Psychotherapy for Borderline Personality: Focusing on Object Relations

For therapists treating patients with borderline personality organization, transference-focused psychotherapy (TFP) has proven to be a remarkably successful approach that effectively targets the pathology of character. The product of more than 25 years of development, it draws on advances in object relations theory and attachment theory with the goal of not merely treating symptoms but changing the patient's underlying personality and quality of life. Psychotherapy for Borderline Personality describes principles of intervention and contains a wealth of practical guidelines on how to apply TFP to individual patients on a session-by-session basis. This groundbreaking treatment manual focuses on the analysis of the transference, showing how to help patients relax their defenses and become active participants in the therapeutic process. The authors describe techniques for seeing past the wall of behavioral and cognitive dissonance typically thrown up by the borderline patient, identifying a patient's conflicting self-conceptions and object representations, and immersing oneself in the turbulent currents of the borderline narrative stream while maintaining the clinical distance required to be a constructive force in patients' lives. -For each phase of treatment-assessment, early treatment, midphase, advanced phase, and termination-the authors describe the tasks of the therapist and the sequence of responses by the patients -Session descriptions are included to illustrate treatment in progress -A separate chapter addresses specific issues in treatment, including crisis management for suicide threats and aggressive behavior -Recognizing that patients with BPO start treatment at different points of their pathology, the authors provide an expansive description of the treatment course with high-level and low-level BPO patients, making the book relevant to a wide range of clinical situations This volume also reflects not only the authors' ongoing experience with TFP in other clinical sites, showing how it can be used in diverse cultural settings, but also research that helps precisely identify the course and type of changes resulting from TFP. Brimming with insights garnered from years of successful clinical application, Psychotherapy for Borderline Personality will sharpen the skills of those already familiar with TFP and introduce others to a trailblazing approach to therapy.

Table of Contents:
Preface. The nature of borderline personality organization. Treatment of borderline pathology: the strategies of transference-focused psychotherapy. Techniques of treatment: the moment-to-moment interventions. Tactics of treatment: laying the foundation for the techniques. Assessment phase, I: clinical evaluation and treatment selection. Assessment phase, II: treatment contracting. Early treatment phase: tests of the frame and impulse containment. Midphase of treatment: movement toward integration with episodes of regression. Advanced phase of treatment and termination. Common treatment complications. Changes processes in transference-focused psychotherapy: theoretical and empirical approaches. References. Index.

About the Author :
John F. Clarkin, Ph.D., is Co-Director of the Personality Disorder Institute at New York Presbyterian Hospital, Westchester Division, and Clinical Professor of Psychology in Psychiatry at the Joan and Sanford I. Weill Medical College and Graduate School of Medical Sciences of Cornell University in New York City. He is Past President of the International Society for Psychotherapy Research. Frank E. Yeomans, M.D., Ph.D., is Clinical Associate Professor of Psychiatry at the Weill Medical College of Cornell University and Director of Training at the Personality Disorders Institute of New York Presbyterian Hospital, and Director of the Personality Studies Institute in New York City. Otto F. Kernberg, M.D., is Director of the Personality Disorders Institute at the New York Presbyterian Hospital, Westchester Division, and Professor of Psychiatry at the Joan and Sanford I. Weill Medical College and Graduate School of Medical Sciences of Cornell University, New York City. He is a training and supervising analyst at the Columbia University Center for Psychoanalytic Training and Research and is a past president of the International Psychoanalytic Association.

Review :
"Pyschotherapy for Borderline Personality offers a clear strategy for treating BPD that follows logically from object relations theory. The text reflects the insight of decades of research and clinical practice with BPD and has the added benefit of incorporating contemporary findings from neurobiology and studies on temperament. This manual would be invaluable for all clinicians practicing psychodynamic psychotherapy, regardless of their level of experience. It is clear and comprehensive in its coverage of BPD treatment and offers reasonable guidelines and strategies for effectively negotiating the complex behavioral and affective oscillations so typical of individuals with BPD. Its 11 chapters present an overview of the theoretical foundations of TFP, followed by an extensive review of the techniques and tactics used to treat BPD, from assessment to termination....Psychotherapy for Borderline Personality is uncompromising in its scholarship as well as inspiring in its clinical formulations....Anyone who wants to understand borderline personality and its treatment from a psychodynamic perspective would do well to read this manual."-- "PsycCRITIQUES", "October 25, 2006" "This book can be used by those with experience in psychoanalysis and those without experience. It is a carefully written, clear treatment manual for TFP for borderline personality disorder. The updated edition includes more of their research data as well as their experience bringing this intervention to other treatment centers. The book successfully provides the principles of the treatment, models the day-to-day interactions, and helps guide clinicians' formulations within their frameworks."-- "Doody's Review Service", "June 2006"