Discussion of difficult assessment cases: psychodynamic perspectives.

I discuss the papers of Kleiger (this issue), Husain (this issue), and Bram (this issue), each of whom described their personality assessment of a very challenging case. Each case illustrates the way in which experienced personality assessors integrate psychoanalytic theory with clinical reasoning, multi-method assessment, and an understanding of the patient-examiner relationship when evaluating patients with serious psychiatric needs. The discussion elaborates particular aspects of each case and integrates the different estuaries through which personality assessors use psychoanalytic theory to develop diagnostic and treatment inferences.