Transference-Focused Psychotherapy for Borderline Personality                 Disorder

Yeomans, Frank E.; Clarkin, John F.; Kernberg, Otto F.

doi:10.1176/appi.books.9781615371006

Cited by 124 publications

(185 citation statements)

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“…In his most recent paper, Kernberg () argues that in patients with severe narcissistic pathology the therapist has ‘to take a more active intervention’. It is important to reiterate that although Milton's () thoughtful paper touches on fundamental issues related to the nature of psychoanalytic practice, Kernberg's development of TFP is predicated on precisely his concern to develop a transference‐based psychoanalytic treatment for patients with severe borderline pathology (Yeomans, Clarkin & Kernberg, ). Benign authority is a further attempt to make a psychoanalytic case for such active interventions.…”

Section: Discussionmentioning

confidence: 99%

The Use of Benign Authority with Severe Borderline Patients: A Psychoanalytic Paradigm

Nathan¹

2018

Brit J Psychotherapy

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Kernberg has suggested that work with severe borderline psychopathology requires limit‐setting interventions to mitigate the possibility of life‐threatening enactments. These actions constitute a deviation from the classical analytic stance of technical neutrality. Taking up these modifications, I argue for a re‐calibration of the analytic task with severe borderline patients predicated on the use of benign authority. Abandoning therapeutic equidistance, I propose a model based on interventions organized around ‘maternal’ and ‘paternal’ functions and the dialectical and generative intercourse between these two poles. Such engagement requires close attention to the countertransference, as enactments are inevitable. In this context I reflect on the way ‘action’ in psychoanalysis is considered pathological, as a countertransference enactment. Clinical vignettes are presented arguing for ‘actions’ based on limit setting and active emotional engagement as therapeutic in their own right, which is consistent with psychoanalytic practice. This realignment of the psychoanalytic project embodies the ideas that Gabbard and Westen introduced in ‘Rethinking therapeutic action’. They suggest that it is now more accurate to speak of therapeutic actions in psychoanalytic treatment, rather than the ‘single‐mechanism theories of therapeutic action’, which may have implications for psychoanalytic practice beyond the treatment of the personality disordered patient.

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Section: Discussionmentioning

confidence: 99%

The Use of Benign Authority with Severe Borderline Patients: A Psychoanalytic Paradigm

Nathan¹

2018

Brit J Psychotherapy

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“…While abundant clinical evidence of positive developments in fundamental personality change with TFP is now available, and justifies, we believe, focused research efforts to empirically study these effects in long‐term follow up studies, the present paper is an effort to update aspects of the basic techniques of TFP as described in the third edition of our manual (Yeomans et al ., ). In essence, these developments represent an expansion of the exploration of the transference by focusing on sharply dissociated expressions of severely self‐destructive tendencies in the patient's external life.…”

Section: Introductionmentioning

confidence: 97%

“…Transference Focused Psychotherapy (TFP) is a manualized, empirically validated psychoanalytic psychotherapy, derived from a synthesis of contemporary object relations theory and modifications of psychoanalytic technique to treat patients whose severity of pathology contraindicates standard psychoanalysis (Clarkin et al ., ; Doering et al ., ; Kernberg et al ., ; Yeomans et al ., ). The specific objective of TFP is the modification of the personality structure of patients with severe personality disorders, particularly borderline personality disorder, but also narcissistic, paranoid, schizoid and schizotypal personality disorders.…”

Section: Introductionmentioning

confidence: 97%

“…TFP is focused not only on reducing the symptoms typically seen in severe personality disorders, such as chronic suicidal behavior, antisocial behavior, substance abuse, and eating disorders (Zanarini et al ., , b), but, as mentioned above, also has the ambitious goal of modifying the personality structure of the patient sufficiently to meaningfully improve functioning in the arenas of work, studies and profession, and intimate relations, such that the individual develops a fuller capacity to integrate emotional commitment, sexual freedom, and tenderness. Such integration leads to improvements in the capacity for genuine friendships as well as investment in creative and cultural pursuits (Yeomans et al ., ).…”

Section: Introductionmentioning

confidence: 97%

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New developments in transference focused psychotherapy

Kernberg

2016

The International Journal of Psychoanalysis

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This paper will summarize recent clinical developments in the treatment of borderline patients at the Personality Disorders Institute at Cornell. The experiences under review will include the careful, ongoing monitoring of developments in the patient's life outside the sessions, and their consideration in diagnosing affective dominance during the hours. Other issues include the discussion of a 'second chance' approach to contract violations; the assessment and concern with the patient's assumption of responsibility for himself; the contradictions between actual behavior patterns and life goals, and between personality potentials and present functioning; the technical implications of particular constellations of regressive narcissistic features; drug dependence and antisocial behavior; and life goals and treatment goals.

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“…Finally, two RCTs compared Schema-focused therapy to Transference-focused therapy (23), and both groups improved their QoL, with differences between the two conditions depending on the outcome measure of QoL (24,25). Finally, Nadort et al (26) found that Schema-Focused Therapy was effective in improving QoL, independently of telephone therapist availability during crises.…”

Section: Introductionmentioning

confidence: 99%

The resilience as predictor of Quality of Life in participants with borderline personality disorder before and after of treatment

Guillén¹,

Tormo

Fonseca-Baeza

et al. 2020

Preprint

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Abstract Background Studies suggested that psychotherapy improved QoL of participants with BPD. However, there are no studies about the differential efficacy of treatments in the QoL of participants with BPD. Moreover, the relationship between QoL and resilience has rarely been studied in participants with BPD. Objectives: a) to examine whether people with BPD have worse QoL than the non-clinical population; b) to examine whether there are statistically significant differences between DBT, STEPPS, and TAU-CBT in the improvement of QoL; c) to examine whether participants show clinically significant improvements in QoL after treatment; d) to analyse whether resilience is associated with QoL before and after the BPD treatment; e) to analyse whether the resilience is a predictor of QoL at pre-treatment and posttreatment. Method: The sample comprised 403 participants (n = 202 participants diagnosed with BPD, and n = 201 non-clinical). MANOVA and regression analysis were performed. Results: participants diagnosed with BPD had statistically significant lower resilience than the non-clinical population, all forms of psychotherapy improved QoL, but there was no clinical change after the treatments, resilience was associated with QoL before and after the treatment of BPD and, resilience was a predictor of QoL before and after the treatment. Conclusion It is necessary to assess QoL in studies of psychotherapy with BPD.

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Transference-Focused Psychotherapy for Borderline Personality Disorder

Cited by 124 publications

References 0 publications

The Use of Benign Authority with Severe Borderline Patients: A Psychoanalytic Paradigm

The Use of Benign Authority with Severe Borderline Patients: A Psychoanalytic Paradigm

New developments in transference focused psychotherapy

The resilience as predictor of Quality of Life in participants with borderline personality disorder before and after of treatment

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