Jeff Fine-Thomas

This is perhaps @JonathanShedler most consequential essay. "We contribute most by being first-rate psychologists, not aspiring to be second-rate physicians."

We can't afford to continue on the path of the previous DSM. I hope the committees will take thoughtful feedback such as suggested by @awaisaftab.

@nadeemhasanpsyd Interesting.

@jefffinethomas CBT approaches (e.g., Beck) seemed to revolved around DSM formulations, plus, I'm sure clinical experience. One supervisor was interested in Millon, but it wasn't a focus of his teaching.

I'm working on a writing project and would love your feedback. When you were in grad school, did you learn about personality styles? If so, in what class?

@nadeemhasanpsyd Say more... what did you learn?

@jefffinethomas Not psychoanalytic ones.

@chris_cannida That's great that they introduced Kernberg. That's more than I got.

@jefffinethomas You expect me to remember 1980?? Yes. Yes they did. That’s where I was first introduced to Kernberg, et al. What I don’t recall is them going deep into how one works with them in therapy.

@racheloblak @JonathanShedler I think a lot of people didn't get a basic understanding of personality in grad school, myself included.

@jefffinethomas @JonathanShedler One of my internship sites mentioned Nancy McWilliams as helpful for case conceptualization, but I didn't have time at the time to delve into her. The psychoanalytic angle was new to me with readings after grad school when I wasn't buried in textbook readings.

@JV_Greetings Hmmm....

@jefffinethomas Nope!

@_adidamas Hmmm... was it covered in case conceptualization?

@jefffinethomas Counselor, Masters Program. Nope, nada. Closest thing was personality disorders in diagnosis class.

@racheloblak @JonathanShedler Did anyone cover personality as it pertained to case conceptualization when you were in grad school?

@jefffinethomas Not as styles, only as disorders. It was revolutionary to discover @JonathanShedler's and Nancy McWilliams' material on this.

@chris_cannida Hi Chris! But, in your Theories of Personality class did they go over personality styles?

@jefffinethomas Yup. Theories of Personality at good ole’ Oklahoma State University

@JV_Greetings That's rough. When you learned case conceptualization, was personality a topic to be considered?

@jefffinethomas Mental health counseling masters. Not even a little bit!

@sheshariyo That's fantastic. You had 2 classes on psychoanalytic theory and practice? That seems unusual these days. Were they required or elective?

@jefffinethomas Currently a clinical psychology doctoral student. We learned about personality styles in two courses during the first year. The classes were Individual Psychoanaltyic Psychotherapy and Basic concepts in psychodynamic therapy.

@breckmundis Interesting. Did you learn anything about personality in practicum/internship?

@jefffinethomas In my social work grad school, nothing about personality styles. Personality commentary was limited to DSM disorders in a psychopathology class.

@drmbennett That's good to hear. When you learned case conceptualization, did they teach you to include personality?

@jefffinethomas In my doctoral psych program, yes, but only in classes about psychodynamic theory.

@LurkingJenny I agree. I get that professors have pressure to publish research and that probably limits their time to do clinical work. But, if I'm wanting to learn clinical work, I want to learn it from someone who is expert at it.

@jefffinethomas That is just the tip of the disturbing iceberg. I don't think it is possible to teach students to do *good* clinical work if you are not doing it yourself. There are so many problems with grad schools/training institutes right now.

@LurkingJenny Oof, I'm sorry to hear that. I guess I'm not surprised to hear stories like yours but it's always disturbing.

@jefffinethomas There also wasn't really "case formulation." There was: identify the symptoms and look at the DSM to see which diagnosis is most likely. It was bad. Really bad.

@LurkingJenny Thanks @LurkingJenny. When you were in grad school did you learn that you should include personality factors when you formulate cases?

@jefffinethomas I was in a grad program for clinical mental health counseling and graduated in 2017. Never learned about personality styles.

Skilled psychotherapy is yin and yang, head and heart, tough and tender, warm acceptance and cold reason, in continual counterbalance. Without one, there’s no connection. Without the other, there’s no change. Today’s therapy culture has lost the balance.