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.

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.

This book offers clear, practical, and simple recommendations for treating patients with personality disorders. The goals of the book are twofold: 1) to describe the essential elements of Transference-Focused Psychotherapy (TFP), an evidence-based treatment for Borderline Personality Disorder, and 2) to describe how core principles and techniques of TFP can be used in a variety of settings to improve clinical management of patients with a broad spectrum of personality pathology, even when patients are not engaged in individual psychotherapy. A short introduction outlines in concise language the core elements of TFP and its origins in object relations theory. The book then takes the clinician through the process of: 1) comprehensive diagnosis, 2) negotiation of the treatment frame, and 3) the overarching strategies, techniques, and tactics used in the individual treatment, including helpful, accessible clinical vignettes. Subsequent chapters build on the literature of TFP in individual psychotherapy, broadening its applications to include crisis management, family engagement, inpatient psychiatry, pharmacotherapy, medical settings, psychiatry residency training. Fundamentals of Transference-Focused Psychotherapy is a valuable resource for psychiatrists, psychologists, and all other medical professionals treating patients suffering from Borderline Personality Disorder, and other severe personality disorder presentations.

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.

Filling a crucial gap in the clinical literature, this book provides a contemporary view of pathological narcissism and presents an innovative treatment approach. The preeminent authors explore the special challenges of treating patients--with narcissistic traits or narcissistic personality disorder--who retreat from reality into narcissistic grandiosity, thereby compromising their lives and relationships. Assessment procedures and therapeutic strategies have been adapted from transference-focused psychotherapy (TFP), a manualized, evidence-based treatment for borderline personality disorder. Rich case material illustrates how TFP-N enables the clinician to engage patients more deeply in therapy and help them overcome relationship and behavioral problems at different levels of severity. The volume integrates psychodynamic theory and research with findings from social cognition, attachment, and neurobiology.

Until recently, borderline personality disorder has been the step-child of psychiatric disorders. Many researchers even questioned its existence. Clinicians have been reluctant to reveal the diagnosis to patients because of the stigma attached to it. But individuals with BPD suffer terribly and a significant proportion die by suicide and engage in non-suicidal self injury. This volume provides state of the art information on clinical course, epidemiology, comorbidities and specialized treatments

This is the second edition of the book that sparked the current wave of interest in schema therapy. Although schema therapy was originally developed by Jeff Young in the USA, it was not until unprecedented outcome data was published from pioneering Dutch clinical trials with BPD patients that the clinical CBT community took serious notice. Schema therapy has now become one of the most popular forms of contemporary CBT. It has parallels to the ‘third wave’ of contextual behavioural science in that it develops traditional CBT in new directions, but while contextual behavioural science priorities behavioural techniques based on acceptance and mindfulness, schema therapy is more cognitive and draws on elements of experiential learning, object relations and psychodynamic therapy in addition to traditional CBT. The first edition of this book has sold more than 3,000 copies at a steady rate of around 500 units per year since 2009.