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"Hatred, Emptiness, and Hope offers an updated vision of psychoanalytic object relations theory, revealing its application to transference focused psychotherapy (TFP), a treatment approach derived from and related to psychoanalysis. With empirical studies carried out by the Personality Disorders Institute at Weill Cornell as a basis, this volume expands the applications of TFP, illustrating it at work in scenarios that include severe personality disorders, disturbances in sexuality and love relations of narcissistic personalities, inpatient hospital treatment, and group settings. It also looks at the implications of new developments in neurobiology on psychoanalytic object relations theory. Readers will benefit from a discussion of the practice of TFP itself, with chapters that tackle the supervision of psychoanalysis, challenges for the future of psychoanalysis, and innovations that can serve to strengthen its role as a profession, a treatment approach, and a social organization within mental health sciences. It focuses on the analysis of particular clinical features of personality pathologies and describes the consideration of contemporary psychoanalytic object relations theory as a general theoretical frame of treatment that permits to conceptualize both normal personality functioning and the very nature of personality disorders. This volume also includes my recent efforts to contribute to the understanding of the relationship between neurobiological dispositions and their interaction with psychodynamic developments, again, both in normality and psychopathology. Finally, this volume explores the application of object relations theory to group processes, love relations, and therapists' training"--
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
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.
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.
The basic text for the understanding of patients with pathological narcissism.
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.
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.
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.
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.