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Borderline Patients: Extending The Limits Of Treatability

Author: Harold W. Koenigsberg

Publisher:

Published: 2000-06-09

Total Pages: 312

ISBN-13:

1. Borderline patients and transference focused psychotherapy 2. factors that shape borderline personality disorder 3. treatment dilemmas arising from misdiagnoses 4. sadomasochism 5. narcissism and psychopathy 6. the impact of attachment status 7. schizoid states and paranoid regression 8. depression and suicidality 9. trauma, sexual pathology, and acting out 10. erotic transference and countertransference 11. using dream material 12. transference focused psychotherapy combined with parmacotherapy 13. transference focused psychotherapy in sequence with other modalities.

Transference-Focused Psychotherapy for Borderline Personality Disorder

Author: Frank E. Yeomans

Publisher: American Psychiatric Pub

Published: 2015-04-01

Total Pages: 431

ISBN-13: 1585625434

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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.

Cognitive-Behavioral Treatment of Borderline Personality Disorder

Author: Marsha M. Linehan

Publisher: Guilford Press

Published: 1993-05-14

Total Pages: 584

ISBN-13: 1606237780

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For the average clinician, individuals with borderline personality disorder (BPD) often represent the most challenging, seemingly insoluble cases. This volume is the authoritative presentation of dialectical behavior therapy (DBT), Marsha M. Linehan's comprehensive, integrated approach to treating individuals with BPD. DBT was the first psychotherapy shown in controlled trials to be effective with BPD. It has since been adapted and tested for a wide range of other difficult-to-treat disorders involving emotion dysregulation. While focusing on BPD, this book is essential reading for clinicians delivering DBT to any clients with complex, multiple problems. Companion volumes: The latest developments in DBT skills training, together with essential materials for teaching the full range of mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance skills, are presented in Linehan's DBT Skills Training Manual, Second Edition, and DBT Skills Training Handouts and Worksheets, Second Edition. Also available: Linehan's instructive skills training videos for clients--Crisis Survival Skills: Part One, Crisis Survival Skills: Part Two, From Suffering to Freedom, This One Moment, and Opposite Action.

Borderline Conditions and Pathological Narcissism

Author: Otto F. Kernberg

Publisher: Jason Aronson, Incorporated

Published: 1995-04-01

Total Pages: 376

ISBN-13: 1461627656

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The basic text for the understanding of patients with pathological narcissism.

Management of Countertransference with Borderline Patients

Author: Glen O. Gabbard

Publisher: Jason Aronson

Published: 2000-10-01

Total Pages: 271

ISBN-13: 1461629462

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Management of Countertransference with Borderline Patients is an open and detailed discussion of the emotional reactions that clinicians experience when treating borderline patients. This book provides a systematic approach to managing countertransference that legitimizes the therapist's reactions and shows ways to use them therapeutically with the patient.

A Primer of Transference-Focused Psychotherapy for the Borderline Patient

Author: Frank E. Yeomans

Publisher: Jason Aronson, Incorporated

Published: 2002-07-31

Total Pages: 302

ISBN-13: 1461627303

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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.

The American Psychiatric Association Publishing Textbook of Personality Disorders, Third Edition

Author: Andrew E. Skodol, M.D.

Publisher: American Psychiatric Pub

Published: 2021-03-31

Total Pages: 762

ISBN-13: 161537339X

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Through dozens of tables, illustrative figures, and real-life case examples, established experts in the field, as well as a new generation of scientists, examine clinical concepts; risk factors for and impact of personality disorders; treatment options (including a new chapter on early identification of borderline psychopathology in children); special populations; and future directions for the field.

Personality-Disordered Patients

Author: Michael H. Stone

Publisher: American Psychiatric Pub

Published: 2007-05-03

Total Pages: 286

ISBN-13: 1585627054

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Determining the amenability of personality disorders to psychotherapy -- a patient's capacity to benefit from verbal approaches to treatment -- is important in helping clinicians determine the treatability of cases. Michael Stone here shares the factors he has observed over long years of practice that can help practitioners evaluate patients, stressing the amenability of the various disorders to amelioration. By focusing on which patients are likely to respond well to therapeutic intervention and which will prove most resistive, his book will help therapists determine with what kinds of patients they will most likely succeed and with which ones failure is almost a certainty. Stone establishes the attributes that affect this amenability -- such as the capacity for self-reflection, motivation, and life circumstances -- as guidelines for evaluating patients, then describes borderline and other personality-disordered patients with varying levels of amenability, from high to low. This coverage progresses from patients belonging to the DSM "anxious cluster," along with the depressive-masochistic character and the hysteric character, to patients who demonstrate an intermediate level of amenability to psychotherapy. He introduces the interrelationship between borderline personality disorder and dissociative disorders and discusses treatability among certain patients in Clusters "A" and "C," as well as others with narcissistic, histrionic, depressive disorders. Final chapters address the most severe aberrations of personality and the limitations they impose on the efficacy of therapy. Personality-Disordered Patients is filled with practical, clinically focused information. This guideline structured book: Covers all personality disorders-including ones not addressed in the latest DSM such as sadistic, depressive, hypomanic, and irritable-explosive Identifies both attributes necessary for treatability and factors associated with low treatability Pays particular attention to borderline disorders, which represent the most discussed conditions and are among the most challenging to psychotherapists Reviews personality traits whose presence, if intense-even if unaccompanied by a definable personality disorder-creates severe problems for psychotherapy Numerous case studies throughout the book provide examples that will help therapists determine which of their own patients are most likely to benefit from their efforts and thereby establish their own limits of effectiveness. By alerting practitioners to when therapy is likely to fail, these guidelines can help them avoid the professional disappointment of being unable to reach the most intractable patients.

Practice Guideline for the Treatment of Patients with Borderline Personality Disorder

Author: American Psychiatric Association

Publisher: American Psychiatric Pub

Published: 2001

Total Pages: 158

ISBN-13: 9780890423196

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The most common personality disorder here and abroad, borderline personality disorder is often misdiagnosed or underdiagnosed. Left untreated, it causes marked distress and impairment in social, occupational, and role functioning, with high rates of self-destructive behavior (attempted and completed suicide). Its pervasive pattern of impulsivity and instability of interpersonal relationships, affects, and self-image begins in early adulthood and presents in a variety of contexts. Developed primarily by psychiatrists in active clinical practice, the revised edition of this popular work offers an updated synthesis of current scientific knowledge and rational clinical practice for patients with borderline personality disorder -- with the important caveat that clinicians should consider, but not limit themselves to, the treatments recommended here. The summary of treatment recommendations is keyed according to the level of confidence with which each recommendation is made and coded to show the nature of its supporting evidence. Highly informative and easy to use, this eminently practical volume is organized into three major parts: Part A contains treatment recommendations (Section I, treatment summaries; Section II, treatment plans; Section III, special clinical considerations; and Section IV, risk management issues during treatment), Part B presents the evidence underlying these treatment recommendations (Section V, an overview of DSM-IV-TR criteria, prevalence rates, and natural history and course; and Section VI, a review of existing treatment literature), and Part C summarizes those areas in which better research data are needed. Remarkably concise and comprehensive, this practice guideline continues to be an indispensable reference for every clinician who treats patients with this heterogeneous and complex disorder.

Fatal Flaws

Author: Stuart C. Yudofsky

Publisher: American Psychiatric Pub

Published: 2007-04-02

Total Pages: 514

ISBN-13: 1585626589

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Featuring case vignettes from nearly 30 years of Dr. Yudofsky's clinical practice and incorporating the knowledge of gifted clinicians, educators, and research scientists with whom he has collaborated throughout that time, Fatal Flaws: Navigating Destructive Relationships With People With Disorders of Personality and Character uniquely captures the rapidly increasing body of clinical and research information about people with severe and persistent personality and character disorders. Within these pages, the author brings to life the psychopathologies of personality and character disorders through vivid vignettes based on composites of his many patients and their most important relationships -- while meticulously changing the identifying facts and relevant details to protect confidentiality. Covering the clinical course, treatment, genetics, biology, psychology, and destructive consequences of hysterical (histrionic), narcissistic, antisocial, paranoid, obsessive-compulsive, addictive, borderline, and schizotypal personality disorders, Fatal Flaws stands out in the literature for these powerful reasons: It is written for an unusually broad audience, from mental health students and trainees of all disciplines, to highly experienced clinicians, to patients who suffer from or are in destructive relationships with people with personality disorders. It is a hybrid -- part psychiatric textbook for clinicians and part self-help manual for patients and clients with personality and character disorders. It is designed to supplement treatment by providing patients with practical, evidence-based information about personality disorders and character flaws. It is particularly valuable to patients who are in psychotherapy, in part, because they are entangled in destructive relationships with people with disorders of personality and/or character. It is written in the first person, with the author directly communicating with a patient who either has a personality or character disorder or is in an important relationship with a person who has such a disorder. It is useful for people who are uncertain whether they or their loved ones have personality or character disorders, and who want to know more about these conditions and their treatments before making a decision about securing the help of a mental health professional. Fatal Flaws: Navigating Destructive Relationships With People With Disorders of Personality and Character is a compelling volume that provides the essential information and a realistic sense of the clinical experience required to inform, orient, and support novice mental health professionals and seasoned practitioners alike as they face the ongoing challenges of treating patients or clients with personality or character disorders. It should also prove to be an invaluable resource for those who wish practical and effective help in understanding and changing their destructive relationships with people who have severe and persistent disorders of personality and/or character.