The Psychotherapist's Interventions: Integrating Psychodynamic Perspectives in Clinical Practice / Edition 1

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This book, which focuses on the psychotherapist's interventions, presents the basic critical activity of the therapist. It applies two predominant paradigms–conflict and deficit–in the treatment of a wide range of patients. The therapist must address and deal with conflictual concomitants as well as developmental derailments because the patient is a product of both. Excerpts of verbatim dialogue are offered to articulate the course of psychotherapeutic interaction as a successive series of co-created communications. Explicit commentaries, interwoven throughout the text, inform the reader of the practitioner's rationale for the particular stand taken (for better or worse) at each moment of the therapeutic process. They provide an intimate vehicle through which to listen to, and understand, the clinician's inner voice during the real-life practice of psychotherapy. Pathology and practice reside on a continuum. Conflict theory does not apply solely to the neuroses, nor does object relations apply only to borderline disorders, and self theory need not be reserved for narcissistic disturbances. The hysterical patient can have ego deficits as well as sexual conflicts; similarly, the depressive patient can show self deficiencies as well as unresolved conflictual problems. Moreover, conflicts are not necessarily restricted to oedipal phases nor deficits to preoedipal ones. Dr. Karasu delineates a clinical approach by which psychotherapy can be geared toward remedying both the underlying psychological deficits (lacks) and the conflicts (wishes/fears) in the progressive maturation and adaptation of an individual. He effectively integrates the major psychodynamic models. No single school can meet the needs of the practitioner in interaction with all patients. Psychotherapy practice for the future will be based on the individual patient's developmental pathology and problems, deficits and conflicts, defenses and compromise formations, unfulfilled needs and unfinished tasks, as well as the level of adaptation and

Incl. ego psychology, object relations theory, self psychology & interpersonal analysis; deficit/conflict etc.

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Editorial Reviews

Paul A. Dewald
Based on his vast clinical experience, Karasu demonstrates that one single theoretical model cannot encompass the entire spectrum of psychopathology presented by patients. He integrates current dynamic theoretical models of psychopatholoy and psychotherapy, using a developmental approach. The unique synthesis in his final chapter can serve as a basis for future development of the art and science of psychotherapy.
Otto F. Kernberg
Drawing on the contributions of ego psychology, object relations theory, self psychology, and interpersonal analysis, Karasu proposes an original integration in a model that combines deficit and conflict theories and dyadic and triadic object relations. He moves eloquently from theory of psychotherapeutic technique to practical clinical interventions with different types of personality organization, helping the psychoanalytic psychotherapist close the gap between theoretical formulation and the immediate, intuitive management of a broad spectrum of patients.
Judd Marmor
A thoughtful, sophisticated, integrative approach to contemporary thinking about the psychotherapeutic process. The case excerpts and Dr. Karasu's accompanying commentaries are extremely instructive and insightful. This is really an outstanding piece of work.
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Product Details

  • ISBN-13: 9781568216898
  • Publisher: Aronson, Jason Inc.
  • Publication date: 1/28/1998
  • Edition description: New Edition
  • Edition number: 1
  • Pages: 344
  • Product dimensions: 6.46 (w) x 9.16 (h) x 0.98 (d)

Meet the Author

T. Byram Karasu, M.D., a graduate of the Yale School of Medicine, Department of Psychiatry, is presently the Silverman Professor and University Chairman of the Deparmtent of Psychiatry and Behavioral Sciences at Albert Einstien College of Medicine/Montefiore Medical Center, and the editor-in-chief of the American Journal of Psychotherapy. He is the author or editor of 20 books, including two novels, Of God and Madness and The Gotham Chronicles—The Culture of Sociopathy; a book of poetry, Rags of My Soul; the seminal work, Treatments of Psychiatric Disorders; and two best sellers, The Art of Serenity and The Spirit of Happiness. Dr. Karasu is a scholar, renowned clinician, teacher and lecturer, and the recipient of numerous awards. He lives in New York City.


Renowned throughout the medical community, psychiatrist T. Byram Karasu, M.D. is the Silverman Professor and Chairman of the Department of Psychiatry & Behavioral Sciences at Albert Einstein College of Medicine and Psychiatrist-in-Chief of Montefiore Medical Center in New York City. A Distinguished Life Fellow of the American Psychiatric Association, he has received numerous awards, including the prestigious Sigmund Freud Award and the APA's Presidential Commendation.

Dr. Karasu has published extensively in professional journals and is the author of psychiatric textbooks such as the seminal Treatments of Psychiatric Disorders. He has also written spiritual self-help guides, including the New York Times bestsellers The Art of Serenity and The Spirit of Happiness; and, in 2009, he published Rags of My Soul, a first book of poetry.

Good To Know

Karasu explained in our interview how he likes to unwind: "I like quietness; I seek sanctuary in places protected from the sounds of civilization. I like to sit still in my garden -- I am a good gardener, hard labor part included -- and I listen to nature, the ultimate teacher. There for hours I do nothing, waiting, not even waiting, just being. At times I touch a flower, I kiss its petals; I try to get very close to bumblebees and butterflies -- a few times their wings hit my eyelashes. In the garden I commune with the birds, insects and vegetation. I feel one with them and whole."

"My other sanctuaries are writing and reading where I converse with myself and with other authors. Reading a minimum of 200 books to writing 1 is a reasonable proportion. Those who write more than they read, tend to rediscover the wheel -- a lower quality of that. Other times I spend time with friends, my alternative home."

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    1. Also Known As:
      Toksoz Karasu, Toksoz B. Karasu, Toksoz Byram Karasu
    2. Hometown:
      New York, New York, and Westport, Connecticut
    1. Date of Birth:
      February 11, 1935
    2. Place of Birth:
      Erzurum, Turkey
    1. Education:
      University of Istanbul School of Medicine, 1959; Yale University School of Medicine, Department of Psychiatry, 1969

Table of Contents

1 The Developmental Model 3
2 Four Developmental and Clinical Configurations 15
3 Primary Relationship Patterns 29
4 The Dyadic Deficit Patient and the Empathic Self-Object 47
5 The Dyadic Conflict Patient and the Projective Container 133
6 The Triadic Deficit Patient and the Prosocial Introject 193
7 The Triadic Conflict Patient and the Reflective Object 249
8 Conclusion: Practice for the Future 309
References 319
Index 335
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