While personality disorders traditionally have been conceptualized
only in adults, it is not uncommon to encounter children and
adolescents with the classic diagnostic signs. Youngsters with
personality disorders may come across as strikingly arrogant,
defiant, and manipulative, yet their demeanor typically masks
devastating experiences of vulnerability and pain. This
groundbreaking volume offers a framework to make sense of childhood
personality disorders, distinguish them from more frequently
diagnosed childhood conditions, and respond appropriately to the
challenges this population presents. Interweaving neurobiological,
psychodynamic, and developmental perspectives, Efrain Bleiberg
presents an effective treatment model grounded in research and
extensive clinical experience. All therapists working with children
and adolescents will find vital insights and strategies in this
lucidly written book. The author first explores the nature and
clinical presentation of childhood personality disorders. Diverse
theoretical and empirical literatures are integrated to show how a
combination of constitutional vulnerability, attachment
difficulties, and trauma may impair the child's capacity to
interpret and respond to the world in human, meaningful terms.
Elucidated are the processes by which specific personality
disorders develop when children--and caregivers--become trapped in
rigid, maladaptive patterns of feeling, coping, and relating. The
book then takes the clinician step-by-step through offering
multimodal interventions that incorporate individual psychotherapy,
family treatment, and pharmacotherapy. Compelling case vignettes
and transcripts bring to life the inner worlds of these frightened
young people and the clinicians who work with them, showing how
treatment can help achieve intrapsychic change, free inhibited
development, and modify the child's family context. Emphasizing the
importance of the therapeutic alliance, the book gives particular
attention to ways that therapists can understand and work with
their own emotional reactions in highly charged clinical
situations. Providing a unique, research-based approach to working
with a notably difficult-to-treat population, this book belongs on
the desks of psychologists, psychiatrists, social workers, and
other clinicians working with children and adolescents. Rendering
complex ideas accessible, it will also be an invaluable resource
for graduate-level students and trainees in these fields.
Winner--Gradiva Award, National Association for the Advancement of
Psychoanalysis
General
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