John F. Clarkin

This essential guide to the prescriptive selection of psychosocial interventions is founded on a research?based model that sequentially considers patient dimensions, environments, settings, therapists, and therapies. It covers the development of a prescriptive decision model, patient predisposing variables, and more.

Deftly combining contemporary theory with clinical practice, Psychodynamic Therapy for Personality Pathology: Treating Self and Interpersonal Functioning is an invaluable resource for any clinician seeking a coherent model of personality functioning and pathology, classification, assessment, and treatment. This insightful guide introduces Transference-Focused Psychotherapy—Extended (TFP-E), a specialized but accessible approach for any clinician interested in the skillful treatment of personality disorders. Compatible with the DSM-5 Section III Alternative Model for Personality Disorders—and elaborating on that approach, this volume offers clinicians at all levels of experience an accessible framework to guide evaluation and treatment of personality disorders in a broad variety of clinical and research settings. In this book, readers will find: • A coherent model of personality functioning and disorders based in psychodynamic object relations theory• A clinically near approach to the classification of personality disorders, coupled with a comprehensive approach to assessment• An integrated treatment model based on general clinical principles that apply across the spectrum of personality disorders• An understanding of specific modifications of technique that tailor intervention to the individual patient's personality pathology• Descriptions of specific psychodynamic techniques that can be exported to shorter-term treatments and acute clinical settings Patient assessment and basic psychodynamic techniques are described in up-to-date, jargon-free terms and richly supported by numerous clinical vignettes, as well as online videos demonstrating interventions. At the end of each chapter, readers will find a summary of key clinical concepts, making this book both a quick reference tool as well as a springboard for continued learning. Clinicians looking for an innovative, trustworthy guide to understanding and treating personality pathology that combines contemporary theory with clinical practice need look no further than Psychodynamic Therapy for Personality Pathology: Treating Self and Interpersonal Functioning.

La Psicoterapia centrada en la transferencia se basa en la teor a de las relaciones objetales -orientaci n que constituye uno de los pilares fundamentales del pensamiento psicoanal tico- y ha sido concebida con la ayuda de una metodolog a de investigaci n y una evaluaci n emp rica rigurosas. Dise ada para tratar a los pacientes m s dif ciles dentro de la cartera de casos del psicoterapeuta psicodin mico, a saber, aquellos que adolecen de una organizaci n borderline de la personalidad, este tratamiento ofrece ya no nicamente un mero alivio de los s ntomas cuanto un enfoque para abordar el trastorno de personalidad subyacente. Permite a los pacientes mejorar su funcionamiento social y vocacional, sus vidas amorosas y su creatividad. En esta gu a de tratamiento dirigida a los profesionales cl nicos, Yeomans, Clarkin y Kernberg, los creadores del enfoque, describen los or genes de la Psicoterapia centrada en la transferencia y acompa an al profesional cl nico a trav s de la exposici n de sus diferentes fases y etapas. Los autores analizan el proceso de selecci n de casos, el establecimiento y el mantenimiento del marco terap utico y el desarrollo y an lisis de la transferencia. Brindan una orientaci n para el manejo de las crisis, el potencial suicida, y los acting-outs sexuales, todo ello ricamente ilustrado con distintos ejemplos cl nicos. Este texto es de lectura obligada para todo aquel profesional que pretenda comprender o aplicar la Psicoterapia centrada en la transferencia, o para quienes desarrollen su labor cl nica con pacientes l mites. Frank E. Yeomans, M. D., Ph. D. es profesor cl nico asociado de Psiquiatr a en la Universidad Weill Cornell y en la Universidad de Columbia. John F. Clarkin, Ph. D. es codirector del Instituto de Trastornos de la Personalidad en la Escuela Superior de Medicina de la Universidad Weill Cornell. Otto F. Kernberg, M. D. es director del Instituto de Trastornos de la Personalidad en la Universidad Weill Cornell y psicoanalista formador en la Universidad de Columbia.

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 essential guide to the prescriptive selection of psychosocial interventions is founded on a research?based model that sequentially considers patient dimensions, environments, settings, therapists, and therapies. It covers the development of a prescriptive decision model, patient predisposing variables, and more.

First published in 1991. Using actual case material, this text shows how psychological assessment contributes to the clarification of diagnostic issues and the development of an optimal treatment plan. It covers disorders usually first evident in childhood and ends with the Axis II personality disorders.

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 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.

First published in 1991. Using actual case material, this text shows how psychological assessment contributes to the clarification of diagnostic issues and the development of an optimal treatment plan. It covers disorders usually first evident in childhood and ends with the Axis II personality disorders.