Narrative Fallacy and Other Limitations of Psychodynamic Case Formulation

This paper describes a phenomenon of narrative fallacy in psychodynamic psychotherapy andmakes a case that it is likely related to therapists’ working memory limitations. The impact ofnarrative fallacy on model complexity is examined with a focus on further improving theefficacy of clinical treatment. The specifics of the psychodynamic meaning-making processgravitating toward searching for causal or teleological explanations are reviewed. Tentativeperspectives on these processes from the standpoint of active inference and neuropsychology arepresented. This paper also examines the issues with verifiability in the psychodynamichypothesis testing process with a focus on the Barnum/Forer effect. Preliminary proposals areformulated to help mitigate the impact of these issues on clinical practice.