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.

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.

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.

After 30 years of declining practice among psychiatrists, psychotherapy is being increasingly recognized as a valuable tool in psychiatric care. While this renewed appreciation offers hope for the future, a serious challenge remains: There are alarmingly few psychiatrists equipped as psychotherapy supervisors to help train the next generation of psychiatrists. Encouraging psychiatrists to consider stepping into this important role is what makes Supervising Individual Psychotherapy such a timely and indispensable resource. With a multipronged approach that combines the theoretical and the practical, supported by illustrative clinical vignettes, this guide focuses on four key areas: • The process of supervisor development, including helpful tools for building supervisory skills and fostering self-growth, practical methods for establishing and maintaining a healthy supervisory relationship, and a collection of vignettes to highlight the supervisee's perspective. Also addressed are common ethical questions that arise in the supervisory process. • Specific techniques used in supervision, including how to establish and monitor goals for supervision, provide supervision via internet-mediated videoconferencing, and thoughtfully plan for the termination of supervision. • Psychotherapy supervision for specific populations and within various care settings, including supervision of supportive therapy in hospital units and emergency departments, cognitive-behavioral therapy, substance use disorder treatment, and combination treatment of psychotherapy and pharmacotherapy. Also discussed are the possible effects of the supervisee's and the supervisor's race, gender identity, and sexual preferenceorientation on the supervisory process. • Challenges that may arise in supervision, including an examination of the effects of marriage, divorce, illness, and death on the supervisory dyad; the legal aspects of supervision (e.g., confidentiality, medicolegal liability); and the risks of burnout in both the supervisor and the supervisee. With a richness of detail organized in an accessible and easy-to-reference format, this book clearly covers the skills, capabilities, and qualities needed to provide effective psychotherapy supervision—and is tailor-made for early- and mid-career supervisors who are looking to develop and refine their skills.

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.

Deftly combining contemporary theory with clinical practice, Psychodynamic Therapy for Personality Pathology: Treating Self and Interpersonal Functioning is an invaluable resource for any clinician seeking a coherent model of personality functioning and pathology, classification, assessment, and treatment. This insightful guide introduces Transference-Focused Psychotherapy-Extended (TFP-E), a specialized but accessible approach for any clinician interested in the skillful treatment of personality disorders. Compatible with the DSM-5 Section III Alternative Model for Personality Disorders-and elaborating on that approach, this volume offers clinicians at all levels of experience an accessible framework to guide evaluation and treatment of personality disorders in a broad variety of clinical and research settings. In this book, readers will find: * A coherent model of personality functioning and disorders based in psychodynamic object relations theory* A clinically near approach to the classification of personality disorders, coupled with a comprehensive approach to assessment* An integrated treatment model based on general clinical principles that apply across the spectrum of personality disorders* An understanding of specific modifications of technique that tailor intervention to the individual patient's personality pathology* Descriptions of specific psychodynamic techniques that can be exported to shorter-term treatments and acute clinical settings Patient assessment and basic psychodynamic techniques are described in up-to-date, jargon-free terms and richly supported by numerous clinical vignettes, as well as online videos demonstrating interventions. At the end of each chapter, readers will find a summary of key clinical concepts, making this book both a quick reference tool as well as a springboard for continued learning. Clinicians looking for an innovative, trustworthy guide to understanding and treating personality pathology that combines contemporary theory with clinical practice need look no further than Psychodynamic Therapy for Personality Pathology: Treating Self and Interpersonal Functioning.

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.