Disorders of the self : new therapeutic horizons : the Masterson approach

First published in 1996. Routledge is an imprint of Taylor & Francis, an informa company.

A testament to the vitality of the Masterson Approach to the study and treatment of the disorders of the self, this incisive volume documents the evolution of Masterson's theoretical and clinical work during the past five years. It is comprised of writings by a second generation of clinicians who both carry on and expand the horizons of the Masterson Approach. Disorders of the Self addresses four new areas of great clinical importance from the perspective of developmental, self, and object relations theory. First, Ralph Klein, Clinical Director of the Masterson Institute), has combined the work of Fairburn and Guntrip with the Masterson Approach to develop and updated, broader, original and clinically useful concept of the Schizoid Disorders of the Self. The force of his approach is illustrated by the focus on the schizoid dilemma and the schizoid compromise, vividly depicted with detailed clinical applications. Candace Orcutt, Senior Faculty Member in the Masterson Institute, along with a colleague, then apply the Masterson Approach to the controversial topic of early abuse - physical and/or sexual - to the developing self. Diagnosis and treatment of narcissistic pathology is the focus of section three. Chapters further refine and expand how the disorders of the self triad - self activation leads to anxiety and depression which lead to defenses - operate in both the patient's life and in the therapeutic relationship. The authors identify and illustrate critical points in treatment, detail the technical approach to the closet narcissistic personality disorder, and address the therapeutic management of devaluation and disappointment reactions along with the countertransference reactions they evoke. The volume concludes by delving into arenas beyond individual psychotherapy for disorders of the self. An innovative approach to group therapy combines the Masterson Approach with that of W. Bion, and authors examine the complexities of drug therapy and comorbidity and their interaction with psychodynamic forces. Disorders of the Self will be a vital addition to the armamentarium of any clinician who works with personality disorders. It demonstrates the continued expansion and evolution of a profound theoretical and clinical paradigm - the Masterson Approach - aimed at penetrating and healing the disorders of the self.

Booknews

A reference for psychiatrists and psychologists written by clinicians who follow the Masterson approach, which focuses on individual, intensive psychotherapy through the eyes of developmental, self, and object relations theory. Its four sections focus on schizoid disorders; the effects of early physical and sexual abuse on the developing self; narcissistic pathology; and arenas beyond individual psychotherapy, such as couples and drug therapy. Annotation c. Book News, Inc., Portland, OR (booknews.com)

Front Cover 1 Disorders of the Self 4 Copyright Page 5 Contents 6 Contributors 8 Preface 10 Part I: The Self-in-Exile: A Developmental, Self, and Object Relations Approach to the Schizoid Disorder of the Self 13 1. Evolution 15 2. Description 25 3. Developmental Theory 45 4. Intrapsychic Structures 56 5. Establishing a Therapeutic Alliance 80 6. Shorter-Term Treatment 106 7. Intensive, Long-Term Psychotherapy 134 8. Safety First: Approaching Treatment of the Schizoid Disorder of the Self 154 9. Narcissistic Defenses Against a Schizoid Disorder 172 Part II: Early Trauma and the Developing Self 190 10. The Influence of Early Trauma on the Developing Self 191 11. Uncovering "Forgotten" Child Abuse in the Psychotherapy of a Borderline Disorder of the Self 215 12. Integration of Multiple Personality Disorder in the Context of the Masterson Approach 237 13. Season of Light/Season of Darkness: The Effects of Burying and Remembering Traumatic Sexual Abuse on the Sense of Self 265 Part III: Perspectives on Treating the Narcissistic Disorder ofthe Self 289 14. Disavowed Narcissism: Fusion and Externalizing Defenses in the Closet Narcissistic Disorder of the Self 291 15. Mirrors of Rage: The Devaluing Narcissistic Patient 308 16. Neutrality Under Attack: Devaluation in the Therapeutic Relationship 321 17. Therapeutic Management of Disappointment Reactions with the Closet Narcissistic Disorder of the Self 333 Part IV: Other Treatment Strategies 342 18. Group Psychotherapy and Disorders of the Self 343 19. Couples Therapy of Patients with Disorders of the Self 371 20. Working with the Collective Marital Self 388 21. Antidepressants in Psychotherapy: Use and Abuse 397 22. Three Bipolar Women: The Boundary Between Bipolar Disorders and Disorders of the Self 414 Name Index 430 Subject Index 432 The evolution of the dynamic schizoid concept and the more specific diagnosis of the schizoid personality disorder (henceforth referred to as the schizoid disorder of the self) brings several questions to mind: 1. Is the concept of a schizoid disorder really a valid, discrete, and clinically useful construct, or might it not be equally well subsumed within the other broad dimensions of psychopathology?