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Mental functioning is a key concept that has been developed from different perspectives by different psychoanalytic theories. The question is to what extent it is possible to find ways for its clinical evaluation using shared criteria. The panel, ‘Observing transformations in patients: The assessment of mental functioning’, took place during Prague Congress on 2 August 2013, organized at the suggestion of the IPA Committee on Clinical Observation (chaired by Marina Altmann). Its focus was the usefulness for analysts of the assessment of patients' mental functioning and their change during treatment. This continues the work of the committee with the Three-Level Model (3-LM) for Observing Patient Transformations and the panel that took place in Mexico (August 2011) in which three diagnostic systems were discussed (OPD-2, 2008; PDM, 2006; DSM-5). The discussion then showed that, even if differently arranged, the similarities of the scales for evaluating mental functioning in the three systems was highly correlated.
The panel was chaired by Ricardo Bernardi and the presenters were Donna Bender (USA), Manfred Cierpka (Germany) and Marvin Hurvich (USA). All presenters are psychoanalysts who have had an important role in the development of the three systems relevant to several categories of the 3-LM. They presented advances in this field and their potential usefulness for case formulation and assessment of patients' transformations during analysis from a psychoanalytic perspective.
Analysts have many times expressed their reluctance to enter into diagnostic considerations because they fear it can be worthless or even detrimental for analytic work. The diagnostic categories as presented by DSM-IV or ICD-10 have been really of very limited utility. However, it is important that analysts have a means for identifying patient transformations. The question, therefore, is what dimensions can best track changes in patients and consequently help analytic work.