Otto F. Kernberg

The panel discussion presented at the New York Psychoanalytic Society and Institute's 1066th Scientific Meeting held on June 8, 2023, takes up aging and dying of an analyst and their impact on patients and on the nature of analytic process. Participants reflect on conflicts and challenges arising with more analysts and patients living to an advanced age, on the unregulated nature of analysts’ retirement, and on multilayered meanings of analysts’ ethical commitment to their work.

Llenando un vacío crucial en la bibliografía clínica, este libro ofrece una visión contemporánea del narcisismo patológico y presenta un enfoque innovador de tratamiento. Los destacados autores exploran las dificultades especiales para tratar a pacientes-ya sea con rasgos narcisistas o con un trastorno narcisista de la personalidad plenamente desarrollado-que se retraen de la realidad para adentrarse en una grandiosidad narcisista, poniendo con ello en peligro sus vidas y sus relaciones interpersonales. Los procedimientos de evaluación y las estrategias terapéuticas han sido adaptados de la psicoterapia focalizada en la transferencia (TFP), que es un tratamiento manualizado y basado en la evidencia para su aplicación originalmente al trastorno límite de la personalidad. Abundante material de casos ilustra la forma en la que la TFP-N permite al profesional clínico implicar a los pacientes más profundamente en la terapia y ayudarlos a superar los problemas de relación y de conducta de diferentes niveles de gravedad. El volumen integra la teoría y la investigación psicodinámicas con los hallazgos derivados de la cognición social, el apego, la mentalización y la neurobiología.

Borderline personality disorder (BPD) was introduced in the DSM‐III in 1980. From the DSM‐III to the DSM‐5, no major changes have occurred in its defining criteria. The disorder is characterized by instability of self‐image, interpersonal relationships and affects. Further symptoms include impulsivity, intense anger, feelings of emptiness, strong abandonment fears, suicidal or self‐mutilation behavior, and transient stress‐related paranoid ideation or severe dissociative symptoms. There is evidence that BPD can be reliably diagnosed and differentiated from other mental disorders by semi‐structured interviews. The disorder is associated with considerable functional impairment, intensive treatment utilization, and high societal costs. The risk of self‐mutilation and suicide is high. In the general adult population, the lifetime prevalence of BPD has been reported to be from 0.7 to 2.7%, while its prevalence is about 12% in …

Le livre d'Otto Kernberg présente une analyse systématique des états-limites-la psychopathologie, le diagnostic, le pronostic et le traitement. Il présente un concept de cet ensemble psychopathologique controversé et étendu, à la lumière de la psychologie du moi et des théories psychanalytiques contemporaines des relations d'objet.

What follows is an overview of the essential theory and technique of transference focused psychotherapy (TFP), a modified psychoanalytic treatment geared to the treatment of individuals with personality disorders, particularly the very severe ones. The TFP is a psychodynamic psychotherapy derived from psychoanalytic principles and techniques and represents an extension of the psychoanalytic model to cover the entire range of severity of personality disorders. It is based on a contemporary formulation of psychoanalytic psychotherapy, updated in the light of both empirical research and scientific developments in boundary fields close to the psychodynamic endeavor, particularly in affective neuroscience and the psychology of couples and small groups (Yeomans et al. 2015).

ImportanceBorderline personality disorder (BPD) affects approximately 0.7% to 2.7% of adults in the US. The disorder is associated with considerable social and vocational impairments and greater use of medical services.ObservationsBorderline personality disorder is characterized by sudden shifts in identity, interpersonal relationships, and affect, as well as by impulsive behavior, periodic intense anger, feelings of emptiness, suicidal behavior, self-mutilation, transient, stress-related paranoid ideation, and severe dissociative symptoms (eg, experience of unreality of one’s self or surroundings). Borderline personality disorder is typically diagnosed by a mental health specialist using semistructured interviews. Most people with BPD have coexisting mental disorders such as mood disorders (ie, major depression or bipolar disorder) (83%), anxiety disorders (85%), or substance use disorders (78%). The etiology of …

Der Beitrag gibt einen Überblick über die grundlegende Theorie und Technik der Übertragungsfokussierten Psychotherapie (Transference Focussed Psychotherapy [TFP]), einer modifizierten psychoanalytischen Behandlung, die insbesondere auf die Therapie von Personen mit besonders schweren Persönlichkeitsstörungen ausgerichtet ist. Die TFP ist eine von psychoanalytischen Prinzipien und Techniken abgeleitete psychodynamische Psychotherapie und stellt eine Erweiterung des psychoanalytischen Modells dar, um das ganze Spektrum von Persönlichkeitsstörungen abzudecken.Die TFP basiert auf einer zeitgemäßen Formulierung der psychoanalytischen Psychotherapie, aktualisiert im Lichte sowohl der empirischen Forschung als auch der wissenschaftlichen Entwicklungen in den Bereichen, die dem psychodynamischen Ansatz nahestehen, insbesondere in den Neurowissenschaften der Affekte und …

Background Previous studies have detected changes in the EEG signal as an effect of psychoanalytic interventions. However, no study has as yet investigated neural correlates of specific psychoanalytic interventions in the EEG power spectrum. In the present case study, we contrasted three types of interventions (clarification, confrontation, interpretation) and a neutral control condition during a structural psychoanalytic interview conducted while EEG was recorded. Methods A 27-year-old male patient diagnosed with major depressive disorder and borderline personality disorder with recurrent suicidal and self-injurious behavior underwent a structural interview while recording EEG. Two independent experts selected by consensus the characteristic episodes of the four conditions (clarification, confrontation, interpretation, neutral control) within the interview which were included in the EEG analyses. Fast Fourier transformation (FFT) was applied to subsegments of the intervention type to analyze the EEG power spectra. Alpha and beta power from central, frontal and parietal sites were considered in linear mixed effects models with segments as a random factor with maximum-likelihood estimates due to the lack of balance in the length of the interview segments. Results The interventions “interpretation” and “confrontation” showed a significantly lower alpha power compared to the control condition in central electrodes. In the frontal and parietal sites of the alpha power and in all beta power sites, the omnibus tests (full model/model without intervention) and comparisons relative to control conditions showed a no significant overall result or failed …