ABSTRACT
My teaching students the art of the clinical formulation begins with an introduction to the dialectic concerning psychopathology. The mainstream view is empirical and holds that psychopathology—at least in its more severe forms—is a biopsychosocial reality, real, palpable almost in its concreteness. Severe psychopathological states have genetic diatheses, clear onsets, more-or-less typical untreated clinical courses, and predictable endings. They can be studied using state-of-the-art scientific methods and ultimately will yield to an accurate appraisal of the complex interplay of many causative variables.
