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Fairbairn's Object Relations Theory in the Clinical Setting

Fairbairn's Object Relations Theory in the Clinical Setting
Author: David P. Celani
Publisher: Columbia University Press
Total Pages: 242
Release: 2010
Genre: Psychology
ISBN: 0231149077

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W. R. D. Fairbairn (1889-1964) challenged the dominance of Freud's drive theory with a psychoanalytic theory based on the internalization of human relationships. Fairbairn assumed that the unconscious develops in childhood and contains dissociated memories of parental neglect, insensitivity, and outright abuse that are impossible the children to tolerate consciously. In Fairbairn's model, these dissociated memories protect developing children from recognizing how badly they are being treated and allow them to remain attached even to physically abusive parents. Attachment is paramount in Fairbairn's model, as he recognized that children are absolutely and unconditionally dependent on their parents. Kidnapped children who remain attached to their abusive captors despite opportunities to escape illustrate this intense dependency, even into adolescence. At the heart of Fairbairn's model is a structural theory that organizes actual relational events into three self-and-object pairs: one conscious pair (the central ego, which relates exclusively to the ideal object in the external world) and two mostly unconscious pairs (the child's antilibidinal ego, which relates exclusively to the rejecting parts of the object, and the child's libidinal ego, which relates exclusively to the exciting parts of the object). The two dissociated self-and-object pairs remain in the unconscious but can emerge and suddenly take over the individual's central ego. When they emerge, the "other" is misperceived as either an exciting or a rejecting object, thus turning these internal structures into a source of transferences and reenactments. Fairbairn's central defense mechanism, splitting, is the fast shift from central ego dominance to either the libidinal ego or the antilibidinal ego-a near perfect model of the borderline personality disorder. In this book, David Celani reviews Fairbairn's five foundational papers and outlines their application in the clinical setting. He discusses the four unconscious structures and offers the clinician concrete suggestions on how to recognize and respond to them effectively in the heat of the clinical interview. Incorporating decades of experience into his analysis, Celani emphasizes the internalization of the therapist as a new "good" object and devotes entire sections to the treatment of histrionic, obsessive, and borderline personality disorders.


Relationship Management Of The Borderline Patient

Relationship Management Of The Borderline Patient
Author: David L. Dawson
Publisher: Routledge
Total Pages: 235
Release: 2013-05-13
Genre: Psychology
ISBN: 113485806X

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This volume offers guidelines for managing the therapist-patient relationship during crisis intervention and longer-term therapy with patients who exhibit borderline symptoms. Since to do no harm is the primary goal of any therapist who encounters such a patient, an appropriate therapist-patient relationship is crucial; moreover, skillful management of this relationship can, in itself, be the most effective and safe treatment. The authors present a conceptual model, based on self psychology and interpersonal theory, for reframing the borderline symptoms and the therapist's reactions. Case examples demonstrate effective relationship management and therapeutic interventions.


The Borderline Patient

The Borderline Patient
Author: James S. Grotstein
Publisher: Routledge
Total Pages: 349
Release: 2014-06-03
Genre: Psychology
ISBN: 1317771710

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This volume focuses on treatment issues pertaining to patients with borderline psychopathology. A section on psychoanalysis and psychoanalytic psychotherapy (with contributors by V. Volkan, H. Searles, O. Kernberg, L. B. Boyer, and J. Oremland, among others) is followed by a section exploring a variety of alternative approaches. The latter include psychopharmacology, family therapy, milieu treatment, and hospitalization. The editors' concluding essay discusses the controversies and convergences among the different treatment approaches.


Management of Countertransference with Borderline Patients

Management of Countertransference with Borderline Patients
Author: Glen O. Gabbard
Publisher: Jason Aronson
Total Pages: 271
Release: 2000-10-01
Genre: Psychology
ISBN: 1461629462

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Management of Countertransference with Borderline Patients is an open and detailed discussion of the emotional reactions that clinicians experience when treating borderline patients. This book provides a systematic approach to managing countertransference that legitimizes the therapist's reactions and shows ways to use them therapeutically with the patient.


A Primer of Transference-focused Psychotherapy for the Borderline Patient

A Primer of Transference-focused Psychotherapy for the Borderline Patient
Author: Frank E. Yeomans
Publisher: Jason Aronson
Total Pages: 308
Release: 2002
Genre: Medical
ISBN: 9780765703552

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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.


Cognitive-Behavioral Treatment of Borderline Personality Disorder

Cognitive-Behavioral Treatment of Borderline Personality Disorder
Author: Marsha M. Linehan
Publisher: Guilford Press
Total Pages: 584
Release: 1993-05-14
Genre: Psychology
ISBN: 1606237780

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For the average clinician, individuals with borderline personality disorder (BPD) often represent the most challenging, seemingly insoluble cases. This volume is the authoritative presentation of dialectical behavior therapy (DBT), Marsha M. Linehan's comprehensive, integrated approach to treating individuals with BPD. DBT was the first psychotherapy shown in controlled trials to be effective with BPD. It has since been adapted and tested for a wide range of other difficult-to-treat disorders involving emotion dysregulation. While focusing on BPD, this book is essential reading for clinicians delivering DBT to any clients with complex, multiple problems. Companion volumes: The latest developments in DBT skills training, together with essential materials for teaching the full range of mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance skills, are presented in Linehan's DBT Skills Training Manual, Second Edition, and DBT Skills Training Handouts and Worksheets, Second Edition. Also available: Linehan's instructive skills training videos for clients--Crisis Survival Skills: Part One, Crisis Survival Skills: Part Two, From Suffering to Freedom, This One Moment, and Opposite Action.


Treating The Borderline Patient

Treating The Borderline Patient
Author: Frank Yeomans
Publisher:
Total Pages: 236
Release: 1992
Genre: Behavior therapy
ISBN:

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Borderline Personality Disorder

Borderline Personality Disorder
Author: Leonard Horwitz
Publisher: American Psychiatric Pub
Total Pages: 278
Release: 1996
Genre: Medical
ISBN: 9780880486897

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Borderline Personality Disorder: Tailoring the Psychotherapy to the Patient explores the challenge of treating patients with borderline personality disorder. These patients make up a large segment of the difficult-to-treat population. The instability of their relationships, the intensity of their affective responses, and their proneness to paranoid reactions all contribute to their difficulty in working consistently and constructively in the psychotherapeutic situation. When one adds these difficult patient problems to the therapist's quandary about how expressive or supportive to be, therapists are indeed often confronted with a challenging therapeutic task. The book begins with a review of the clinical and research literature pertaining to the treatment of borderline patients. It presents a unique, empirically based intensive study of three borderline patients, based on transcripts of audiotaped therapy sessions. The research methodology is reviewed, and clinically oriented descriptions of the three patients, their psychotherapy processes, and their outcomes are included. Following an overall summary of results, conclusions regarding the differential indications for supportive versus expressive emphasis in psychotherapy are discussed. In their research, the authors recorded every psychotherapy session and studied a randomly selected group of sessions. Therefore, the reader is provided with increased insight into what is most effective with what kind of patient at a given point in the therapy process.


Handbook of Good Psychiatric Management for Borderline Personality Disorder

Handbook of Good Psychiatric Management for Borderline Personality Disorder
Author: John G. Gunderson
Publisher: American Psychiatric Pub
Total Pages: 182
Release: 2014-01-15
Genre: Medical
ISBN: 1585625302

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The diagnosis and treatment of patients with BPD can be fraught with anxiety, uncertainty, and complexity. How welcome, then, is the Handbook of Good Psychiatric Management for Borderline Personality Disorder, which teaches clinicians what to do and how to do it, as well as what not to do and how to avoid it. The author, a renowned researcher and clinician, has developed a new evidence-based treatment, Good Psychiatric Management (GPM) that comfortably utilizes cognitive, behavioral, and psychodynamic interventions that are practical and simple to implement. Because psychoeducation is an important component of GPM, the book teaches clinicians how to educate their patients about BPD, including the role of genetics and the expected course of the disease. This approach offers advantages both to practitioners, who become more adept at honest communication, and to patients, who are encouraged to have realistic hopes and to focus on strategies for coping with BPD in daily life. The book is structured for maximum learning, convenience, and utility, with an impressive array of features. Section I provides background on BPD, including the myths that sometimes discourage clinicians from treating these patients and that hamper the effective treatment of the disorder. Section II, the GPM Manual, provides a condensed and clear description of the most essential and specific GPM interventions that clinicians can learn from and use in everyday practice. Section III, the GPM Workbook, offers case vignettes which reference chapters from the manual. Each vignette has a number of "decision points" where alternative interventions are proposed and discussed. To further facilitate learning, a set of nine interactions is found in a series of online video demonstrations. Here, readers can see in vivo illustrations of the GPM model in practice. Finally, a set of appendices provides critical information, such as a comparison of GPM with other evidence-based treatments of BPD, scaling risk and response strategies, and family guidelines. Designed to be a basic case management text for all hospital, outpatient clinic, or office-based psychiatrists or mental health professionals who assume primary responsibility for the treatment of those with BPD, the Handbook of Good Psychiatric Management for Borderline Personality Disorder constitutes a breakthrough in the treatment of these often misunderstood patients.


Psychotherapy of the Quiet Borderline Patient

Psychotherapy of the Quiet Borderline Patient
Author: Vance R. Sherwood
Publisher: Jason Aronson
Total Pages: 328
Release: 1994
Genre: Medical
ISBN:

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The as-if patient very often comes to treatment at the behest of someone else, or comes with only the vaguest sense that something is wrong, hence, the patient does not usually notice that nothing is happening in therapy.