By Otto Kernberg
During this booklet a number one psychoanalytic clinician and theoretician provides his recommendations at the most up-to-date psychodynamic advancements and insights relating to remedy of critical character problems. Dividing his discussions into sections, one on psychopathology and the opposite on psychotherapy, Dr. Otto Kernberg examines borderline character disease, narcissism, sexual inhibition, transference and countertransference, suicidal behaviour, and consuming problems. In every one bankruptcy he integrates the tips of eu and Latin American psychoanalytic thinkers, bringing them to the eye of English-speaking readers. This ebook incorporates a number of lately released magazine articles. Their assortment into one quantity makes available Dr. Kernberg's current pondering on an immense topic.
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Additional info for Aggressivity, Narcissism, and Self-Destructiveness in the Psychoterapeutic Relationship: New Developments in the Psychopathology and Psychotherapy of Severe Personality Disorders
The increase of impulse control and affect tolerance during treatment confirms that Theory of Personality Disorders splitting mechanisms are central in the pathology. The hypomanic personality disorder, in contrast, appears to include a pathology of affect activation that points to temperamental predisposition; this probably also holds true for its milder form, the cyclothymic personality. Borderline personality disorders presenting intense aggression may evolve into the sadomasochistic personality disorder.
Therefore the difference between past pathogenic experiences and their transformation into currently structured unconscious dispositions is not as great as in the primitive transferences of patients with borderline personality organization. I assume that in all cases the transference is dynamically unconscious in the sense that, because of either repression or splitting, the patient unconsciously distorts the current experience owing to his fixation to past pathogenic conflicts with a significant internalized object.
The borderline and the schizoid may be described as the simplest forms of personality disorder, reflecting fixation at the level of separation-individuation and the “purest” ex- 17 18 Psychopathology pression of the general characteristics of borderline personality organization. Fairbairn (), in fact, described the schizoid personality as the prototype of all personality disorders and described the psychodynamics of these patients: the splitting operations separating “good” and “bad” internalized object relations, the self-representation and object representation dyads of the split-off object relations, the consequent impoverishment of interpersonal relations, and their replacement by a defensive hypertrophy of fantasy life.