Treatment of Severe Personality Disorders: Resolution of Aggression and Recovery of Eroticism

In Treatment of Severe Personality Disorders: Resolution of Aggression and
Recovery of Eroticism, the influential psychoanalyst and psychiatrist Otto
Kernberg presents an integrated update of the current knowledge of personality
disorders, their neurobiological and psychodynamic determinants, and a specific
psychodynamic psychotherapy geared to resolve the psychopathology of these
conditions-namely, the syndrome of identity diffusion and its influence on the
capacity for emotional wellbeing and gratifying relationships with significant
others. The author updates the findings of the Personality Disorders Institute
of the Weill Cornell Medical College Department of Psychiatry, which are derived
from the empirical research and clinical investigation of severe personality
disorders, and addresses the effectiveness of transference-focused
psychotherapy, a specific psychodynamic treatment for these disorders developed
at the Institute. The volume focuses particularly on an essential group of
techniques common to all psychoanalytically derived treatments and clarifies the
corresponding differential features of various psychodynamic treatment
approaches.

In prose both precise and evocative, the author:

Examines the classification of personality disorders, the way competing
viewpoints have influenced the evolution of DSM-III and DSM-IV, and the impact
of new knowledge on the classification of DSM-5, with emphasis on how conflicts
between scientific and political considerations have hindered the classification
of personality disorders in the past. Illustrates in detail how present
knowledge of neurobiological structures and neurotransmitters intertwines with
the psychodynamic determinants of how psychic experience is organized. Explores
psychodynamic psychotherapies and contemporary developments and controversies in
the field. For example, the role of interpretation in borderline pathology is
examined using a clinical case, and a new formulation of supportive
psychodynamic psychotherapy is described. Addresses severe narcissistic
pathology-its diagnosis, prognosis, and treatment. Specifically, the book
presents an overview of treatment options for severe narcissistic personality
disorder, explores the distortions in verbal communication that may arise during
psychotherapy with these patients, and focuses on the differential diagnosis of
antisocial behavior. Examines the diagnosis and treatment of sexual pathology,
and explores the vicissitudes of the love lives of patients with severe
personality disorders. Concludes with a chapter on the essential preconditions
in the education of psychodynamic psychotherapists to carry out the challenging
and complex psychotherapeutic work in this field.

In describing both the
limits and the advances in therapeutic effectiveness, the Treatment of Severe
Personality Disorders: Resolution of Aggression and Recovery of Eroticism
performs a great service, and it will surely become a classic of the
psychoanalytic literature.