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Rapaport and Gill,two important later figures who contributed to the structure of psychoanalytic case formulation,argued that a comprehensive case formulation would have to include the following multiple perspectives:dynamic, structural,genetic,adaptive,topographic,and economic.That is,corresponding to the order of the preceding terms,the formulation would have to address the patient's major con-flicts (dynamic: e.g.wishes,and defenses against those wishes), those as-pects of the patient's personality involved in the conflicts(structural: e.g.,id vs. superego),the historical and developmental etiology of the conflicts(genetic),the adaptive and maladaptive compromise formations involved in the patient's defensive and coping strategies (adaptive),the conscious versus unconscious status of the conflicts(topographic),and the "eco-nomic" consequences of the preceding factors, not in the original sense of the distribution of "mobile" and "bound" cathexes but in the more de-scriptive sense of how constricted and brittle the patient's adjustment is by virtue of the excessive "energy" invested in his or her defensive ma-neuvers.Although contemporary case formulations generally contain less metapsychological language than in the past,with the exception of the economic viewpoint,they do attempt to cover the perspectives just outlined.
29 Març 2008 11:42