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Table 6 Illustrations of “Inferred mechanism”, by different clinicians (1 and 2), both matched (patient X) and mismatched (patient Y)

From: Psychodynamic case formulations without technical language: a reliability study

Patient X Clinician 1: A tendency to have difficulties making decisions since secondary school. Scared by macular bleeding in the eye early in the 20-ies. Indecisive when choosing a career (salesman, artist, author) and reluctant to marry for fear of being limited by all the responsibilities. At the same time guilt feelings for not taking responsibility.
Patient X Clinician 2: The patient was kind and smart, avoided conflicts. The patient has always had problems making decisions and been bothered by ambivalence with major life decisions like committing to a sweetheart or choosing a career as an artist etc. The romantic relationship was dominated by fear of becoming trapped in a marriage with children where the spouse would be dominant. Chose to move from the partner half a year ago to concentrate on a career as an artist. Ambivalence and anxiety/depressive symptoms for the last 1–2 months after feelings of professional failure.
The average similarity on this matched rating (4 raters) was 5.75, ranging from 5 to 6.
Patient Y Clinician 1: Lively, somewhat bad tempered. Always jealous of the 1 year younger brother. Many friends, restless, active. Intensely in love with a beautiful wife. Two teenage kids. Headache, irritable. Marriage conflicts for many years. But he regards headache and fatigue as non-explainable symptoms. He is like his father, but while his mother resigned, his wife does not. The patient has also symptoms when the burden of responsibilities increases.
The average similarity on this mismatched rating (4 raters) was 2, ranging from 1 to 4.