A Primer Of Transference Focused Psychotherapy For The Borderline Patient

Treating borderline patients is one of the most challenging areas in psychotherapy because of the patient's extreme emotional expressions, the strain it places on the therapist, and the danger of the patient acting out and harming himself or the therapeutic relationship. Many clinicians consider this patient population difficult, if not impossible, to treat. However, in recent years dedicated experts have focused their clinical and research efforts on the borderline patient and have produced treatments that increase our success in working with borderline patients. Transference-Focused Therapy (TFP) is psychodynamic treatment designed especially for borderline patients. This book provides a concise and comprehensive introduction to TFP that will be useful both to experienced clinicians and also to students of psychotherapy. TFP has its roots in object relations and it emphasizes that the transference is the key to understanding and producing change. The patient's internal world of object representations unfolds and is lived in the transference with the therapist. The therapist listens for and makes use of the relationship that is revealed through words, silence, or, as often occurs in the case of individuals with some borderline personality disorder, acting out in subtle or not-so-subtle ways. This primer offers clinicians a way to understand and then use the transference and countertransference for change in the patient.

Treating borderline patients is one of the most challenging areas in psychotherapy because of the patient's extreme emotional expressions, the strain it places on the therapist, and the danger of the patient acting out and harming himself or the therapeutic relationship. Many clinicians consider this patient population difficult, if not impossible, to treat. However, in recent years dedicated experts have focused their clinical and research efforts on the borderline patient and have produced treatments that increase our success in working with borderline patients. Transference-Focused Therapy (TFP) is psychodynamic treatment designed especially for borderline patients. This book provides a concise and comprehensive introduction to TFP that will be useful both to experienced clinicians and also to students of psychotherapy.

Transference-Focused Psychotherapy for Borderline Personality Disorder: A Clinical Guide presents a model of borderline personality disorder (BPD) and its treatment that is based on contemporary psychoanalytic object relations theory as developed by the leading thinker in the field, Otto Kernberg, M.D., who is also one of the authors of this insightful manual. The model is supported and enhanced by material on current phenomenological and neurobiological research and is grounded in real-world cases that deftly illustrate principles of intervention in ways that mental health professionals can use with their patients. The book first provides clinicians with a model of borderline pathology that is essential for expert assessment and treatment planning and then addresses the empirical underpinnings and specific therapeutic strategies of transference-focused psychotherapy (TFP). From the chapter on clinical assessment, the clinician learns how to select the type of treatment on the basis of the level of personality organization, the symptoms the patient experiences, and the areas of compromised functioning. In order to decide on the type of treatment, the clinician must examine the patient's subjective experience (such as symptoms of anxiety or depression), observable behaviors (such as investments in relationships and deficits in functioning), and psychological structures (such as identity, defenses, and reality testing). Next, the clinician learns to establish the conditions of treatment through negotiating a verbal treatment contract or understanding with the patient. The contract defines the responsibilities of each of the participants and defines what the reality of the therapeutic relationship is. Techniques of treatment interventions and tactics to address particularly difficult clinical challenges are addressed next, equipping the therapist to employ the four primary techniques of TFP (interpretation, transference analysis, technical neutrality, and use of countertransference) and setting the stage for and guiding the proper use of those techniques within the individual session. What to expect in the course of long-term treatment to ameliorate symptoms and to effect personality change is covered, with sections on the early, middle, and late phases of treatment. This material prepares the clinician to deal with predictable phases, such as tests of the frame, impulse containment, movement toward integration, episodes of regression, and termination. Finally, the text is accompanied by supremely instructive online videos that demonstrate a variety of clinical situations, helping the clinician with assessment and modeling critical therapeutic strategies. The book recognizes that each BPD patient presents a unique treatment challenge. Grounded in the latest research and rich with clinical insight, Transference-Focused Psychotherapy for Borderline Personality Disorder: A Clinical Guide will prove indispensable to mental health professionals seeking to provide thoughtful, effective care to these patients.

This book offers clear, practical, and simple recommendations for treating patients with personality disorders. The goals of the book are twofold: 1) to describe the essential elements of Transference-Focused Psychotherapy (TFP), an evidence-based treatment for Borderline Personality Disorder, and 2) to describe how core principles and techniques of TFP can be used in a variety of settings to improve clinical management of patients with a broad spectrum of personality pathology, even when patients are not engaged in individual psychotherapy. A short introduction outlines in concise language the core elements of TFP and its origins in object relations theory. The book then takes the clinician through the process of: 1) comprehensive diagnosis, 2) negotiation of the treatment frame, and 3) the overarching strategies, techniques, and tactics used in the individual treatment, including helpful, accessible clinical vignettes. Subsequent chapters build on the literature of TFP in individual psychotherapy, broadening its applications to include crisis management, family engagement, inpatient psychiatry, pharmacotherapy, medical settings, psychiatry residency training. Fundamentals of Transference-Focused Psychotherapy is a valuable resource for psychiatrists, psychologists, and all other medical professionals treating patients suffering from Borderline Personality Disorder, and other severe personality disorder presentations.

Transference-Focused Psychotherapy for Adolescents With Severe Personality Disorders is a manual for clinicians who wish to learn an effective psychodynamic treatment for young people with personality disorders (PDs). Despite converging evidence that PDs emerge in childhood and are clearly evident in adolescence, research on effective treatments has been limited. The editors have therefore created a book that details treatment models with strong theoretical foundations and examines systematic interventions designed to explore and resolve the conflicts and behaviors, common to PDs, that impede normal adolescent development. The book begins with an overview of psychopathology and normal adolescent development from a psychodynamic perspective. The next section offers therapeutic approaches, including a discussion of the major goals and strategies of TFP-A, the clinical evaluation and assessment process, establishment of the treatment framework and collaboration with parents, and finally, the techniques and tactics of TFP-A. The last section of the book reviews the phases of treatment and discusses the strengths and competencies a therapist must have to successfully conduct transference-based therapy. Authored by experts in the field (including Dr. Kernberg, a pioneer in object relations), Transference-Focused Psychotherapy for Adolescents (TFP-A) with Severe Personality Disorders teaches clinicians how to conduct TFP-A, with the ultimate goal of resolving the intrapsychic restrictions that interfere with normal adolescent development.

Borderline conditions are a growing presence in the treatment room, yet they are uncommonly resistant to treatment. Dr. Kernberg and his colleagues have already articulated the modality they call Transference-Focused Psychotherapy. Now, in an unusually textured elaboration, they confront the complications that limit treatability—co-existing psychopathologies, early trauma/dissociation, problems endemic to the therapeutic situation (attachment disturbances, erotic transferences)—and bring new rounds of clinical ammunition to meet those challenges.

Until recently, borderline personality disorder has been the step-child of psychiatric disorders. Many researchers even questioned its existence. Clinicians have been reluctant to reveal the diagnosis to patients because of the stigma attached to it. But individuals with BPD suffer terribly and a significant proportion die by suicide and engage in non-suicidal self injury. This volume provides state of the art information on clinical course, epidemiology, comorbidities and specialized treatments

Filling a crucial gap in the clinical literature, this book provides a contemporary view of pathological narcissism and presents an innovative treatment approach. The preeminent authors explore the special challenges of treating patients--with narcissistic traits or narcissistic personality disorder--who retreat from reality into narcissistic grandiosity, thereby compromising their lives and relationships. Assessment procedures and therapeutic strategies have been adapted from transference-focused psychotherapy (TFP), a manualized, evidence-based treatment for borderline personality disorder. Rich case material illustrates how TFP-N enables the clinician to engage patients more deeply in therapy and help them overcome relationship and behavioral problems at different levels of severity. The volume integrates psychodynamic theory and research with findings from social cognition, attachment, and neurobiology.