The Inseparable Nature of Love and Aggression : Clinical and Theoretical Perspectives

xiii xiv THE INSEPARABLE NATURE OF LOVE AND AGGRESSION treatment of individual patients, followed by the application of this approach to group psychotherapy. TFP has been empirically studied, with randomized clinical trials demonstrating its efficacy and comparing it with alternative treatment methods carried out in our institute and replicated in a randomized controlled trial in Munich and Vienna. This chapter includes, in fact, a summary of the recently published updated version of the manual of TFP. Chapter 3 focuses on essential mechanisms of change operating in psychodynamic psychotherapies in general, and in TFP in particular, namely, improvement in reflective function or "mentalization." In this chapter, I review critically the corresponding literature and relate it to the corresponding development, within cognitive-behavioral psychotherapies, of the concept of "mindfulness." This exploration leads to the role of interpretation as a central technique in TFP and its illustration with a detailed clinical case of a borderline patient where interpretation was carried out in an early treatment session. Chapter 4 explores one other key element in the psychodynamic psychotherapy of severe personality disorders, namely, the therapist's management of the countertransference-that is, the activation of powerful affective reactions in the therapist as a consequence of his or her encounter with and efforts to understand the severely regressive emotional transference reactions of these patients. Here I review and update the management of countertransference under particularly difficult treatment situations, illustrating it with clinical case material. The analysis of particularly challenging and difficult treatment situations, the almost "impossible" cases that often defy even experienced therapists' efforts, is explored in detail in Chapters 5 and 6. These two chapters focus on patients with severe narcissistic personality disorders, a frequent comorbidity of borderline personality disorders, that typically includes a significant group of treatmentresistant patients. In these two chapters, I describe difficult and challenging complications that may arise in the corresponding treatments and how to diagnose and deal with them. In particular, Chapter 6 points to a subtle but potentially highly destructive neglect of the passage of time in some severely ill patients and in the development of their corresponding treatments. The treatment of severe personality disorders requires, on the part of the clinician at any level of expertise, the possibility of consulting with colleagues and, at times, obtaining supervision. In Chapter 7, I discuss the role of the consultant or supervisor of psy-gether and in our discussion of all these issues, helped me to clarify my own thoughts and to gain new understanding regarding many subjects touched on in this book. They include, in the United States, Drs « Otto Kernberg is a towering figure in the field of psychoanalysis and has accomplished seminal work in object relations and the treatment of borderline and narcissistic patients. This volume collects his recent work in several areas: severe personality disorders, couples in conflict, and religious experience. In each area, he explores the relationship between the psychoanalytic, clinical psychiatric, and neurobiological approaches, yielding insights and analysis that are compelling, thought-provoking, and at times startling in their penetrating brilliance. In addition, the book addresses the challenges that psychoanalysis faces in the current medical environment, and the need to strengthen its ties with academic institutions. Beautifully written, the book is designed to both provoke questions and provide enlightenment on a variety of critical issues within psychotherapy. Specifically, the volume: - Explores new approaches to diagnosis and new psychotherapeutic techniques to treat the most severe personality disorders, particularly severe narcissistic psychopathology, based on new research findings; - Relates psychoanalytic theory to neurobiological findings by illuminating the influences of neurobiological structures and intrapsychic conflicts on the development of the personality; - Examines the psychoanalytic and neurobiological underpinnings of sexual love, from the organization of brain structures and neurotransmitters to the overall systems of erotic activation, attachment and bonding. This systematic approach provides insight into the nature of passionate love and the psychodynamic features of the love relationship; - Addresses psychodynamic factors in the religious experience and the search for universal ethical values, and explores the crucial function of religious experience in dealing with the ideological challenges of social life; and - Identifies the serious problems facing psychoanalytic education, institutions, and the profession of psychoanalysis, and proposes solutions to energize the field and increase its contributions to scientific research and progress. In The Inseparable Nature of Love and Aggression: Clinical and Theoretical Perspectives, Kernberg demonstrates his belief that the collaboration of psychoanalysis and neurobiology has the potential to significantly advance our understanding of the human mind. The full spectrum of mental health clinicians, as well as educated general readers, will find this to be a work of creativity and substance. » -- Résumé de l'éditeur] About the AuthorIntroductionAcknowledgmentsPART I: Severe Personality DisordersChapter 1. Identity RECENT FINDINGS AND CLINICAL IMPLICATIONSChapter 2. Psychoanalytic Individual and Group Psychotherapy THE TRANSFERENCE-FOCUSED PSYCHOTHERAPY (TFP) MODELChapter 3. Mentalization, Mindfulness, Insight, Empathy, and InterpretationChapter 4. Countertransference RECENT DEVELOPMENTS AND TECHNICAL IMPLICATIONS FOR THE TREATMENT OF PATIENTS WITH SEVERE PERSONALITY DISORDERSChapter 5. The Almost Untreatable Narcissistic Patient Chapter 6. The Destruction of Time in Pathological NarcissismChapter 7. Supervision THE SUPERVISOR'S TASKSPART II: Reflections on Psychoanalytic Theory and Its ApplicationsChapter 8. Psychoanalytic Affect Theory in the Light of Contemporary Neurobiological FindingsChapter 9. The Concept of the Death Drive A CLINICAL PERSPECTIVEChapter 10. Some Observations on the Process of MourningPART III: The Psychology of Sexual LoveChapter 11. The Sexual Couple A PSYCHOANALYTIC EXPLORATIONChapter 12. Limitations to the Capacity to loveChapter 13. Sexual Pathology in Borderline PatientsPART IV: Contemporary Challenges for PsychoanalysisChapter 14. Psychoanalysis and the University A DIFFICULT RELATIONSHIPChapter 15. "Dissidence" in Psychoanalysis: A PSYCHOANALYTIC REFLECTIONPART V: The Psychology of Religious ExperienceChapter 16. Psychoanalytic Perspectives on the Religious ExperienceChapter 17. The Emergence of a Spiritual Realm Index Kernberg, a professor of psychiatry at Weill Cornell Medical College and Training and Supervising Analyst at Columbia University's Center for Psychoanalytic Training and Research, provides an over-view of new and old theoretical perspectives and clinical approaches to love and aggression in borderline personality disorder and more "normal" neurotic disorders. Freud's drive-theory of libido and death-drive. Of the five sections that divide his seventeen chapters, he spends the most time exploring severe personality disorder, the developmental origins of normal identity, transference-focused psychotherapy, mechanisms of change operating in psycho-dynamic approaches to therapy, and counter-transference in psychotherapy. Other sections and chapters reflect on psychoanalytic theory and its application, neurobiological considerations for affect theory, the psychology of sex & love, mourning, the contemporary relevance of psychoanalysis in the university and its "dissidents", and psychoanalytic perspectives on religious experience. Written clearly enough to be accessible to a general audience with an interest in psychoanalysis, but with enough details and carefully examined case studies to be relevant to clinicians as well. Annotation ©2012 Book News, Inc., Portland, OR (booknews.com)

The task Dr. Otto Kernberg takes up in The Inseparable Nature of Love and Aggression: Clinical and Theoretical Perspectives is to first distinguish, then to interrelate psychoanalytic, clinical psychiatric, and neurobiological perspectives in a variety of areas, beginning with severe personality disorders and extending to love, destructiveness, mourning, spirituality, and the future of psychoanalytic inquiry. Dr. Kernberg is renowned for his work with borderline and narcissistic patients, and in this book, he offers new approaches to the diagnosis and treatment of the most severe personality disorders, particularly the spectrum of severe narcissistic psychopathology. His effort to relate psychoanalytic to neurobiological findings continues in two fascinating areas -- the study of sexual love and of religious experience -- and he examines object relations theory in relation to these two phenomena.

Kernberg's analysis of love and aggression is both bold and nuanced and will captivate the professional psychotherapist as well as the psychologically astute general reader.

American Psychiatric Publishing

The task Dr. Otto Kernberg takes up in The Inseparable Nature of Love and Clinical and Theoretical Perspectives is to first distinguish, then to interrelate psychoanalytic, clinical psychiatric, and neurobiological perspectives in a variety of areas, beginning with severe personality disorders and extending to love, destructiveness, mourning, spirituality, and the future of psychoanalytic inquiry. Dr. Kernberg is renowned for his work with borderline and narcissistic patients, and in this book, he offers new approaches to the diagnosis and treatment of the most severe personality disorders, particularly the spectrum of severe narcissistic psychopathology. His effort to relate psychoanalytic to neurobiological findings continues in two fascinating areas the study of sexual love and of religious experience and he examines object relations theory in relation to these two phenomena. Kernberg s analysis of love and aggression is both bold and nuanced and will captivate the professional psychotherapist as well as the psychologically astute general reader. This book distinguishes, then interrelates psychoanalytic, clinical psychiatric, and neurobiological perspectives in a variety of areas, beginning with severe personality disorders and extending to love, destructiveness, mourning, spirituality, and the future of psychoanalytic inquiry.