Focus: The importance of diagnosis
Vol. 37 No. 1 (2026)
Operationalized Psychodynamic Diagnosis. Tailor-made: the experience of meeting with the patient in diagnosis and during the therapeutic process
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: 30 April 2026
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The article presents the Operationalized Psychodynamic Diagnosis in its newest third version (OPD-3) as a clinical, educational, and research tool capable of responding to the needs of so-called “real therapies” in institutional contexts and in daily clinical practice. Drawing on a critical reflection on the limitations of categorical diagnostic systems and the inherent difficulties in defining “fact” in clinical practice, the article explores the role of theories, beliefs, and “private theories” between patient and therapist in the process of psychodynamic observation and understanding. The risk of premature closure of clinical thinking, linked to the Bionian concept of “chosen fact” and the notion of “overvalued ideas”, is discussed, stressing the importance of bottom-up tools that foster a phenomenological description that is rigorous but open to complexity. In this framework, the OPD is presented as a multi-axial and procedural diagnostic model, capable of integrating different levels of observation – disease experience, interpersonal relationships, intrapsychic conflicts, and personality structure – while maintaining a balance between standardization and attention to the uniqueness of each case. Ample space is devoted to the theoretical and clinical framework of the OPD-3, to the main innovations introduced in the third edition of the manual, and its use for diagnosis, planning, and monitoring of treatment.
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Operationalized Psychodynamic Diagnosis. Tailor-made: the experience of meeting with the patient in diagnosis and during the therapeutic process. (2026). Ricerca Psicoanalitica, 37(1). https://doi.org/10.4081/rp.2026.1160
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