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Psychodynamic Formulation



Psychodynamic Formulation

Deborah L. Cabaniss, Sabrina Cherry, Carolyn J. Douglas, Ruth Graver, Anna R. Schwartz

ISBN: 978-1-118-55729-7 March 2013 Wiley-Blackwell 280 Pages

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How do our patients come to be the way they are?

What forces shape their conscious and unconscious thoughts and feelings?

How can we use this information to best help them?  

Constructing psychodynamic formulations is one of the best ways for mental health professionals to answer questions like these. It can help clinicians in all mental health setting understand their patients, set treatment goals, choose therapeutic strategies, construct meaningful interventions and conduct treatment.

Despite the centrality of psychodynamic formulation to our work with patients,  few students are taught how to construct them in a clear systematic way.  This book offers students and practitioners from all fields of mental health a clear, practical, operationalized method for constructing psychodynamic formulations, with an emphasis on the following steps: 

  • DESCRIBING problems and patterns
  • REVIEWING the developmental history
  • LINKING problems and patterns to history using organizing ideas about development.

 The unique, up-to-date perspective of this book integrates psychodynamic theories with ideas about the role of genetics, trauma, and early cognitive and emotional difficulties on development to help clinicians develop effective formulations.

Psychodynamic Formulation is written in the same clear, concise style of Psychodynamic Psychotherapy: A Clinical Manual  (Wiley 2011). It is reader friendly, full of useful examples, eminently practical, suitable for either classroom or individual use, and applicable for all mental health professionals. It can stand alone or be used as a companion volume to the Clinical Manual.


Acknowledgments ix

Introduction xi

PART ONE Introduction to the Psychodynamic Formulation 1

1 What is a Psychodynamic Formulation? 3

2 How do We Use Psychodynamic Formulations? 8

3 How do We Construct a Psychodynamic Formulation? 12


4 Self 23

5 Relationships 32

6 Adapting 41

7 Cognition 52

8 Work and Play 61

Putting it Together – A Description of Problems and Patterns 69


9 What We’re Born with – Genetics and Prenatal Development 81

10 The Earliest Years 90

11 Middle Childhood 101

12 Later Childhood, Adolescence, and Adulthood 113

Putting it Together – A Developmental History 123


13 Trauma 143

14 Early Cognitive and Emotional Difficulties 152

15 Conflict and Defense 163

16 Relationships with Others 173

17 The Development of the Self 182

18 Attachment 191

Putting it Together–A Psychodynamic Formulation 201

PART FIVE Psychodynamic Formulations in Clinical Practice 213

19 Psychodynamic Formulations in Acute Care Settings 215

20 Psychodynamic Formulation in Pharmacologic Treatment 222

21 Psychodynamic Formulation in Long-Term Psychodynamic

Psychotherapy: Revising Over Time 230

22 Sharing Formulations with Our Patients 238

Epilogue 247

Appendix – How to Use Psychodynamic Formulation: A Guide for Educators 249

Recommended Reading 253

Index 259

“This informative, thoughtfully organized, Cleary written book addresses a central topic that is being ever more exiled into the shadows of psychiatric knowledge and practice.”  (Journal of Clinical Psychiatry, 1 December 2014)

"This is the best book I have read on psychodynamic formulation.  Clearly written, with a warm, conversational style and numerous clinical examples, this book shows the reader how centrally important a psychodynamic formulation is to understanding the patient and guiding the treatment—not just in psychotherapy—but in all clinical settings.  The authors systematically guide the reader in developing skills and building knowledge to construct a psychodynamic formulation and thinking deeply about patients.  It is the most comprehensive and accessible learning guide on psychodynamic formulation to date!" (Debra Katz,Vice Chair for Education at the University of Kentucky and Director of Psychiatry Residency Training, USA)

“This highly anticipated companion text to Psychodynamic Psychotherapy: A Clinical Manual provides a sophisticated yet easily understandable approach to developing psychodynamic formulations, one of the most challenging and important aspects of learning psychodynamic psychotherapy.  Cabaniss and her coauthors understand how to present the complex world of psychodynamic psychotherapy and formulation in a way that beginning students can grasp and apply to their clinical work with patients.  The system of developing formulations (Describe-Review-Link) provides focus, clarity and the flexibility to create meaningful ways of understanding our patients that will be of great benefit to both beginners and skilled clinicians.  This book is a great advance in the way to approach developing the formulations that are the bedrock of well conceived treatment.” (David A. Goldberg, M.D California Pacific Medical Center, San Francisco, USA)