On being human: The power of specificity in psychotherapy in the South African context.

In this paper, we are concerned with the relevance of psychodynamic therapy in the South African context, where treatment is often brief, interrupted and conducted in compromised conditions. We present the case of Lana, a 25 year old South African coloured woman, who was diagnosed with depression and who sought psychotherapy at a university clinic. We aim to illustrate how focusing on the specificity of the case (the dynamics of the patient and therapist and their particular process) over and above the psychiatric diagnosis of the patient, was helpful therapeutically. It is our contention that understanding one's patient from a psychodynamic perspective can have value in the South African public sector. After introducing the case, we present the psychodynamic formulation which draws on McWilliams's notion of psychodynamic diagnosis and Fairbairn's object relations theory. We then discuss the ways in which the formulation facilitated an idiosyncratic approach to understanding and working with Lana over the course of therapy, and how this led to positive therapeutic outcomes. We argue that focusing on the specificity of cases is important in facilitating effective therapeutic interventions, and that this may be particularly true in contexts where a compromised treatment structure and power differentials can lead to therapist paralysis or other enactments. [ABSTRACT FROM AUTHOR]