Concept
Transference-focused psychotherapy
A psychoanalytic psychotherapy, set out in a treatment manual, for patients with borderline personality organization, developed by Otto Kernberg with John Clarkin, Frank Yeomans and colleagues at Cornell. Within a firm treatment contract, usually with two sessions a week, the therapist follows the dominant patterns of relating as they appear in the transference and interprets the split images of self and other behind them, aiming to integrate those images and so overcome identity diffusion.
Development
1999
introduced by Otto F. Kernberg
With John Clarkin and Frank Yeomans at Cornell, Kernberg turned his psychoanalytic treatment of borderline patients into a manualised method, first published as Psychotherapy for Borderline Personality (1999).
In Psychotherapy for Borderline Personality (1999)
Relations
- 1999 introduced by Otto F. Kernberg
With John Clarkin and Frank Yeomans at Cornell, Kernberg turned his psychoanalytic treatment of borderline patients into a manualised method, first published as Psychotherapy for Borderline Personality (1999).
- derives from Borderline personality organization
Transference-focused psychotherapy was built as the treatment for borderline personality organization: its aim of integrating split images of self and others follows directly from the structural account of the disorder.
Works
- 1999
Psychotherapy for Borderline Personality
Psychotherapy for Borderline Personality (New York: Wiley, 1999) is the first full treatment manual of transference-focused psychotherapy (TFP), written by John F. Clarkin, Frank E. Yeomans and Otto F. Kernberg at the Personality Disorders Institute of Weill Cornell. It turns the expressive psychoanalytic psychotherapy that Kernberg had described for patients with borderline personality organization into a manualized, teachable treatment, held twice weekly within a firm frame. Its premise is object-relational: the borderline patient's inner world is split into polarized, affect-laden pairs of self and other representations, idealized and persecutory, victim and destroyer. In the relationship with the therapist these pairs are enacted, and the therapist is drawn into shifting roles. The book is in three parts. The first sets out the ingredients of the treatment: its theory, its overarching goals, the strategies that prevail over weeks and months, the tactics of each session, and the techniques by which they are carried out. The second follows the phases of treatment: assessment and the negotiation of a treatment contract, early tests of the frame and the containment of impulsive and self-destructive acting out, a middle phase of growing integration interrupted by regressions, and an advanced phase leading to termination. The third deals with special problems such as crises, suicidal and parasuicidal behaviour, hospitalization and medication. Throughout, the authors teach the therapist to identify and name the dominant object-relational dyad in the here-and-now, to clarify, confront and interpret it from a stance of technical neutrality, and to use the countertransference as information. The aim is not only to reduce symptoms but to integrate split-off parts of the self, so that the patient comes to experience self and others as whole, complex people. Verbatim clinical vignettes illustrate each step. The manual underlay the randomized trials of TFP that followed, was translated into German in 2001, and was revised in 2006 as Psychotherapy for Borderline Personality: Focusing on Object Relations.
See also
Linked from
People
References
- Psychotherapy for Borderline Personality1999Evidence for a relation