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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 is well worth the time and attention of residents, practicing psychiatrists, and other mental health clinicians whether they are new to therapy, new to psychodynamic therapy, or experienced therapists. Although I have been practicing for close to 40 years, I learned new things from it, and I have already recommended the volume to colleagues who are eager to begin learning in greater depth about psychodynamic theory and the technique of therapy. My advice was to get into the book, take it seriously, and work away at it. For those with the ability to do so, making it the work of a reading group to support each other's learning, or with a supervisor, or both, may make sense. And the authors also offer TFP courses online and at various sites around the country.
— Eric M. Plakun, M.D., Associate Medical Director and Director of Biopsychosocial Advocacy, Austen Riggs Center, Stockbridge, MA, and Leader of the American Psychiatric Association Psychotherapy Caucus, Arlington, VA
Frank E. Yeomans, M.D., Ph.D., is Clinical Associate Professor of Psychiatry at Weill Cornell Medical College, Director of Training at the Personality Disorders Institute at Weill Cornell Medical College, and Adjunct Associate Professor of Psychiatry at the Columbia Center for Psychoanalytic Training and Research, New York, New York.
John F. Clarkin, Ph.D., is Codirector of the Personality Disorders Institute at Weill Cornell Medical College and Clinical Professor of Psychology in Psychiatry at Weill Cornell Medical College, New York, New York.
Otto F. Kernberg, M.D., is Director of the Personality Disorders Institute at Weill Cornell Medical College, Professor Emeritus at Weill Cornell Medical College, and Training and Supervising Analyst at Columbia University Center for Psychoanalytic Training and Research, New York, New York.
ABOUT THE AUTHORS
PREFACE
VIDEO GUIDE
Chapter
1. The Nature Of Normal And Abnormal Personality Organization
Chapter 2.
Empirical Development Of Transference-Focused Psychotherapy: A Clinical
Research Process
Chapter 3. Strategies Of Transference-Focused
Psychotherapy
Chapter 4. Assessment Phase: Clinical Evaluation And
Treatment Selection
Chapter 5. Establishing The Treatment Frame:
Contracting, Medication, And Adjunctive Treatments
Chapter 6.
Techniques Of Treatment: Moment-To-Moment Interventions And Mechanisms Of
Change
Chapter 7. Tactics Of Treatment And Clinical
Challenges
Chapter 8. Early Treatment Phase: Test Of The Frame, Impulse
Containment, And Identifying DYADS
Chapter 9. Midphase Of Treatment:
Movement Toward Integration With Episodes of Regression
Chapter 10.
Advance Phase Of Treatment and Termination
Chapter 11. Trajectories Of
Change In Transference-Focused Psychotherapy
REFERENCES
INDEX