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A Primer of Transference-Focused Psychotherapy for the Borderline Patient
By: Frank E. Yeomans, Otto F., MD Kernberg, John F. Clarkin
Hardcover | 1 July 2002
At a Glance
284 Pages
23.2 x 15.9 x 2.6
Hardcover
RRP $180.00
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Industry Reviews
In this remarkable volume, Yeomans, Clarkin, and Kernberg have accomplished the impossible by combining a highly sophisticated theory of psychopathology and technique with a practical handbook for the treatment of borderline patients. The reader will find here a concise review of a psychoanalytic approach to understanding borderline personality organization. The clinician will also find a detailed step-by-step guide to the complex process of turning the emotionally intense and often chaotic interactions generated by these patients into useful psychotherapeutic dialogue. While this book presents itself as A Primer of Transference-Focused Psychotherapy for the Borderline Patient, it has much to offer psychodynamic psychotherapists at all levels of experience in their treatment of patients at all levels of personality organization. -- Elizabeth L. Auchincloss, M.D., Weill Medical College of Cornell University
Yeomans, Clarkin, and Kernberg's A Primer of Transference-Focused Psychotherapy for the Borderline Patient stands out like a beacon to the rest of the psychodynamic community. In an era of empirically supported therapies, the work of the Cornell group has shown that it can be done, that it can be done superbly, and that it can be done without violating a single one of our cherished ideals as psychoanalytic clinicians. This is an excellent and immensely helpful introduction to the most successful program of intervention research on psychodynamic psychotherapy anywhere. It is a must-have. -- Peter Fonagy, University College, London
A Primer of Transference-Focused Psychotherapy for the Borderline Patient provides an excellent introduction and resource guide for object-relations therapy for these [borderline] patients. This is an excellent introductory and reference source for object-relations therapy with borderline patients. It is user-friendly and practical in its discussions of theory, technique, and long-term considerations for ethical and therapeutic pitfalls. An abundance of resource and bibliographic references are provided to direct the reader to more in-depth discussions of the key topics. The text provides a road map for the budding therapist when encountering splitting, therapeutic boundaries, and threats to the treatment contract. Excellent examples are provided to illustrate the identification of negative object dyads and ways they are manifest in transference material. * PsycCRITIQUES *
| Preface | |
| Who Are the Patients? Diagnostic Issues | |
| What is borderline personality disorder (BPD)? | p. 3 |
| What is the borderline personality organization (BPO) and how does it provide a broader understanding and conceptual framework than borderline personality disorder (BPD)? | p. 5 |
| What is identity diffusion? | p. 8 |
| What is reality testing? | p. 9 |
| What are primitive defense mechanisms? | p. 10 |
| What is object relations theory and how does it apply to borderline personality and transference-focused psychotherapy (TFP)? | p. 12 |
| How are defense mechanisms understood in terms of internalized object relations? | p. 18 |
| How does the development of internal psychological structure differ in normal individuals as compared to individuals with borderline personality? | p. 23 |
| What is psychic structure? | p. 26 |
| Are there circumstances in which adults who are not borderline function at a split level of psychic organization? | p. 27 |
| In the primitively organized split psyche, what interactions might be expected within and among the object relations dyads? | p. 28 |
| How does one assess for BPO and BPD? | p. 31 |
| What are the origins of borderline personality organization? | p. 33 |
| What is the Essence of the Treatment? | |
| What is TFP? | p. 39 |
| What are the patient inclusion and exclusion criteria for TFP? | p. 41 |
| Aside from the strict exclusion criteria, are there other prognostic factors? | p. 43 |
| What kind of change can be expected from TFP? | p. 45 |
| How does TFP modify traditional psychodynamic psychotherapy to create a treatment specific to borderline patients? | p. 47 |
| What are the principle alternative treatments for BPD and BPO? | p. 49 |
| Treatment Strategies | |
| What is the concept of treatment strategies? | p. 55 |
| What are the specific treatment strategies? | p. 57 |
| Treatment Tactics | |
| What are the treatment tactics? | p. 67 |
| Tactic #1 - Contract Setting | |
| Does therapy start with the first session? | p. 71 |
| What constitutes an adequate evaluation? | p. 73 |
| Is it possible to include others, beside the patient, in the evaluation process? | p. 74 |
| What does the therapist say to the patient after arriving at a diagnostic impression? | p. 75 |
| When is the treatment contract set with the patient? | p. 79 |
| What therapeutic concepts underlie the treatment contract? | p. 80 |
| What are the universal elements of the treatment contract? | p. 86 |
| What are the elements of the contract that are specific to the individual patient? | p. 88 |
| How do I keep anxiety about the possibility of patients' killing themselves from distracting me from my work? | p. 91 |
| What about patients who call very frequently? | p. 95 |
| What calls are appropriate? | p. 96 |
| What is done if the patient breaks the treatment contract? | p. 97 |
| When and how does a therapist shift from the contract-setting phase of therapy to the therapy itself? | p. 100 |
| What are the most common ways therapists have to intervene to protect the treatment frame? | p. 101 |
| What is the concept of secondary gain and why is it important to eliminate it? | p. 103 |
| Choosing the Priority Theme to Address | |
| Given the amount of data therapists are exposed to in a session, how to they decide what to address? | p. 107 |
| What are the economic, dynamic, and structural principles that guide the therapist's attention? | p. 108 |
| What are the three channels of communication? | p. 111 |
| What is the hierarchy of priorities with regard to material presented in a session? | p. 114 |
| How does the therapist use this hierarchy from moment to moment in the course of a session? | p. 116 |
| Which items on this list generally present a special challenge to the therapist? | p. 118 |
| Is there a strict separation between the addressing obstacles to therapy and the analytic work itself? | p. 120 |
| The Remaining Tactics | |
| How does the therapist maintain the balance between expanding incompatible views of reality between patient and therapist and establishing common elements of reality? | p. 125 |
| Why is it important to maintain an awareness of analyzing both the positive and negative aspects of the transference? | p. 131 |
| Treatment Techniques | |
| What are the techniques used in TFP? | p. 137 |
| What is meant by clarification in TFP? | p. 138 |
| What is meant by confrontation in TFP? | p. 140 |
| What is meant by interpretation? | p. 142 |
| What are the different levels of interpretation? | p. 143 |
| How should interpretations be delivered? | p. 148 |
| How does the therapist go about the transference analysis of primitive defenses? | p. 151 |
| What is technical neutrality and how does the therapist manage it in TFP? | p. 156 |
| How do therapists monitor their countertransference and integrate what they learn from it into the treatment? | p. 160 |
| Course of Treatment After the Contract | |
| What are the phases of TFP? | p. 163 |
| Does treatment generally demonstrate a linear progression? | p. 164 |
| What are some of the early problems that may be encountered in carrying out the treatment? Early problems I - Testing the frame/contract | p. 166 |
| Early problems II - The meaningful communication is subtle and is in the patients' actions more than in his or her words | p. 169 |
| Early problems III - The therapist has difficulty with how important the therapist has become to the patient | p. 172 |
| How does the therapist manage affect storms? | p. 174 |
| What are the signs of progress in TFP? | p. 178 |
| What are the signs that the patient is nearing the termination of therapy and how does the therapist conceptualize and discuss termination? | p. 179 |
| Some Typical Treatment Trajectories | |
| Is it possible to delineate some typical treatment trajectories that illustrate TFP principles as the therapy evolves? | p. 185 |
| Common Complications of Treatment | |
| How does the therapist deal with the threat of the patient dropping out of treatment? | p. 213 |
| Are patients with childhood sexual and/or physical abuse capable of engaging in TFP? | p. 217 |
| Is hospitalization ever indicated in the course of treatment? | p. 220 |
| If the patient is hospitalized, should the therapist meet with the patient in the hospital? | p. 223 |
| What is the role of medications in TFP? | p. 224 |
| Who should prescribe the medications? | p. 229 |
| What are the most typical transference meanings of medication? | p. 231 |
| How does one handle crises around interruptions in the treatment? | p. 232 |
| How does the therapist deal with intense eroticized transferences? | p. 233 |
| Requirements for Doing TFP | |
| What are the basic skills needed to do this treatment? | p. 237 |
| What forms and levels of supervision are necessary/advisable? | p. 241 |
| Practical Questions in Delivering the Treatment | |
| How does one get consultation on the TFP treatment of BPO patients or organize a supervision group? | p. 245 |
| How does one cover these patients when the therapist is away? | p. 246 |
| What if I work in a clinic that does not support twice-a-week therapy? | p. 247 |
| Is there empirical data to show that TFP is effective? | p. 248 |
| A Final Note | p. 253 |
| Index | p. 271 |
| Table of Contents provided by Blackwell. All Rights Reserved. |
ISBN: 9780765703552
ISBN-10: 0765703556
Published: 1st July 2002
Format: Hardcover
Language: English
Number of Pages: 284
Audience: General Adult
Publisher: GLOBE PEQUOT
Country of Publication: GB
Dimensions (cm): 23.2 x 15.9 x 2.6
Weight (kg): 0.58
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