Perry J C, Luborsky L, Silberschatz G, Popp C
Department of Psychiatry, Cambridge Hospital, MA.
Psychiatry. 1989 Aug;52(3):302-23. doi: 10.1080/00332747.1989.11024452.
While psychodynamic theory and therapy are approaching their centennial, the science of psychodynamics is still in an earlier developmental stage. Any scientific field generates the most controversy and excitement when it is still developing. For psychodynamic psychology this means that its basic units of observation as well as its rules for justifying clinical inference in formulating and testing dynamic hypotheses require more development. In short, we are still evaluating different methods for both discovering and validating psychodynamic propositions. This is especially true for central features of dynamic psychology, including intrapsychic conflict, relationships, and transference patterns. This report compares three different methods for making a dynamic case formulation: 1) the Core Conflictual Relationship Theme (CCRT) of Luborsky (Crits-Christoph and Luborsky 1985a,b; Luborsky 1976, 1977, 1984, and companion paper in this issue; Levine and Luborsky 1981), 2) the Plan Diagnosis (PD) method of Silberschatz, Curtis and colleagues of the Mount Zion group (Caston 1986; Curtis and Silberschatz 1986; Rosenberg et al. 1986; Curtis et al. 1988) and, 3) the Idiographic Conflict Formulation (ICF) of Perry and Cooper (1985, 1986, and companion paper in this issue). Each has a slightly different focus. The CCRT focuses on relationship patterns as the central feature of individual dynamics and transference in or out of the treatment situation. The Plan Diagnosis focuses on dynamic features related to transference, resistance and insight in therapy. The Idiographic Conflict Formulation focuses on stress and internal conflict, and the individual's adaptation to them in or out of treatment.
尽管心理动力学理论和疗法即将迎来百年诞辰，但心理动力学科学仍处于早期发展阶段。任何科学领域在发展过程中都会引发最多的争议和兴奋点。对于心理动力学心理学而言，这意味着其基本观察单位以及在制定和检验动力学假设时为临床推断提供依据的规则都需要进一步发展。简而言之，我们仍在评估用于发现和验证心理动力学命题的不同方法。对于动力心理学的核心特征，包括心理内部冲突、人际关系和移情模式，情况尤其如此。本报告比较了三种不同的进行动力学个案制定的方法：1）卢伯斯基的核心冲突关系主题（CCRT）（克里茨 - 克里斯托夫和卢伯斯基，1985a，b；卢伯斯基，1976，1977，1984，以及本期的配套论文；莱文和卢伯斯基，1981），2）锡安山小组的西尔伯沙茨、柯蒂斯及其同事的计划诊断（PD）方法（卡斯顿，1986；柯蒂斯和西尔伯沙茨，1986；罗森伯格等人，1986；柯蒂斯等人，1988），以及3）佩里和库珀的个性化冲突制定（ICF）（1985，1986，以及本期的配套论文）。每种方法的侧重点略有不同。CCRT将关系模式作为个体动力学和治疗情境内外移情的核心特征。计划诊断侧重于与治疗中的移情、阻抗和领悟相关的动力学特征。个性化冲突制定侧重于压力和内部冲突，以及个体在治疗情境内外对它们的适应。
