Severe Personality Disorders

Severe Personality Disorders
Author: Otto F. Kernberg
Publisher: Yale University Press
Total Pages: 402
Release: 1993-01-01
Genre: Psychology
ISBN: 9780300053494

In this important book, one of the world's foremost psychoanalysts provides the clinician with tools to diagnose and treat severe cases of personality disorder, including borderline and narcissistic structures. Dr. Kernberg not only describes techniques he has found useful in clinical practice but also further develops theories formulated in his previous work and critically reviews other recent contributions. "A splendid book . . . of great value for anyone involved in psychotherapy with patients suffering from one or another variety of personality disorder, as well as for anyone who is teaching or doing research in this field. . . . An outstandingly fine and valuable book.--Harold F. Searles, M.D., Journal of Nervous and Mental Disease "Kernberg is a synthesizing, creative eclectic on the contemporary psychoanalytic and psychodynamic scene, broadly based in theory and in practice, a powerful intelligence, a prolific writer, and a man of ideas....This is a challenging and provocative book."--Alan A. Stone, M.D., American Journal of Psychiatry "A major work that brings together in one volume a host of clinical insights into people with a variety of severe personality disorders.... Anyone who has attempted to work with patients with severe personality disorders will be rewarding by studying this book." --Robert D. Gillman, Psychoanalytic Quarterly

Aggression in Personality Disorders and Perversions

Aggression in Personality Disorders and Perversions
Author: Otto F. Kernberg
Publisher: Yale University Press
Total Pages: 332
Release: 1992-01-01
Genre: Psychology
ISBN: 9780300065084

In this important new book, Dr. Otto F. Kernberg, one of the world's foremost psychoanalysts, explores the role of aggression in severe personality disorders and in normal and perverse sexuality, integrating new developments in psychoanalytic theory with findings from clinical work with severely regressed patients. The book also integrates Dr. Kernberg's recent studies of the descriptive, structural, and psychodynamic features of problems stemming from pathological aggression with the vicissitudes of their psychoanalytic treatment. Finally, Dr. Kernberg demonstrates the importance of differential diagnosis for effective psychoanalytically inspired treatment of these disorders, providing a rich variety of clinical illustrations. The book begins by relating the dual-drive theory of libido and aggression to contemporary developments in affect theory. Dr. Kernberg then applies this general theory of affects to aggression, which in its pathological form centers on the affect of hatred. He analyzes sado-masochistic, hysterical-hysteroid, and narcissistic-antisocial spectrums of personality disorders, emphasizing how aggression is structured in each group. Dr. Kernberg next describes and updates the theoretical frame underlying his approach to the treatment of these disorders, outlines their clinical manifestations, and illustrates their diagnosis and treatment, ranging from standard psychoanalysis with infantile personalities, to psychoanalytic psychotherapy with borderline personalities, to the psychotherapeutic approach to the treatment of psychosis and hospital milieu treatment in the management of highly regressed patients. In the final section, Dr. Kernberg links the findings from psychoanalytic approaches to personality disorders with those from the psychoanalytic study of sexual perversions.

Love Relations

Love Relations
Author: Otto F. Kernberg
Publisher: Yale University Press
Total Pages: 224
Release: 1998-01-01
Genre: Psychology
ISBN: 9780300074352

Internationally renowned psychoanalytic theorist and clinician Dr. Otto Kernberg here examines the success and failure of sexual love in couples, from adolescence to old age. Dr. Kernberg considers both "normal" and pathological relationships, including the role of narcissism, masochism, and aggression in each. The result expands the boundaries of our current understanding of love relations.

Treatment of Severe Personality Disorders

Treatment of Severe Personality Disorders
Author: Otto F. Kernberg, M.D.
Publisher: American Psychiatric Pub
Total Pages: 322
Release: 2018-04-05
Genre: Medical
ISBN: 1615371435

In Treatment of Severe Personality Disorders: Resolution of Aggression and Recovery of Eroticism, the influential psychoanalyst and psychiatrist Otto Kernberg presents an integrated update of the current knowledge of personality disorders, their neurobiological and psychodynamic determinants, and a specific psychodynamic psychotherapy geared to resolve the psychopathology of these conditions -- namely, the syndrome of identity diffusion and its influence on the capacity for emotional wellbeing and gratifying relationships with significant others. The author updates the findings of the Personality Disorders Institute of the Weill Cornell Medical College Department of Psychiatry, which are derived from the empirical research and clinical investigation of severe personality disorders, and addresses the effectiveness of transference-focused psychotherapy, a specific psychodynamic treatment for these disorders developed at the Institute. The volume focuses particularly on an essential group of techniques common to all psychoanalytically derived treatments and clarifies the corresponding differential features of various psychodynamic treatment approaches. In prose both precise and evocative, the author: Examines the classification of personality disorders, the way competing viewpoints have influenced the evolution of DSM-III and DSM-IV, and the impact of new knowledge on the classification of DSM-5, with emphasis on how conflicts between scientific and political considerations have hindered the classification of personality disorders in the past. Illustrates in detail how present knowledge of neurobiological structures and neurotransmitters intertwines with the psychodynamic determinants of how psychic experience is organized. Explores psychodynamic psychotherapies and contemporary developments and controversies in the field. For example, the role of interpretation in borderline pathology is examined using a clinical case, and a new formulation of supportive psychodynamic psychotherapy is described. Addresses severe narcissistic pathology -- its diagnosis, prognosis, and treatment. Specifically, the book presents an overview of treatment options for severe narcissistic personality disorder, explores the distortions in verbal communication that may arise during psychotherapy with these patients, and focuses on the differential diagnosis of antisocial behavior. Examines the diagnosis and treatment of sexual pathology, and explores the vicissitudes of the love lives of patients with severe personality disorders. Concludes with a chapter on the essential preconditions in the education of psychodynamic psychotherapists to carry out the challenging and complex psychotherapeutic work in this field. In describing both the limits and the advances in therapeutic effectiveness, the Treatment of Severe Personality Disorders: Resolution of Aggression and Recovery of Eroticism performs a great service, and it will surely become a classic of the psychoanalytic literature.

Transference-Focused Psychotherapy for Borderline Personality Disorder

Transference-Focused Psychotherapy for Borderline Personality Disorder
Author: Frank E. Yeomans
Publisher: American Psychiatric Pub
Total Pages: 430
Release: 2015-04-01
Genre: Medical
ISBN: 1585625434

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.

Handbook of Dynamic Psychotherapy for Higher Level Personality Pathology

Handbook of Dynamic Psychotherapy for Higher Level Personality Pathology
Author: Eve Caligor
Publisher: American Psychiatric Pub
Total Pages: 296
Release: 2007-04-02
Genre: Medical
ISBN: 1585626422

Offering a sophisticated introduction to a contemporary psychodynamic model of the mind and treatment, this book provides an approach to understanding and treating higher level personality pathology. It describes a specific form of treatment called "dynamic psychotherapy for higher level personality pathology" (DPHP), which was designed specifically to treat the rigidity that characterizes that condition. Based on psychodynamic object relations theory, DPHP is an outgrowth of transference-focused psychotherapy (TFP) and is part of an integrated approach to psychodynamic treatment of personality pathology across the spectrum of severity -- from higher level personality pathology, described in this volume, to severe personality pathology, described in a companion volume, Psychotherapy for Borderline Personality: Focusing on Object Relations. Together, they provide a comprehensive description of an object relations theory-based approach to treatment of personality disorders, embedded in an integrated model of personality. As a guide to treatment, Handbook of Dynamic Psychotherapy for Higher Level Personality Pathology provides a clear, specific, and comprehensive description of how to practice DPHP from beginning to end, presented in jargon-free exposition using extensive clinical illustrations. The authors offer a comprehensive description of psychodynamic consultation that includes sharing the diagnostic impression, establishing treatment goals, discussing treatment options, obtaining informed consent, and establishing treatment frame. Throughout, the book emphasizes fundamental clinical principles that enable the clinician to think through clinical decisions moment-to-moment and also to develop an overall sense of the trajectory and goals of the treatment. Among the book's benefits: Takes a diagnosis-driven approach, presenting a clear model of both the psychopathology and its treatment; Explains underlying theory and basic elements of DPHP for those first learning dynamic therapy; Offers an integrated, innovative synthesis of contemporary psychodynamic approaches to personality pathology and psychodynamic psychotherapy; Describes goals, strategies, tactics, and techniques of the treatment to demonstrate its flexibility over a relatively long course of treatment; Provides sophisticated discussion of integrating dynamic psychotherapy with medication management and other forms of treatment. DPHP offers a broad range of patients the opportunity to modify maladaptive personality functioning in ways that can permanently enhance their quality of life. Handbook of Dynamic Psychotherapy for Higher Level Personality Pathology provides experienced clinicians with a hands-on approach to that method, and is also useful as a primary textbook in courses focusing on the technique of dynamic psychotherapy or in courses on psychodynamics.

Treating Pathological Narcissism with Transference-Focused Psychotherapy

Treating Pathological Narcissism with Transference-Focused Psychotherapy
Author: Diana Diamond
Publisher: Guilford Publications
Total Pages: 490
Release: 2021-11-11
Genre: Psychology
ISBN: 1462546684

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.

The Inseparable Nature of Love and Aggression

The Inseparable Nature of Love and Aggression
Author: Otto F. Kernberg
Publisher: American Psychiatric Pub
Total Pages: 422
Release: 2012-09-24
Genre: Medical
ISBN: 1585629766

Otto Kernberg is a towering figure in the field of psychoanalysis and has accomplished seminal work in object relations and the treatment of borderline and narcissistic patients. This volume collects his recent work in several areas: severe personality disorders, couples in conflict, and religious experience. In each area, he explores the relationship between the psychoanalytic, clinical psychiatric, and neurobiological approaches, yielding insights and analysis that are compelling, thought-provoking, and at times startling in their penetrating brilliance. In addition, the book addresses the challenges that psychoanalysis faces in the current medical environment, and the need to strengthen its ties with academic institutions. Beautifully written, the book is designed to both provoke questions and provide enlightenment on a variety of critical issues within psychotherapy. Specifically, the volume: Explores new approaches to diagnosis and new psychotherapeutic techniques to treat the most severe personality disorders, particularly severe narcissistic psychopathology, based on new research findings; Relates psychoanalytic theory to neurobiological findings by illuminating the influences of neurobiological structures and intrapsychic conflicts on the development of the personality; Examines the psychoanalytic and neurobiological underpinnings of sexual love, from the organization of brain structures and neurotransmitters to the overall systems of erotic activation, attachment and bonding. This systematic approach provides insight into the nature of passionate love and the psychodynamic features of the love relationship; Addresses psychodynamic factors in the religious experience and the search for universal ethical values, and explores the crucial function of religious experience in dealing with the ideological challenges of social life; and Identifies the serious problems facing psychoanalytic education, institutions, and the profession of psychoanalysis, and proposes solutions to energize the field and increase its contributions to scientific research and progress. In The Inseparable Nature of Love and Aggression: Clinical and Theoretical Perspectives, Kernberg demonstrates his belief that the collaboration of psychoanalysis and neurobiology has the potential to significantly advance our understanding of the human mind. The full spectrum of mental health clinicians, as well as educated general readers, will find this to be a work of creativity and substance.