201: Contemporary Diagnosis

Course Description

Instructor

Evan Leibu, M.D.

October 21 – December 2, 2024
Mondays, 8:35 – 10:00 pm

Co-requisites

Candidates must have at least one case in supervised psychoanalysis to be eligible to take second year courses.

Course Description

This course offers an introduction to contemporary diagnostic practices, examining how they compete with and complement psychoanalysis. We will focus on modern diagnostic frameworks, including phenomenology and neurobiology, and how these intersect with traditional psychoanalytic theories. The course will explore the impact of the DSM-III’s shift in diagnostic criteria on psychoanalytic practice, as well as the historical context and theoretical foundations of both the DSM and PDM. A critical analysis of both classic and contemporary approaches will be conducted through case studies, such as the examination of obsessive-compulsive disorder in Freud’s “Rat Man” case and the diagnosis and treatment of masochism, integrating both perspectives to inform current clinical practice.

Course Objectives

Upon completion of this course, participants should be able to:

  1. Analyze the historical and theoretical shifts introduced with the DSM-III and evaluate their impact on psychoanalytic diagnosis and practice.
  2. Apply Nancy McWilliams’ framework on Levels of Personality Organization to contemporary diagnostic scenarios, including the OCD spectrum and the “Rat Man” case.
  3. Integrate neuropsychoanalytic perspectives with classical psychoanalytic theories to enhance the understanding and treatment of personality disorders.
  4. Compare and contrast psychoanalytic and psychiatric diagnostic models, particularly in relation to obsessive-compulsive disorder and masochistic character pathology and discuss their implications for clinical treatment.

Evaluation Method

Each student’s participation in class discussion and his or her demonstration of understanding of the course objectives and reading material is assessed in a written evaluation by the instructor(s).

Schedule of Classes & Course Readings

These articles are protected under relevant copyright regulations. They are available in the New York Psychoanalytic Society & Institute Electronic Reserve for your convenience, and for your personal use.

READINGS ARE CONFIRMED.

I. How we got here: DSM, Phenomenology and Psychic Determinism

CLASS 1: October 21, 2024
REQUIRED READINGS

Mayes, R. A., & Horwitz, A. V. (2005). DSM-III and the revolution in the classification of mental disorders. Journal of the History of the Behavioral Sciences, 41(3), 249–267.

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Brenner, C. (1992). Elementary textbook of psychoanalysis (5th printing). International Universities Press. [Read pp. 1-16]

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II. Classifying a spectrum of illness: ‘Levels’ of Personality Organization

CLASS 2: October 28, 2024
REQUIRED READINGS

McWilliams, N. (1994). Levels of personality organization. Psychoanalytic Diagnosis, Guilford Press. [Read Ch. 3 & 4]

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III. Attempting Integration in Classification

CLASS 3: November 4, 2024
REQUIRED READINGS

Shedler, J., & Westen, D. (Eds.). (2006). Psychodynamic Diagnostic Manual (pp. 93-119). Guilford Press.

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Shedler, J., & Westen, D. (Eds.). (2006). Psychodynamic Diagnostic Manual (pp. 385-402). Guilford Press.

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IV. The Neuropsychoanalytic Approach

CLASS 4: November 11, 2024
REQUIRED READINGS

Kaplan-Solms, K., & Solms, M. (2002). The future of psychoanalysis in neuroscience: A methodological proposal. In Clinical Studies in Neuro-Psychoanalysis: Introduction to a Depth Neuropsychology (pp. 58-69). Other Press.

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Kaplan-Solms, K., & Solms, M. (2002). Towards a neuroanatomy of the mental apparatus. In Clinical Studies in Neuro-Psychoanalysis: Introduction to a Depth Neuropsychology (pp. 241-284). Other Press.

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V. Using a Contemporary Approach to Read Beyond the Text: OCD and the Rat Man

CLASS 5: November 18, 2o24
REQUIRED READINGS

Freud, S. (1909). Notes Upon a Case of Obsessional Neurosis. The Standard Edition of the Complete Psychological Works of Sigmund Freud. 10:151-318. [Read pp. 158-173] 

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Hollander, E., Friedberg, J. P., Wasserman, S., Yeh, C. C., & Iyengar, R. (2005). The case for the OCD spectrum. In J. S. Abramowitz & A. C. Houts (Eds.), Concepts and controversies in obsessive-compulsive disorder (pp. 95-118)

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VI. The Diagnosis of Masochism – Its role in guiding treatment

CLASS 6: November 25, 2024
REQUIRED READINGS

Blum, H.P. (2011). Masochism: Passionate Pain and Erotized Triumph. Psychoanal. Rev., 98(2):155-169.

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Cooper, A. (1988). Narcissistic-Masochistic Character in Masochism: Current Psychoanalytic Perspectives, Analytic Press: Hillsdale, NJ, pp. 117-138.

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VII. Integration and Diagnosis as it Guides Treatment

CLASS 7: December 2, 2024
REQUIRED READINGS

Kernberg, O.F. (2019). Therapeutic Implications of Transference Structures in Various Personality Pathologies. J. Amer. Psychoanal. Assn., 67(6):951-986.

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