Inverted Pyramid Method of Case Conceptualization.

Kohut’s Self Psychology has been identified as a useful model for

understanding developmental intervention. Kohut proposes a theory of
personality centered on the construct of self-development.
The “inverted pyramid” provides a specific stepwise method of
organizing client information that can serve as a bridge between self-
theory and its application to specific client instances.
According to Kohut adolescence is a time when emerging young
adults begin to supply their own energy and motivation for work, school
and leisure. At this time reliable goals, ideals and relationships and the
sense of continuity are required to sustain and nourish the self are
necessary for productive work and effective psychological functioning
to occur.
The following are three phase appropriate interactions with
parents which contribute to development.
1. Development of ‘grandiose self” from which emerge
ambitions, energy and desire for accomplishment. At this stage
if the child experiences parents who chronically withhold
empathy or affirmative mirroring may later be limited by
insufficient unreliable self-esteem in adulthood.
2. Development of “idealized parental image” from which
emerge ideals and mature goals around which ambitions are
organized. A child whose parents are unstable adult models
may later have difficulty forming constant, reliable young adult
goals, ideals and sense of direction.
3. Development of “twinship” or the “alter ego” which results in
mature identification with others and adult relationships and
group memberships. However if parents were insufficient
mentors, persons may find difficulty in personal and group
relationships.

Inverted Pyramid Method of Case Conceptualization.

Step 1. Problem Identification: Identify and list symptomatic

behaviour and client dimensions.
Feeling of being unloved, dislike of dad, grandmother and sister,
struggle with academics, feeling of being neglected by the dad who only
focuses on the sister, clash over daily matters with the paternal
grandmother, sense of insecurity over losing his family, getting bullied
in school, feeling of neglect by other family members who shower
attention on the sister.

Step 2. Thematic and Functional Groupings.

1. Feeling neglected and unloved by dad and other family members.
2. Struggle with academics and getting bullied in school.
3. Dislike of grandmother.
4. Sense of Insecurity.

Step 3. Inferences about difficulties in Self-functioning. Attach

thematic groupings to inferred areas of difficulty in Self-Function.
(a) Idealizing Line: - Feeling of Neglect. “Nobody loves me”.
(b) Twinship Line: - Difficulty in personal and group relationships. “I
hate my grandmother, dad and sister.”

Step 4. Narrow to Basic Defects in Self Development

Sense of self as Fractured: - Feeling of being unloved and
unwanted.