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Psychodynamic Diagnostic Manual #2
Psychodynamic Diagnostic Manual PDM-2
Now completely revised (over 90% new), this is the authoritative diagnostic manual grounded in psychodynamic clinical models and theories. Explicitly oriented toward case formulation and treatment planning, PDM-2 offers practitioners an empirically based, clinically useful alternative or supplement to DSM and ICD categorical diagnoses. Leading international authorities systematically address personality functioning and psychological problems of infancy, childhood, adolescence, adulthood, and old age, including clear conceptualizations and illustrative case examples. Purchasers get access to a companion website where they can find additional case illustrations and download and print five reproducible PDM-derived rating scales in a convenient 8 1/2" x 11" size.
New to This Edition
*Significant revisions to all chapters, reflecting a decade of clinical, empirical, and methodological advances.
*Chapter with extended case illustrations, including complete PDM profiles.
*Separate section on older adults (the first classification system with a geriatric section).
*Extensive treatment of psychotic conditions and the psychotic level of personality organization.
*Greater attention to issues of culture and diversity, and to both the clinician's and patient's subjectivity.
*Chapter on recommended assessment instruments, plus reproducible/downloadable diagnostic tools.
*In-depth comparisons to DSM-5 and ICD-10-CM throughout.
Sponsoring associations include the International Psychoanalytical Association, Division 39 of the American Psychological Association, the American Psychoanalytic Association, the International Association for Relational Psychoanalysis & Psychotherapy, the American Association for Psychoanalysis in Clinical Social Work, and five other organizations.
Winner--American Board and Academy of Psychoanalysis Book Prize (Clinical Category)
New to This Edition
*Significant revisions to all chapters, reflecting a decade of clinical, empirical, and methodological advances.
*Chapter with extended case illustrations, including complete PDM profiles.
*Separate section on older adults (the first classification system with a geriatric section).
*Extensive treatment of psychotic conditions and the psychotic level of personality organization.
*Greater attention to issues of culture and diversity, and to both the clinician's and patient's subjectivity.
*Chapter on recommended assessment instruments, plus reproducible/downloadable diagnostic tools.
*In-depth comparisons to DSM-5 and ICD-10-CM throughout.
Sponsoring associations include the International Psychoanalytical Association, Division 39 of the American Psychological Association, the American Psychoanalytic Association, the International Association for Relational Psychoanalysis & Psychotherapy, the American Association for Psychoanalysis in Clinical Social Work, and five other organizations.
Winner--American Board and Academy of Psychoanalysis Book Prize (Clinical Category)
1078 pages, Paperback
Published June 20, 2017
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Displaying 1 - 5 of 5 reviews
July 6, 2017
How is this "90% new" when the section on Feeding and Eating Disorders reflects an understanding of these difficulties that could seamlessly fit into a book written in the early seventies? I'm taken aback by the carelessness with which this topic was approached.
February 20, 2022
I read this boob as a reference and not from beginning to end. Like a bird who come and eat some seed and go away and come back again and do the same whenever needs.
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January 4, 2023I like much of the psychoanalytic writing of Nancy Mcwilliams, on diagnosis, therapy, case formation. I just acquired the PDM2, which macwilliams has had a lot to do with. The Psychodynamic Diagnostic Manual, Second Edition is an alternative to the DSM, offering a more enlightened, scientifically informed and humanistic, talking therapy oriented perspective. I have so far only read bits and pieces of it.
I am generally annoyed when i read a review in which someone has found a reference to some single issue about which they have strong views, has read a few pages of a book dealing with this issue and has then rushed ahead with a sweeping condemnation of the book because these few pages dont happen to be in tune with their particular perspective.
I do not intend what follows to be taken as an attack on this book. Knowing the involvement of McWilliams I am quite sure that the book is full of good things. But having done exactly what I have just referred to, looked up a couple of controversial topics where McWilliams perspective has not been clear from other writings, I now do feel a bit more sympathy for some of the jump the gun reviews in question. Some issues are just too important to get wrong.
I read the section on 'sexual incongruence' and found it to be deeply ambivalent and contradictory, veering between uncritical support for affirmation and medical intervention and support for 'detailed diagnosis and psychological treatments.; [p 445-6] I suppose I had expected that psychoanalytically informed researchers would have been the first to see though the utterly unscientific and incoherent gender ideology. Yet here was the idea taken for granted that there really are gender dysphoric or trans individuals who really can be accurately diagnosed and can and should be treated with puberty blockers and surgery. The writers refer critically to earlier researchers whose 'theories conflated gender identity with sexual orientation..'..yet they themselves do precisely this, failing to pick up on the fact that this 'dysphoria' is frequently a confused child's response to hostility to their developing homosexual feeling. The account follows the typical sexism of trans gender ideology in supposing some magical inborn gender essence of masculinity or femininity sometimes at odds with bodily sexuality, rather than seeing gender as the social stereotyping of a patriarchal sex class system.
In the section on Lesbian, Gay and Bisexual Populations the text actually acknowledges that 'given the pervasiveness of heteronormativity and sexism, development in children who grow up to be lesbian, gay or bisexual, is often characterised by 'gender confusion' and 'gender stress'. in gender confusion, individuals interpret their first same sex attractions by using gender stereotypes. for example a girl may think 'since i'm attracted to women then i'm a man...' And 'homonegativity is pervasive in a variety of contexts..' [p 443]. Exactly right. yet on the very next page this is completely forgotten. In addressing 'gender Incongruence' the text tells us that '... because psychotherapeutic approaches have not proven successful in relieving gender incongruence social, juridical, medical, and surgical gender reassignment is currently the treatment of choice......Gender reassignment with hormonal and/or surgical treatment has been reported to improve the social, psychological and sexual well being and functioning of gender incongruent adolescents...' '''progressive and accepting communities are increasingly creating safe spaces; positive transgender role models and networks of families with gender variant children may be available'. These claims are made without qualification, logical argument or solid evidence. They are completely at odds with the generally anti drugs, insight based approach of McWilliams and other psychoanalysts,.
They are also at odds with the increasing numbers of public health authorities, including the Florida Board of Medicine, the UK Health Advisory Board and National Institute of Health Care Excellence, that have found past research supposedly supporting beneficial outcomes from use of puberty blockers, cross sex hormones and surgical interventions to address childhood gender dysphoria, is generally of very poor quality. NICE refers to 'existing studies being 'small and subject to bias and confounding.' The UK Cass review into the operation of the Tavistock GIDS Clinic came to similar conclusions and led to the closure of the Clinic on grounds of potential harm caused by its affirmative, non exploratory approach, with immediate resort to puberty blockers.
Radical feminists and other critics of gender ideology, including increasing numbers of concerned parents, will be asking at this point, given that there are now school classes around the western world where half the class go on the internet and come back the next day declaring themselves to be trans, exactly how it can be asserted that 'psychotherapeutic approaches' can be 'ruled out'.. And exactly how spaces for children can be described as 'safe' as they push such children towards poisoning and bodily mutilation, towards brain damage, castration, d.estruction of fertility and of sexual feeling, on the basis of lies about boys really being girls or really being able to become girls, and vice versa. ....But then the text switches again. 'Decisions about gender reassignment in adolescence should be made only after a comprehensive medical and psychological evaluation' [p446]. The question is, what evaluation and on what basis are these decisions supposed to be made ? The implication seems to be that some sort of appropriately in depth investigation could identity girls who really are boys and boys who really are girls. But there is no such investigation.
I identified one source of the 'gender dysphoria' phenomenon in children being victims of homophobia. This book does so too, though not while actually discussing dysphoria. I think that reference to other forms of child abuse are needed for a more comprehensive explanation. There are obviously now strong and increasing elements of social /psychological contagion, with strong hysterical dimensions. Freuds own writing on Group Psychology, possibly reread in light of Bions Experiences in Groups and the insights of Klein and Alice Miller into group psychology are probably important here. There is strong evidence of mis or undiagnosed autistic issues being involved in some cases.......
DSM 5 is desperate not to equate non mainstream sexual orientations with mental illness. And it identifies particular sexual interests with disorders only where those concerned feel personal [as opposed to social] distress about their interest or where their desire or behaviour involves others distress, injury or death, or involves sexual relations with unwilling others or others unable to give legal consent. Some leading trans activists like Andrea james, were initially quite happy to identify themselves as autogynephiles, subject to a paraphilic 'sexual condition', if not a disorder or perversion. They accepted that their cross dressing was associated with their being sexually aroused by the idea of having a female body. But then male trans activists, including James, decided to turn against and reject the whole idea of autogynephilia. They were not sexually turned on by a fantasy of becoming or already being a woman, rather their thoughts were evidence of their really being women. or they were responses to their being born in the 'wrong' body. Here again, the PDM2 appears to defer to such trans activists seeking to portray their fantasy as reality, to mystify their actual psychology and motivation, in not acknowledging the existence of autogynephilia. There is no mention of anywhere in this book as far as I can see. But the desire of some male autogynefiles to have sex with lesbians, frequently expressed in rude, threatening and aggressive fashion , certainly involves serious distress on the part of some lesbians.
In her study of Psychoanalytic Psychotherapy, McWilliams says [p137] that 'self knowledge is one goal of psychoanalytic treatment, but a more profound goal is self acceptance.' You cannot accept who you truly are unless you have genuine knowledge of who you are. Yet in this area of 'incongruence' apparently knowledge and acceptance go out of the window. Therapists are here urged to endorse and be guided by radical misapprehensions and delusions.
Nobody is 'assigned a gender at birth'. The great majority of newborns or preborms are correctly identified as of male or female sex. A tiny percentage are correctly identified as intersex. Misidentifiction happens in a minute percentage of cases of eg androgen insensitivity (where the categorisation should have been intersex) . This great majority of dichotomously sexed beings then become subject, by virtue of this identification, to different patterns of socialisation which turn them into dichotomously gendered adults. In a patriarchal society this socialisation involves a greater or lesser degree of restrictive stereotyping and the maintenance of an oppressive sex class system of domination.
Rather than rejecting patriarchal stereotypes, homophobia and misogyny, gender ideology endorses and embraces them. You are a girl who likes girls. Or cars . Or plumbing. You are a boy who likes boys or babies or knitting. Your [true, essential] gender doesn't match your bodily sex. But you will be ok, will be happy, if such bodily sex is altered, corrected, by being brought into alignment with true gender. And the next step is radical physical assault upon the bodies of vulnerable young people, particularly young lesbians. And grovelling support for ruthless autogynephilic men insisting that they are lesbian women.
I am generally annoyed when i read a review in which someone has found a reference to some single issue about which they have strong views, has read a few pages of a book dealing with this issue and has then rushed ahead with a sweeping condemnation of the book because these few pages dont happen to be in tune with their particular perspective.
I do not intend what follows to be taken as an attack on this book. Knowing the involvement of McWilliams I am quite sure that the book is full of good things. But having done exactly what I have just referred to, looked up a couple of controversial topics where McWilliams perspective has not been clear from other writings, I now do feel a bit more sympathy for some of the jump the gun reviews in question. Some issues are just too important to get wrong.
I read the section on 'sexual incongruence' and found it to be deeply ambivalent and contradictory, veering between uncritical support for affirmation and medical intervention and support for 'detailed diagnosis and psychological treatments.; [p 445-6] I suppose I had expected that psychoanalytically informed researchers would have been the first to see though the utterly unscientific and incoherent gender ideology. Yet here was the idea taken for granted that there really are gender dysphoric or trans individuals who really can be accurately diagnosed and can and should be treated with puberty blockers and surgery. The writers refer critically to earlier researchers whose 'theories conflated gender identity with sexual orientation..'..yet they themselves do precisely this, failing to pick up on the fact that this 'dysphoria' is frequently a confused child's response to hostility to their developing homosexual feeling. The account follows the typical sexism of trans gender ideology in supposing some magical inborn gender essence of masculinity or femininity sometimes at odds with bodily sexuality, rather than seeing gender as the social stereotyping of a patriarchal sex class system.
In the section on Lesbian, Gay and Bisexual Populations the text actually acknowledges that 'given the pervasiveness of heteronormativity and sexism, development in children who grow up to be lesbian, gay or bisexual, is often characterised by 'gender confusion' and 'gender stress'. in gender confusion, individuals interpret their first same sex attractions by using gender stereotypes. for example a girl may think 'since i'm attracted to women then i'm a man...' And 'homonegativity is pervasive in a variety of contexts..' [p 443]. Exactly right. yet on the very next page this is completely forgotten. In addressing 'gender Incongruence' the text tells us that '... because psychotherapeutic approaches have not proven successful in relieving gender incongruence social, juridical, medical, and surgical gender reassignment is currently the treatment of choice......Gender reassignment with hormonal and/or surgical treatment has been reported to improve the social, psychological and sexual well being and functioning of gender incongruent adolescents...' '''progressive and accepting communities are increasingly creating safe spaces; positive transgender role models and networks of families with gender variant children may be available'. These claims are made without qualification, logical argument or solid evidence. They are completely at odds with the generally anti drugs, insight based approach of McWilliams and other psychoanalysts,.
They are also at odds with the increasing numbers of public health authorities, including the Florida Board of Medicine, the UK Health Advisory Board and National Institute of Health Care Excellence, that have found past research supposedly supporting beneficial outcomes from use of puberty blockers, cross sex hormones and surgical interventions to address childhood gender dysphoria, is generally of very poor quality. NICE refers to 'existing studies being 'small and subject to bias and confounding.' The UK Cass review into the operation of the Tavistock GIDS Clinic came to similar conclusions and led to the closure of the Clinic on grounds of potential harm caused by its affirmative, non exploratory approach, with immediate resort to puberty blockers.
Radical feminists and other critics of gender ideology, including increasing numbers of concerned parents, will be asking at this point, given that there are now school classes around the western world where half the class go on the internet and come back the next day declaring themselves to be trans, exactly how it can be asserted that 'psychotherapeutic approaches' can be 'ruled out'.. And exactly how spaces for children can be described as 'safe' as they push such children towards poisoning and bodily mutilation, towards brain damage, castration, d.estruction of fertility and of sexual feeling, on the basis of lies about boys really being girls or really being able to become girls, and vice versa. ....But then the text switches again. 'Decisions about gender reassignment in adolescence should be made only after a comprehensive medical and psychological evaluation' [p446]. The question is, what evaluation and on what basis are these decisions supposed to be made ? The implication seems to be that some sort of appropriately in depth investigation could identity girls who really are boys and boys who really are girls. But there is no such investigation.
I identified one source of the 'gender dysphoria' phenomenon in children being victims of homophobia. This book does so too, though not while actually discussing dysphoria. I think that reference to other forms of child abuse are needed for a more comprehensive explanation. There are obviously now strong and increasing elements of social /psychological contagion, with strong hysterical dimensions. Freuds own writing on Group Psychology, possibly reread in light of Bions Experiences in Groups and the insights of Klein and Alice Miller into group psychology are probably important here. There is strong evidence of mis or undiagnosed autistic issues being involved in some cases.......
DSM 5 is desperate not to equate non mainstream sexual orientations with mental illness. And it identifies particular sexual interests with disorders only where those concerned feel personal [as opposed to social] distress about their interest or where their desire or behaviour involves others distress, injury or death, or involves sexual relations with unwilling others or others unable to give legal consent. Some leading trans activists like Andrea james, were initially quite happy to identify themselves as autogynephiles, subject to a paraphilic 'sexual condition', if not a disorder or perversion. They accepted that their cross dressing was associated with their being sexually aroused by the idea of having a female body. But then male trans activists, including James, decided to turn against and reject the whole idea of autogynephilia. They were not sexually turned on by a fantasy of becoming or already being a woman, rather their thoughts were evidence of their really being women. or they were responses to their being born in the 'wrong' body. Here again, the PDM2 appears to defer to such trans activists seeking to portray their fantasy as reality, to mystify their actual psychology and motivation, in not acknowledging the existence of autogynephilia. There is no mention of anywhere in this book as far as I can see. But the desire of some male autogynefiles to have sex with lesbians, frequently expressed in rude, threatening and aggressive fashion , certainly involves serious distress on the part of some lesbians.
In her study of Psychoanalytic Psychotherapy, McWilliams says [p137] that 'self knowledge is one goal of psychoanalytic treatment, but a more profound goal is self acceptance.' You cannot accept who you truly are unless you have genuine knowledge of who you are. Yet in this area of 'incongruence' apparently knowledge and acceptance go out of the window. Therapists are here urged to endorse and be guided by radical misapprehensions and delusions.
Nobody is 'assigned a gender at birth'. The great majority of newborns or preborms are correctly identified as of male or female sex. A tiny percentage are correctly identified as intersex. Misidentifiction happens in a minute percentage of cases of eg androgen insensitivity (where the categorisation should have been intersex) . This great majority of dichotomously sexed beings then become subject, by virtue of this identification, to different patterns of socialisation which turn them into dichotomously gendered adults. In a patriarchal society this socialisation involves a greater or lesser degree of restrictive stereotyping and the maintenance of an oppressive sex class system of domination.
Rather than rejecting patriarchal stereotypes, homophobia and misogyny, gender ideology endorses and embraces them. You are a girl who likes girls. Or cars . Or plumbing. You are a boy who likes boys or babies or knitting. Your [true, essential] gender doesn't match your bodily sex. But you will be ok, will be happy, if such bodily sex is altered, corrected, by being brought into alignment with true gender. And the next step is radical physical assault upon the bodies of vulnerable young people, particularly young lesbians. And grovelling support for ruthless autogynephilic men insisting that they are lesbian women.
February 17, 2021
The PDM-2 offers a psychodynamic view of diagnosis and case formulation in psychotherapy. It is a much more useful way of looking at mental health than the more familiar DSM-5
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March 9, 2018616.89001 P9745 2017
Displaying 1 - 5 of 5 reviews