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The Psychiatric Interview in Clinical Practice

The Psychiatric Interview in Clinical Practice, Second Edition

Roger A. MacKinnon, M.D., Robert Michels, M.D., and Peter J. Buckley, M.D.
679 pages
ISBN 978-1-58562-395-2
Item #62395

In this extensively revised and expanded new edition of the classic, The Psychiatric Interview in Clinical Practice, the authors continue to address the challenges inherent in clinical interviewing—the complexities of defense mechanisms, conflicts, wishes, and fantasies—as they did in their original 1971 edition while also acknowledging the task of adapting their interview strategies to a new era of psychiatry.

New perspectives on psychopathology often emphasize descriptive phenomenological approaches and encourage psychiatric interviewing that is overly focused on describing symptoms and establishing diagnoses. The Psychiatric Interview in Clinical Practice stresses that the clinician needs to learn about patients, their problems, their illness, and their lives. From this readers will understand the universal presence of personality types and the importance of the personality as a determining factor in the unfolding of the psychiatric interview.

Students learning psychiatry often ask, "But what do I say to the patient?" In 20 new and updated chapters, The Psychiatric Interview answers that question by using clinical vignettes from the authors' everyday work, what they said in a wide variety of clinical situations and what they felt and thought that led them to say it. Specifically this new edition includes,

  • New chapter sections addressing the process of eliciting a patient's psychodynamic history and the role of information technology in the psychiatric interview.
  • New chapters on narcissistic, masochistic, anxious, traumatized, and borderline patients, emphasizing the importance of personality type in determining the evolution of psychiatric disorders and providing copious clinical detail illustrating both what to do and what not to do when interviewing these patients.
  • A new chapter presenting a contemporary perspective on "the patient of different background," in which the authors offer valuable guidance on how to approach racial, ethnic, cultural, age, and sexual-orientation differences between interviewer and patient.
  • Updated chapters on psychotic patients, patients with schizophrenia, and cognitively impaired patients, and on depressed, obsessive-compulsive, and histrionic patients, incorporating new, emotionally moving vignettes of interviewer-patient interchanges garnered from the authors' extensive clinical experience.
  • Updated chapters on hospitalized, psychosomatic, and emergency patients, which are not only psychotherapeutically instructive but also brimming with practical advice for medical students, house staff, doctors, nurses, and social workers.

Although The Psychiatric Interview in Clinical Practice is about psychiatric interviewing, many readers will likely recognize aspects of themselves in some of the clinical descriptions. The hope is that this self-recognition will lead to greater self-understanding and self-acceptance as well as to greater understanding and acceptance of others. The clinical examples are about real people, including the authors themselves, their friends, students, and patients. The authors selected situations or traits that are so common and typical that nearly all readers would be able to relate to them.

The Psychiatric Interview in Clinical Practice promises to be an enjoyable read as well as a tremendous learning experience for trainees in all of the mental health professions, from medical students and psychiatric residents to psychologists, social workers, and nurses.

Foreword. Preface. Acknowledgements. Part I: General Principles. General principles of the interview. General principles of psychodynamics. Part II: Major Clinical Syndromes. The obsessive-compulsive patient. The histrionic patient. The narcissistic patient. The masochistic patient. The depressed patient. The anxiety disorder patient. The traumatized patient. The borderline patient. The antisocial patient. The paranoid patient. The psychotic patient. The psychosomatic patient. The cognitively impaired patient. Part III: Special Clinical Situations. The emergency patient. The hospitalized patient. The patient of different background. Part IV: Technical Factors Affecting The Interview. Note taking and the psychiatric interview. Telephones, e-mail, and the psychiatric interview. Afterword. Bibliography. Index.

"The long-awaited second edition of this classic text on the psychiatric interview meets—and in fact exceeds—our expectations. In addition to broadening significantly the discussion of the diagnostic process, particularly regarding the borderline and narcissistic spectrum of personality disorders, this text expands on new developments in psychodynamic theory and their technical implications for therapy. Contemporary object relations theory, the Kleinian development, self psychology, and relational psychoanalysis are clearly and succinctly summarized and integrated into a highly sophisticated psychodynamic interview. Given the multiple pressures on the contemporary clinician that tend to compete with a focus on the comprehensive assessment of patients, this book is a most welcome call to action regarding a careful, in-depth diagnostic assessment of patients' symptoms, personality, and psychological functioning."—Otto F. Kernberg, M.D., Professor of Psychiatry, Weill Medical College of Cornell University, New York, New York; Director, Personality Disorders Institute, The New York-Presbyterian Hospital, Payne Whitney Westchester, White Plains, New York; and Former President, International Psychoanalytic Association

"This book is a must-read for anyone interested in human relationships and mental disorders."—Thomas F. Anders, M.D., Distinguished Professor Emeritus, Dept of Psychiatry & Behavioral Sciences, UC Davis M.I.N.D. Institute; President, American Academy of Child and Adolescent Psychiatry

"The scope of this text is far greater than the clinical interview. The authors include in their chapters detailed discussions of differential diagnosis that go well beyond the descriptive characteristics on which most discussions are based. They also incorporate vignettes that reflect psychotherapeutic strategies. In this regard, the book is also useful in teaching psychotherapy to beginning trainees. . . . Readers who spend time dipping into this volume will be richly rewarded with the wealth of clinical wisdom in its pages."—Glen O. Gabbard, M.D., Brown Foundation Chair of Psychoanalysis and Professor of Psychiatry, Baylor College of Medicine, Houston, Texas

Roger A. MacKinnon, M.D., is Professor Emeritus of Clinical Psychiatry at the College of Physicians and Surgeons of Columbia University in New York, New York.

Robert Michels, M.D., is Walsh McDermott University Professor of Medicine and Psychiatry at Weill Medical College of Cornell University in New York, New York.

Peter J. Buckley, M.D., is Professor of Psychiatry at Albert Einstein College of Medicine of Yeshiva University in Bronx, New York.