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This fine text articulates a theoretical framework for the process of developing a clinical and psychodynamic formulation. Richard Brockman, a psychiatrist and psychoanalyst, draws from the work of Eric Kandel and Joseph LeDoux to correlate events in the mind to events in the brain. The author is firmly rooted in the psychoanalytic tradition, referring to recent studies in neuroscience to inform and enhance his psychotherapeutic work, particularly regarding affect and insight.
Brockman approaches the mind–brain problem with pragmatism. How can approaching psychotherapy as a science enhance our psychodynamic understanding of our patients? How do advances in neuroscience deepen our dynamic formulations, clarify the role of affect, and predict a patient's capacity to hear interpretations? Brockman develops two central themes in this text. First, he applies the scientific method to the process of developing a clinical formulation. Then, he develops the concept of psychobiological freedom, which describes the patient's capacity to reflect on and contextualize affective experience.
Brockman suggests we place a priority on maintaining multiple hypotheses in the form of clinical formulations about the internal world of the patient. To Brockman, “The clinical formulation is the central aspect of the therapeutic process, establishing direction” (p. ix). The formulation is an evolutionary process, always being refined and retested. In addition, it provides direction for navigating the work. For example, holding a formulation in mind predicts enactments and anticipates specific forms of resistance.
Brockman develops a lucid and robust framework for the process of creating and using the psychodynamic formulation. He highlights the critical importance of struggling to develop a formulation from the very beginning of working with a patient. Actively holding a formulation in mind orients the work and makes sense of new data. Brockman uses the scientific method to frame this discussion