Toward a Model for Synthesizing Psychodynamic Perspectives in Psychopathology to Support Cross-Theoretical Treatment Formulation

Description

Somdeb Mitra (Department of Psychology, University of Calcutta, West Bengal)

Diagnostic categories in the field of clinical psychology often face challenges due to significant overlaps. Dimensional thinking is often considered to be useful in case conceptualization. Psychodynamic approaches to understanding psychopathology have a historical significance and are considered to be useful for understanding a wide range of psychiatric disorders. Within the psychodynamic paradigm, there are several schools of thought that highlight different areas of psychopathology and often differ significantly from each other, and lead to confusion for novice clinicians. The current paper aims to review some widely accepted views within the field of psychoanalysis and develop a conceptual model. While acknowledging the differences from various theoretical perspectives as well as the potential for overlap, the proposed integrative model links different developmental stages with distinct categories of anxieties, defenses, personality organizations, and symptomatic manifestations, and connects them to treatment approaches within and beyond the domain of psychodynamic thinking. The paper also links these concepts with the findings of projective assessments, which are routinely conducted by clinical psychologists in India. A case illustration is also provided to demonstrate how such dimensional thinking can guide treatment, even beyond the psychodynamic paradigm. Such an approach can help develop flexible treatment plans and enhance the chances of developing an effective therapeutic alliance.