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The Lerner & Lerner Scale for assessing primitive defenses is reviewed. According to its conceptual roots, initial studies assessed the scale's efficacy in distinguishing groups of borderline patients from groups of other diagnostic entities. Later studies extended the use of the scale to assess various clinical groups assumed to have a borderline personality structure. Results from several studies indicate a high level of reliability as judged by degree of interrater agreement. In a host of studies, the scale was found to be valid in distinguishing borderline patients from other types of patients, eating disordered patients from normal controls, and gender disturbed children from normal controls. Another Rorschach scale for assessing primitive defenses was also reviewed and compared.

This study was designed to compare personality disorders in restricting and bulimic anorexics. Thirty patients fulfilled DSM‐III criteria for anorexia nervosa and 38 patients fulfilled, in addition, DSM‐III criteria for bulimia. Patients were given Axis I and II, DSM‐III diagnoses. They were administered Gunderson's Diagnostic Interview for Borderlines, the MMPI, and the Childhood Events Questionnaire. We find from these different lines of evidence that both restricter and bulimic anorexics requiring hospital treatment equally display a major character pathology. However, there are characterological differences in that bulimics tend to discharge impulses and conflicts through action, similar to their family members.

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Amid controversy, the multiple personality disorder and other disturbances involving dissociation provide fertile soil for comparing competing views of psychopathology and treatment. In this article, I describe the treatment of a highly incapacitated patient who presented with severe dissociative symptomatology. The patient was seen in psychoanalytic psychotherapy. The case is discussed in terms of defense, transference, reconstruction, and the representational world.Despite heated controversy surrounding its validity, clinical value, and heuristic importance, the diagnostic entity multiple personality disorder (MPD) has provided a fertile ground for examining competing conceptualizations of a particular psychopathological process. This is important, for how we conceptualize and think about a particular disturbance-not simply how we label it-affects the way we treat it. It influences the ambience of the treatment, how we understand the patient's productions, our therapeutic goals, and the nature and direction of our interventions.Classen, Koopman, and Spiegel (1993) considered the MPD an extreme form of dissociative syndrome that can be conceptualized as a chronic posttraumatic stress disorder. Based on empirical evidence (Coons & Milstein, 1986;Putnam, Guroff, Silverman, Barban, & Post, 1986) that has shown a relation between MPD and severe and multiple childhood traumas, the authors argued for a treatment approach tailored specifically to the type oi trauma and nature of posttraumatic symptomatology.The suggested treatment is active and directed and involves a variety of techniques including cognitive restructuring, the active mobilization of relationships, and hypnosis. Although insight is a desired goal, Classen et al.

On the basis of the work of Schachtel and Mayman, the author previously outlined an experiential approach to the Rorschach that differed from both an empirical approach and a more classic psychoanalytic approach originally proposed by Rapaport. Herein, the author further describes that approach by focusing on the person of the assessor as he or she goes about interpreting a protocol. Borrowing from the treatment literature, the author discusses the processes involved, including the need to immerse oneself in the raw data, the internal split between the experiencing self and the observing self, and the role of empathy and reflection.

With changes in the structure of the Menninger Foundation and its relocation from Topeka, Kansas, to Houston, Texas, and the greater opportunity for psychologists to obtain full psychoanalytic training, interest among psychologists/psychoanalysts in psychological testing has waned. This, in my judgment, is unfortunate, because it raises the possibility that fewer psychoanalytically oriented psychologists will be aware of the work of Rapaport and his contributions to testing. Based on the conviction that Rapaport's legacy is worth preserving, especially at a time when several are calling for a firming up of the scientific basis of psychoanalysis, in this article I review Rapaport's contributions to psychological testing, those of his students and colleagues, and discuss the work of current writers within this tradition.