. She is also Director of the Psychodynamic Psychotherapy Program at the Columbia University Center for Psychoanalytic Training and Research. She has taught and supervised psychiatry Residents, and psychoanalytic candidates at Columbia for many years, and received the Irma Bland Teaching Award from the American Psychiatric Association.

Sabrina Cherry, M.D. is Associate Clinical Professor of Psychiatry at Columbia University College of Physicians and Surgeons and practices psychiatry and psychoanalysis in New York City. She has been an active teacher and supervisor of both interpersonal and psychodynamic psychotherapy in the Columbia Residency program for twenty years.  She is now a Training and Supervising Analyst and an active teacher of psychoanalytic candidates at Columbia Center for Psychoanalytic Training and Research. Dr. Cherry is the recipient of awards from the American Psychiatric Association and from Columbia for her contributions to education and research.


Acknowledgments ix

Introduction xi

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 The Evaluation 13

3 Creating a Safe Place and Beginning the Evaluation 15

4 Assessment of Ego Function 24

5 Formulation: The Problem→ Person → Goals→ Resources Model 43

6 Indications for Psychodynamic Psychotherapy 51

PART THREE Beginning the Treatment 61

7 Informed Consent and Setting Goals 63

8 Setting the Frame and Establishing Boundaries 72

9 Developing a Therapeutic Alliance 84

10 Therapeutic Neutrality 90

11 Conducting a Psychotherapy Session: Decisions about Length and Frequency 98

12 Our Patients' Feelings about Us and Our Feelings about Our Patients 107

13 Empathic Listening 116

14 Looking for Meaning 126

15 Medication and Therapy 130

PART FOUR Listen/Reflect/Intervene 141

16 Learning to Listen 143

17 Learning to Reflect 149

18 Learning to Intervene 158

PART FIVE Conducting a Psychodynamic Psychotherapy: Technique 187

19 Affect 191

20 Free Association and Resistance 203

21 Transference 217

22 Countertransference 233

23 Unconscious Conflict and Defense 242

24 Dreams 259

Review activity for Part Five – understanding a moment in therapy 271

PART SIX Meeting Therapeutic Goals 277

25 Improving Self-Perceptions and the Ability to Regulate Self-Esteem 279

26 Improving Relationships with Others 288

27 Improving Characteristic Ways of Adapting 297

28 Improving Other Ego Functions 304

PART SEVEN Working Through and Ending 321

29 Working Through 323

30 Termination 331

31 Continuing to Learn 344

Recommended Reading 349

Index 361


"This helpful book should serve as a primer for all psychiatric residents, as it provides a wonderful launching point for further reading into psychodynamically oriented therapies." (The Residents' Journal, a publication of The American Journal of Psychiatry, 2012)

"The second part of the book focuses on patient evaluation and assessment for psychodynamic psychotherapy. The highlight of this section is chapter 4, on the assessment of ego function. It is superb. In fewer than twenty pages, the authors explain ego strength, describe eleven basic ego functions (adapted from the work of Bellack and Goldsmith), define and give clear examples of each ego defense, and briefly discuss superego function. This chapter contains the clearest and most concise discussion of ego function (defenses) I have ever read." (Journal of the American Psychoanalytic Association, July 2012)

"Although the clear prose, well-organized format, and rich insights make this book a pleasure to read, it is the abundance of carefully annotated case examples on almost every page that differentiates this book from others like it. At a time when many psychiatry resident programs do not provide adequate training in psychodynamic psychotherapy, this book provides a much-needed corrective. Although it is meant as a book for initial learning, this is the kind of book that will remain on the reader's desk as a frequently thumbed companion and reference." (The Journal of Nervous and Mental Disease, May 2012)

"This splendid book by Deborah Cabaniss and her colleagues vividly and eloquently describes and explains expert psychotherapeutic technique, as well as demonstrating exemplary teaching skills......The authors are unusually gifted in constructing brief clinical exchanges that are informative, self-contained, and convincingly true to life. They have mastered the art of narrative—in their book in general, and especially in the vignettes... The quality of their writing is so superb that I will quote from it liberally. I believe many trainees will be inspired by the book to pursue further training in psychotherapy and psychoanalysis." (The Psychoanalytic Quarterly, 2012)

"Throughout the book, one sees evidence that the authors “have been there, seen that, and done the right thing about it.” They have distilled their long experience into clear and readable prose; resorting minimally to jargon; they speak directly to the likely concerns of students. I recommend the book for its intended audience and for anyone interested in the art and science of psychodynamic psychotherapy."  (Psychoanalytic Psychology, December 2011)

"This book is appropriate for any behavioral health professional interested in learning psychodynamic psychotherapy, including psychiatrists, psychologists, and students of these disciplines. The authors are well entrenched in the East Coast psychodynamic culture and tradition." (Doody's, September 2011)