This hands-on manual from Leigh McCullough and associates teaches the nuts and bolts of practicing short-term dynamic psychotherapy, the research-supported model first presented in Changing Character, McCullough's foundational text. Introduction 1(12) PART I. THEORY, EVALUATION, AND FORMULATION Affect and Affect Phobia in Short-Term Treatment 13(22) What Is an Affect Phobia? 13(1) Why This Therapy Focuses on Affect 14(4) The Definition and Classification of Affect 18(4) Adaptive versus Maladaptive Expression of Affects 22(2) The Development and Treatment of Affect Phobias: An Introduction 24(3) The Importance of Anxiety Regulation 27(2) Goals of Treatment 29(6) Exercises 32(3) Affect Phobia, Psychodynamic Conflict, and Malan's Two Triangles 35(20) Reformulating Psychodynamic Conflict as Affect Phobia 35(2) Understanding Affect Phobias by Using Malan's Two Triangles: The Universal Principle of Psychodynamic Psychotherapy 37(7) Making Important Distinctions about Feelings 44(2) Restructuring Affect Phobias through Systematic Desensitization: The Main Treatment Objectives 46(9) Exercises 51(4) Assessment and Selection of Treatment for the Patient 55(26) Overview of the Initial Assessment 55(2) How the DSM Multiaxial Assessment Guides Treatment Selection 57(5) How to Rate the Global Assessment of Functioning (GAF) Scale 62(3) Indications and Contraindications for Short-Term Dynamic Psychotherapy 65(3) Using the GAF Scale to Tailor Treatment to Patients' Needs 68(4) The Supportive--Exploratory Continuum of Interventions 72(9) Exercises 75(6) How to Formulate a Core Psychodynamic Conflict: Spotting Affect Phobias 81(32) An Overview of the Formulation Process 81(5) Identifying Defenses: How Adaptive Feelings Are Avoided 86(2) Identifying the Adaptive Activating Feelings: What Feelings Are Feared and Avoided? 88(1) Identifying Anxieties/Inhibitions: The Reason Why Adaptive Feelings Are Avoided 89(3) Summarizing the Formulation in Terms of Affect Phobia 92(2) Examples of How to Formulate Core Conflicts 94(4) Identifying Pitfalls in Formulating Core Conflicts 98(3) Repetition to Revise and Refine the Formulation 101(8) Exercises 101(8) PART II. DEFENSE AND AFFECT RESTRUCTURING Introduction to Part II 109(4) Defense Restructuring, Section 1: Defense Recognition 113(25) Overview of Defense Recognition 113(6) Pointing Out Defenses against Phobic Affects 119(3) Validating Defenses 122(1) Pointing Out Strengths That Exist Alongside Defenses 123(1) Managing Difficult Defenses 124(6) Repeating Interventions until Defenses Are Recognized 130(8) Exercises 131(7) Defense Restructuring, Section 2: Defense Relinquishing 138(29) Overview of Defense Relinquishing 139(4) Identifying Consequences of Defensive Behavior: Costs and Benefits 143(3) Distinguishing the Origin of Defenses from the Maintenance of Defenses: Then versus Now 146(2) Grieving Losses Due to Defenses 148(1) Building Self-Compassion When There Is No Grief 149(1) Identifying the Secondary Gain of Defenses: Hidden Meanings and Rewards 150(6) Repeating Interventions to Enhance Motivation to Give Up Defenses 156(11) Exercises 158(9) Affect Restructuring, Section 1: Affect Experiencing 167(40) Overview of Affect Experiencing 167(10) Exposure to Phobic Feeling/the Feared Affect 177(12) Response Prevention: Defense Restructuring as Needed 189(1) Identifying Pitfalls in Affect Experiencing 190(3) Repeating Interventions until Affect Phobia Is Desensitized 193(2) Some Frequently Asked Questions 195(12) Exercises 196(11) Affect Restructuring, Section 2: Affect Expression 207(30) Overview of Affect Expression 208(5) Building Expressive and Receptive Capacities 213(2) Bearing Interpersonal Conflict 215(1) Integrating Feelings 216(1) Role Playing of Difficult Interactions 217(1) Providing Information to Aid Expression 218(3) Pitfalls in Affect Expression 221(2) Repeating Practice until Affect Expression Flows Naturally 223(10) Exercises 224(9) PART III. SELF- AND OTHER-RESTRUCTURING Introduction to Part III 233(4) Self-Restructuring: Building Compassion and Care for Self 237(28) Overview: Restructuring for a Positive Sense of Self 238(7) Building Receptive Capacity to One's Own Feelings 245(5) Changing Perspectives on the Self: Encouraging Patients to Imagine How Others See Them 250(4) Finding and Encouraging the Lost Voice 254(1) Encouraging ``Parenting'' of the Self 255(1) Reducing the Externalization of Needs 256(2) Repeating Interventions until Phobias about Self-Feelings Are Desensitized and Self-Worth Improves 258(7) Exercises 259(6) Other-Restructuring: Building Adaptive Inner Images of Others 265(28) Overview: Restructuring Affect Phobias about Relationships with Others 266(8) Building the Receptive Capacity to Others' Feelings 274(2) Changing Perspectives: Viewing Others More Accurately and Compassionately 276(3) Identifying and Restructuring Addictive Attachments 279(2) Recovering ``Lost Loves'': Caring Persons in the Past 281(3) Repeating Interventions until Phobias about Relationships Are Desensitized 284(9) Exercises 285(8) PART IV. DIAGNOSTIC CONSIDERATIONS AND TERMINATION Treating Specific Diagnoses: The Relationship between DSM Diagnoses and Affect Phobias 293(15) How Affect Phobias Underlie Diagnoses and Are Maintained by Primary and Secondary Gain 293(1) Integrating Nature and Nurture: The Biopsychosocial Model 294(1) Using Axis I Diagnoses to Inform Treatment of Affect Phobias 295(6) Using Axis II Diagnoses to Guide Treatment of Affect Phobias 301(6) Conclusion: Focusing on Affect Phobias That Underlie Diagnoses 307(1) Termination 308(15) Overview of Termination 308(5) Assessing What Changes Have Been Made 313(3) Assessing Why Changes Have Been Made 316(1) Celebrating Progress and Acknowledging What Needs More Work 317(1) Exploring the Full Range of Feelings for the Therapist 318(3) Replacing the Loss of Therapy 321(1) Conclusion and Commencement 322(1) Appendix Answers to Exercises 323(30) References 353(4) Index 357