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This book offers clinicians a long-awaited comprehensive paradigm for assessing object relations functioning in disturbed younger and older adolescents. It gives a clear sense of how object relations functioning is manifest in different disorders, and illuminates how scores on object relations measures are converted into a therapeutically relevant diagnostic matrix and formulation. Outlining the process of object relations assessment, Kelly presents vividly detailed cases of a range of disorders including anorexia nervosa, borderline states, depressive disorders, and trauma. The cases portray the vicissitudes of object relations functioning and disruption that result in a unique structural developmental composite for a given adolescent. A major concern is demonstrating the utility and validity of two object representation measures--The Mutuality of Autonomy Scale (MOA) and The Social Cognition Object Relations Scale (SCORS)--that are the main ones employed in the assessment of adolescents. MOA and SCORS scores facilitate a multidimensional understanding of the nuances of an adolescent's object relations functioning, and provide clinicians with organized, theory-based data leading to clear, specific treatment directions and guidelines and appropriate therapeutic programming. The book addresses the following questions: * Is individual psychotherapy indicated--will this adolescent benefit from an insight-oriented approach? * What are the likely directions that transference parameters will take in the treatment? * What types of countertransference reactions are likely to be anticipated in a given patient? * Is medication likely to be helpful in making this adolescent more accessible for treatment? Focusing only on adolescents, covering both the TAT and the Rorschach, and utilizing object relations theory as its major interpretive foundation, the book offers practitioners an alternative to general references based on a more actuarial, nomothetic, and atheoretical interpretive approach. It reflects one school of contemporary thought in projective assessment--one that advocates a more phenomenological, theory-based approach to test application and interpretation.
The self psychology of Heinz Kohut has been an important force in contemporary psychoanalytic thought and its ramifications for therapy have been extensively explored. Now, Marshall Silverstein offers the first analysis of the application of self psychology to projective diagnostic assessment. Differentiating the self psychological approach from an ego psychological interpretation of classical drive theory, he clearly outlines the principal contributions of Kohut, including the concepts of selfobject functions, empathy, transmuting internalization, and compensatory structure. Providing numerous clinical examples, he shows how the major selfobject functions of mirroring, idealization, and twinship can be identified on projective tests. Silverstein then demonstrates how conventional assessment approaches to grandiosity, self-esteem, and idealization can be reconceptualized within the framework of self psychology, and he also contrasts ego psychological interpretations with self psychological interpretations. This book makes a strong case for the importance of the clinical identification of self states. It will help practitioners understand their patients' varied attempts to repair an injury to the self to restore self-esteem (compensatory structure) and the clinical consequences of self-disorders, including disintegration products such as narcissistic rage and affect states characterized by empty depression, chronic boredom, and lack of zest.
Rorschach Assessment of Psychotic Phenomena takes the reader beyond where James H. Kleiger’s original work, Disordered Thinking and the Rorschach, left off. This new book offers readers a number of conceptual bridges between Rorschach characteristics commonly associated with psychotic phenomena and a range of psychological, neurocognitive, and psychoanalytic constructs that help psychologists move beyond static, test-bound interpretations of scores and indices. Beginning with a broad-based understanding of disordered thinking and reality testing, Kleiger provides an updated review of the contributions of past Rorschach luminaries and contemporary figures who have helped make the Rorschach a robust tool for assessing aspects of psychotic-level experience. The contributions of major figures are highlighted and assessed in terms of their empirical, conceptual, and practical implications. In addition to providing a balanced, respectful review of each of these leading figures and the systems they developed, Kleiger offers a new way of organizing and conceptualizing what is currently understood about Rorschach scoring variables pertaining to psychotic phenomena. Kleiger’s aim is to help Rorschach practitioners not only consolidate their grasp of key scoring variables and what each means about an individual’s thought processes and internal experiences, but also expand their clinical understanding of the psychotic phenomena being assessed. He includes a wide range of psychotic phenomena, like negative symptoms, cognitive impairment, magical thinking, and impairment of insight, all of which are subjects of diagnostic interest when using the Rorschach with psychotically prone individuals. The final section on psychopathology looks at how the Rorschach is useful in differential diagnosis of primary psychoses and those conditions that may include secondary psychotic phenomena. In step with contemporary DSM-5 standards, Kleiger organizes his discussion of severe psychopathology in a manner consistent with how psychotic phenomena are currently understood in the clinical and scientific literature. In addition to reviewing key clinical characteristics of these conditions, along with Rorschach contributions to the diagnosis of these disorders, he also focuses his lens on the Rorschach assessment of malingered psychosis and psychotic phenomena in children and adolescents. Written with the same well-researched attention to detail and integrative style as Kleiger's earlier work, Rorschach Assessment of Psychotic Phenomena will prove invaluable to clinical psychologists, psychiatrists, and psychoanalysts interested in understanding and assessing psychosis.
Comprehensive Handbook of Psychological Assessment, Volume 2 presents the most up-to-date coverage on personality assessment from leading experts. Contains contributions from leading researchers in this area. Provides the most comprehensive, up-to-date information on personality assessment. Presents conceptual information about the tests.
Few books illuminate a domain of clinical inquiry as superbly as Psychoanalytic Perspectives on the Rorschach. Paul Lerner has written a comprehensive text that offers a richly detailed, multidimensional vision of the Rorschach as the ideal medium for operationalizing, testing, and in some instances transforming contemporary clinical theory. For psychoanalytic therapists, the book provides a fascinating overview of how the coevolution of psychoanalytic theory and Rorschach technique has created new possibilities for conceptual integration. Lerner explores recent advances in our ability to operationalize such clinical concepts as splitting, dissociation, and false-self organization. He then reviews how these advances have been applied to research into psychic organization across different diagnostic categories, including anorexia and bulimia, aggressive and psychopathic personality, and schizotypal disorders. Finally, Lerner shows how the resulting data offer a unique vantage point from which to clarify such critical topics as developmental object relations and the structure of primitive experience. Rorschach scholars will appreciate Lerner's informed discussions of theorists as diverse as Rapaport and Schachtel, Exner and Mayman, Schafer and Leichtman. Rorschach students, for their part, will find the book an unusually lucid introduction to test administration, scoring, interpretation, and report writing. Even here, however, Lerner's breadth and originality are apparent, for his exposition of these testing fundamentals incorporates fresh discussions of the nature of the Rorschach test, the impact of the patient-examiner relationship, and the value of the test in treatment planning. Timely, definitive, and uniquely integrative, Psychoanalytic Perspectives on the Rorschach will be valued by students, clinicians, and researchers well into the next century.
Comprised of five unique and extended case studies, Personality Assessment in Depth examines contemporary clinical problems that are familiar to clinicians, but have not been explored extensively in the personality assessment field. Each case study demonstrates the test protocols of the Rorschach test, Thematic Apperception Test, MMPI or MCMI, and Human Figure Drawings. Important clinical questions and areas of theoretical concern are examined, including differential diagnosis of disorders of affect and personality in light of contemporary viewpoints about these disturbances, personality and adaptation accompanying neuropsychological deficit, and stages of development, including differentiating these from personality characteristics viewed longitudinally, the latter demonstrated by a noteworthy comparison of two evaluations of the same patient, first as a 15-year-old adolescent and then as a 25-year-old adult. A battery of performance and self report personality instruments are applied to the cases, allowing the author to integrate findings across multiple tests and thereby expose clinical psychology students to personality assessment in a broad perspective. Cases are discussed comprehensively, relying on a thorough consideration of thematic content examined alongside formal test scores. Further, the Rorschach findings are examined using both the Exner Comprehensive System and the recently-introduced Rorschach Performance Assessment System approaches. The cases are considered using a broad psychodynamic framework for interpretation, employing classical ego psychology, object relations, and self psychological theoretical perspectives. This is an essential casebook for professionals and students, demonstrating the depth and richness of personality considered alongside the empirical foundations of personality assessment.
For decades, The Rorschach Inkblot Method (RIM)--the most popular of the projective tests--has been routinely employed for personality assessment and treatment planning. But in recent years, it has not been free from controversy. Criticisms of its validity and empirical support are catalyzing new efforts to strengthen its foundations and document its broad utility. Among the most common--yet also most confusing and challenging--categories of clinical disorders is the personality disorders. However, minimal data have been available on the RIM evaluation of most of those found in DSM-IV. This welcomed book constitutes the first research-grounded, comprehensive guide to the use of the RIM in assessing personality disorders. The first section offers a theoretical overview of personality disorders and constructs a framework and compelling rationale for the legitimate role of the RIM in their assessment. The second, third, and fourth sections present Cluster A disorders--paranoid, schizoid, and schizotypal; Cluster B disorders--antisocial and psychopathic, borderline, histrionic, and narcissistic; and Cluster C disorders--avoidant, dependent, and obsessive-compulsive. The fifth section presents passive aggressive and depressive personality disorders, currently being proposed for DSM inclusion. Each chapter in these four sections includes an extensive description of the disorder, a review of empirical studies of the use of the RIM to assess it, an analysis of the Rorschach variables that may characterize patients diagnosed with it, and a depiction of a real case and discussion of the ways in which the RIM contributed to its formulation. The sixth and final section explores the relationship between psychoanalytic theory and the RIM. Rorschach Assessment of the Personality Disorders brings practical help for clinicians and clinicians-in-training, and suggests new paths for researchers seeking to advance our understanding of the complexities of these disorders.
In Disordered Thinking and the Rorschach, James Kleiger provides a thoroughly up-to-date text that covers the entire range of clinical and diagnostic issues associated with the phenomenon of disordered thinking as revealed on the Rorschach. Kleiger guides the reader through the history of psychiatric and psychoanalytic conceptualizations of the nature and significance of different kinds of disordered thinking and their relevance to understanding personality structure and differential diagnosis. He then moves on to thorough reviews of the respective contributions of David Rapaport, Robert Holt, Philip Holzman, and John Exner in conceptualizing and scoring disordered thinking on the Rorschach. These synopses are followed by an equally fascinating examination of less well known research conceptualizations, which, taken together, help clarify the basic interpretive conundrums besetting the major systems. Finally, having brought the reader to a full understanding of systematic exploration to date, Kleiger enters into a detailed analysis of the phenomenological and psychodynamic aspects of disordered thinking per se. Even experienced clinicians will find themselves challenged to reconceptualize such familiar categories as confabulatory or combinative thinking in a manner that leads not only to new diagnostic precision, but also to a richer understanding of the varieties of thought disturbances with their equally variable therapeutic and prognostic implications. With Disordered Thinking and the Rorschach, Kleiger has succeeded in summarizing a wealth of experience pertaining to the rigorous empirical detection and classification of disordered thinking. Equally impressive, he has taken full advantage of the Rorschach as an assessment instrument able to capture the richness of personality and thus capable of providing a unique clinical window into those crucially important differences in the quality of thought that patients may evince.
This book provides a definitive empirical study of antisocial character pathology and its assessment through the use of the Rorschach. Drawing upon a decade of research with nearly 400 individuals in various hospitals and prisons, the authors paint an extraordinary intrapsychic picture of the personality structure and psychodynamics of these troublesome patients. Serving as both an educational tool and a reference text, this book presents: * Rorschach data on several different antisocial groups -- conduct disordered children and adolescents, antisocial personality disordered adult males with and without schizophrenia, antisocial adult females, and male and female sexual homicide perpetrators; * nomothetic (group) and idiographic (case study) data; * data which have been analyzed and theoretically interpreted using both structural methods and psychoanalytic approaches which represent the cutting edge of Rorschach theory and practice; and * a developmental approach in analyzing Rorschach data gathered from antisocial children, adolescents, and adults -- providing striking similarities. This is the first Rorschach database of this type that has ever been published. As such, it serves as a valuable reference text for Rorschach users -- providing a definitive empirical base, theoretical integration, and a focus on individuals who create severe problems for society.