Dear members,

I would like to give a special thanks to our remarkable ISTFP Public Relations Committee for the particularly relevant and moving newsletter they have produced. We can all benefit from the reflections on mourning they have written. At a time when loss and threat are very present in the world and in our lives, it is important to be reminded that we can continue to build our lives and our community.

Frank E. Yeomans, MD, PhD

Frank E. Yeomans, MD, PhD, is a Clinical Professor of Psychiatry at the Joan and Sanford I. Weill Medical College and Graduate School of Medical Sciences of Cornell University. He is a Senior Consultant in and teaches internationally for the Personality Disorders Institute, and is in private practice in White Plains and New York City.

Author’s Website

Let’s start by wishing everyone a healthy, safe, and productive year for all the members of the ISTFP in 2024! That being said we, at the Public relations and Communications Committee, decided to start the new year with a review of 2023 so all members are aware of general health of our society. We hope it will encourage those of you who have worked tirelessly doing volunteer work to contribute to the society and spark interest in others to get involve.

To us, the ISTFP is like a living organism so we have made a list of health indicators that we will try to review each year. And, since we love empirical evidence, we will show you numbers that we will refresh every year. Let’s see what the data tells us. Is the ISTFP growing or slowly fading away?

Mathieu Norton-Poulin, M.Ps.

Mathieu Norton-Poulin is a psychologist in private practice in Gatineau, Québec. He graduated from Laval University in 1995 and started his training in transference focused psychotherapy in 2005. Member of the TFP-Québec group he as been practicing as a certified TFP therapist for the last 11 years. Since 2009 he organized several training events and has given lectures on TFP for medical doctors and college students. He maintains a blog where he write, in plain words, articles to explain TFP to the general public.

Read author’s Blog

Consistent with the theme of this newsletter, the research digest will focus on a paper where Dr. Kernberg elaborates on some observations regarding the process of mourning. Our intention is to review some psychoanalytic literature on this complex process, which certainly does not lack heterogeneity.

While some brain regions have been indicated as possible candidates related to mourning (see Chambers J 2023 for a review), we chose not to focus on the neurobiology underlying mourning, given the lack of consensus over the definition, the dynamic and complex nature of the processes, and the different responses to different losses, which, combined with the limitations of biological investigations in humans, exponentially increase the number of variables to account for rigor.

We will, however, mention how circadian rhythms, heart rate, blood pressure, and other homeostatic regulatory mechanisms are impacted by the loss of a close relationship.

Silvia Bernardi

Silvia Bernardi, MD, is an Assistant Professor of Psychiatry at Columbia University. After graduating from medical school in Florence Italy in 2006, Silvia emigrated to the USA to work intensively in neuroscience research, studying the bases of the interaction between emotions and cognition. Silvia completed her residency in Psychiatry at Columbia and has since practiced privately in New York. She trained in Transference Focused Psychotherapy and continues to see patients for medication management and psychotherapy while conducting her research to unlock further knowledge to support the biological underpinnings of TFP and borderline personality disorder.

Author’s website

Glauco Valdivieso

Glauco Valdivieso is a Peruvian psychiatrist, psychotherapist, and researcher based in Lima, Peru. He completed his medical degree at the Universidad Nacional Mayor de San Marcos and specialized in psychiatry at the Hospital Nacional Víctor Larco Herrera, becoming a board-certified psychiatrist in 2018.

He is a certified psychotherapist in Transference-Focused Psychotherapy (TFP), trained by the International Society of Transference-Focused Psychotherapy (ISTFP). In addition, he has completed formal training in Cognitive Psychotherapy, Dialectical Behavior Therapy (DBT), and Mentalization-Based Treatment (MBT).

More information

Dr. Valdivieso is the co-founder and medical director of the Instituto Peruano para el Estudio y Abordaje Integral de la Personalidad (IPEP), where he also coordinates the TFP Peru division. He founded and currently leads the Chapter on Personality Disorders within the Peruvian Psychiatric Association (APP), and works at the Mental Health Unit of Hospital de Villa El Salvador in Lima.

He is also a co-founder and editorial board member of the Latin American Journal of Personality, a collaborative initiative with the Instituto Argentino para el Estudio de la Personalidad y sus Trastornos (IAEPD). Additionally, he serves on the editorial board of the Peruvian Journal of Psychiatry. Internationally, he is a Board Member of the International Society for the Study of Personality Disorders (ISSPD), where he chairs the Communications Committee and leads the Latin American Regional Group.

His main clinical and research interests include the treatment of personality and mood disorders, with a particular focus on advancing research in Transference-Focused Psychotherapy (TFP).

Author’s facebook page

Dear members,

I am Chiara De Panfilis, co-chair of the Applied TFP Committee. Together with my co-chair, Richard Hersh, I will present you the members of our committee, its history and achievements.

Our committee is comprised of twelve members: Eve Caligor (USA), Sergio Dazzi (Italy), Chiara De Panfilis (Italy), Richard Hersh (USA), Tennyson Lee (UK), Jonathan Radcliffe (UK), Michael Rentrop (Germany), Eulalia Ripoll (Spain), Christiane Roesch (Switzerland), Maria Jesús Rufat (Spain), Luis Valenciano (Spain), Jo-anna VanDenBosch (UK). 

We aim to bring together, to study, and to develop the various applications of TFP principles in mental health settings other than the standard, twice-a-week outpatient individual psychotherapy setting.

Examples include, but are not limited to:

• Modifications of TFP for family interventions, group therapy, or forensic settings
• Implementation of inpatient treatment for personality disorders (PD) with TFP principles techniques and strategies
• Application of TFP principles within a variety of clinical situations and experiences such as:
  • general outpatient psychiatric care for PD
  • consultation-liaison psychiatry or medical settings
  • psychoeducation interventions.

Broadly speaking, such initiatives are referred to as “Applied TFP”. Examples of some of the elements of TFP that can be brought into these different settings are an emphasis on the role of a clear treatment frame and the utility of conceptualizing any clinical encounter in terms of the internal representations of self and other that are activated.

Chiara De Panfilis

MD, Associate Professor in Psychiatry

Chiara De Panfilis, MD, is an associate professor of Psychiatry in the Department of Medicine and Surgery, Unit of Neuroscience, University of Parma, Italy. Her main research interests are the potential social-cognitive mechanisms that shape the clinical picture and the psychosocial functioning of individuals suffering with personality disorders. She was previously a visiting research fellow at the Personality Disorders Institute of Weill Cornell Medical School, New York. For her research she received a grant from the International Psychoanalytic Association and awards from the International Society of Transference-Focused Psychotherapy (ISTFP) and the Society for Personality Assessment. She is co-founder and research coordinator of the Personality Disorders Lab (Parma-Milan, Italy). She is a board member of the ISTFP and is clinically active in implementing general psychiatric care for personality disorders with TFP principles. She authored
more than sixty peer-reviewed publications.

Richard G. Hersh

MD, Special Lecturer, Department of Psychiatry, Columbia University 

Richard G. Hersh, MD, was an attending psychiatrist at Massachusetts General Hospital and McLean Hospitals while an Instructor in Psychiatry at Harvard Medical School before coming to Columbia University Medical Center where he was a psychiatrist on the inpatient service before serving for fifteen years as the Associate Director of the Department of Psychiatry’s Intensive Outpatient Program. He has been trained in Transference-Focused Psychotherapy (TFP) for treatment of personality disorders and has fulfilled the requirements for Teacher and Supervisor status for TFP. He as serves on the Scientific Advisory Board of the National Education Alliance for Borderline Personality Disorder (NEA-BPD) and recently co-authored the textbook “Fundamentals of Transference-Focused Psychotherapy: Applications in Psychiatric and Medical Settings” published in 2017 by Springer.

Exploring the Therapeutic Universe of Aurora Döll Gallardo

In the captivating realm of mental health, I came across Aurora Döll Gallardo, a woman from Madrid whose life is dedicated to Psychotherapy, Psychiatry, and Medicine, and who has become an ardent advocate for Transference-Focused Psychotherapy (TFP).

Let’s begin with Aurora’s mornings. Before immersing herself in the daily hustle, she indulges in the luxury of a morning run in a nearby natural park—a ritual that provides her with peace and balance, the perfect starting point for the day ahead. More than a routine, she sees it has a revitalizing ritual.

As a true Madrilenian, Aurora shares her love for Zarzuela and the rich history of her city. From intriguing tidbits like the meaning of “Mayrit” (spring) to her detailed knowledge of medieval coats of arms, she guides us through a unique version of Madrid, a place she considers “the most beautiful city in the world.”

Transitioning from everyday life, we dive into her professional journey. From being a Community Psychiatrist at the CSM de Villa Vallecas to becoming the head of the Alcohol Addiction Unit at Hospital Dr. Rodríguez Lafora, Aurora has woven a diverse and enriching network. We look forward to her helping us appreciate the usefulness of a TFP approach in treating substance abuse, a topic on the program of the ISTFP Biennial Conference in September.

TFP takes center stage as the protagonist of this story. Aurora discovers her calling during five years of work in a Therapeutic Community for Personality Disorders. This is when she had a transformative encounter with TFP that motivated her to learn the treatment. Although TFP training was initially unavailable in Madrid, her determination led her to embrace it as soon as the opportunity arose in 2019-2020.

Reflections and Challenges in the Spanish Landscape

In our conversation, Aurora highlights the duality of TFP practice in Spain: despite currently being predominantly a private practice model of therapy, she envisions the potential for applying its principles in the public healthcare system. She acknowledges challenges, from overcoming prejudices to retaining patients in forms of treatment even when contracts are broken, but she is motivated to meet these obstacles with optimism.

Exploring the future of TFP in Spain, Aurora advocates for its dissemination and continuous training, adapting to various clinical environments without losing sight of necessary standards. While recognizing the power of technology, she emphasizes the importance of human connection and enriching supervision that only professionals can provide.

Thus, our conversation concludes, leaving us with the image of a passionate woman, dedicated to TFP and convinced that, in the therapeutic universe, the balance between technology and human connection is key. We sincerely thank Aurora Döll Gallardo for sharing her journey with us and hope that her story inspires others to learn and extend the application of TFP, with a commitment to understanding the importance of the human relation in the context of institutional work.

Diana Téllez Quiroz

Diana Téllez Quiroz, PhD

Diana Téllez has been a Psychodynamic Psychotherapist since 2005. She obtained a Master’s in Psychotherapy for Children, Adolescents, and Adults in 2009 and a Doctorate in Psychoanalytic Psychotherapy from the Mexican Psychoanalytic Association in 2012.

She holds a PhD and Master’s in APM. Certified supervisor, teacher, and therapist in TFP, Circle of Security, and AAI. Psychologist with experience in personality disorders, specializing in MBT and EFT. Member of ISTFP and ISSPD.

Author’s website

Dear Colleagues,

This is a frightening and dangerous time, and a time to try to call on the best within us to help each other through. The horrific terrorist attack on Israel has ignited a situation with no end in sight. And yet we all hope for an end to the bloodshed … we hope that terrorism will be eliminated from our world and peaceful solutions can be found.

We continue to have news of war, slaughter, and violence elsewhere as well. As indirect as our efforts may seem, we must continue to try to help people have a better understanding of the irrational forces of the mind that contribute to the violence and to try to make progress in increasing reason over unchecked passion.

In the world of TFP, we tend to be optimistic that our efforts can help those individuals who come to us with their pain and suffering. Issues of pain and suffering outside the consulting room are much more challenging. 

Frank E. Yeomans, MD, PhD

Frank E. Yeomans, MD, PhD, is a Clinical Associate Professor of Psychiatry at the Joan and Sanford I. Weill Medical College and Graduate School of Medical Sciences of Cornell University. He is a Senior Consultant in and teaches internationally for the Personality Disorders Institute, and is in private practice in White Plains and New York City.

Author’s Website

When I was studying psychology at Laval University, in the beautiful city of Quebec, Canada, one of my great pleasure was to go to the main library and randomly read from compendiums of articles on psychoanalysis. I remember the quiet excitement of having access to so much knowledge at the tip of my fingers. I felt surrounded by a warm community of thinkers that were, like me, striving to understand the human heart.

This is why graduation came with a sense of loss. Working as a psychologist in private practice in a different city, I would no longer have free access to my intellectual kindred spirits. I quickly understood that yearly subscriptions to scientific papers were just too expensive for a beginning psychologist. I also noticed that the articles I was interested in were published in different journals and that it would be impossible to gain access to all of them. Even if I bought different book editions of the works of Freud, Melanie Klein, or Bowlby, I felt alone in a relationship with ghosts. I needed access to new research, contemporary scholars. That was one of the joys I experienced when I started reading books and articles by Kernberg , Clarkin, Yeomans, Caligor, Diamond and others.

Mathieu Norton-Poulin, M.Ps.

Mathieu Norton-Poulin is a psychologist in private practice in Gatineau, Québec. He graduated from Laval University in 1995 and started his training in transference focused psychotherapy in 2005. Member of the TFP-Québec group he as been practicing as a certified TFP therapist for the last 11 years. Since 2009 he organized several training events and has given lectures on TFP for medical doctors and college students. He maintains a blog where he write, in plain words, articles to explain TFP to the general public.

Read author’s Blog

Dear Colleagues,

When it was formed, the ISTFP established the Training & Education Committee to uphold quality standards for international TFP training and supervision, to promote the development of standardized teaching tools, and to work on ways we can improve how we educate our students and supervise both our students and each other. The T&E Committee also plays a crucial role in shaping the educational policy of the ISTFP, preparing certification regulations, and establishing guidelines and documents for examinations.

The T&E Committee currently comprises 15 members, including two co-chairs (Luis Valenciano and myself), from various countries: Marion Braun (GR); Peter Bucheim (GR); Eve Caligor (USA); Sergio Dazzi (IT); Stephan Doering (AU); Diana Diamond (USA); Frank Denning (UK); Nel Draijer (NL); Katarzyna Gwozdz (PL); Otto Kernberg (USA); Judit Lendvay (USA); Mathias Lohmer (GR); Philipp Martius (GR); Verónica Steiner (CL); Frank E. Yeomans (USA).

Irene Sarno

Irene Sarno Ph.D. is a psychotherapist and a psychoanalyst of the International Psychoanalytic Association (IPA). In her clinical practice she works mainly with adolescents, young adults, and adults. She trained between USA and Italy with Otto Kernberg and coll. on Transference-Focused Psychotherapy for adults and adolescents, and she is a certified TFP teacher and supervisor for both adults and adolescents. She is a founding member of the Personality Disorders Lab (PdLab), branch society of the International Society of Transference-Focused Psychotherapy (ISTFP). With the PdLab she has organized a number of training programs on TFP in Italy.
She is Adjunct Professor of Psychotherapy and Counselling at the University of Milan-Bicocca, where she is also consultant at the Psychological Counselling Centre for University Students.
She is author of national and international scientific articles, books and book chapters on Non Suicidal Self-Injury, diagnosis and assessment, and personality disorders.

PD lab website

Last June, I had the pleasure of conducting an enlightening interview with Mariana del Hoyo, a dedicated and passionate psychiatrist who recently completed her residency. Our conversation focused on Mariana’s journey and her profound interest in Transference-Focused Psychotherapy. I am excited to share this experience with all of you.

Her educational background is diverse. Not only does she have a Bachelor’s degree in Medicine from UNAM but she as also completed a postgraduate degree in Rural Development from UAM Xochimilco, a postgraduate program in Competencies for Managing BPD from UIC Barcelona, and a specialization in Psychiatry at the National Institute of Psychiatry “Ramón de la Fuente” in Mexico.

Her fascination with TFP began during her psychiatric residency, where she was deeply intrigued by the wide-ranging symptomatology of personality disorders. It stood out as a powerful technique that empowers individuals who have experienced invalidation in the past, helping them recognize their capacity for self-reflection. She was particularly impressed by how TFP integrates the therapist’s introspection and tackles not only the complexities of borderline personality disorder, but also fundamental human concerns.

Throughout her journey, Mariana has actively sought additional training and education. She has completed theoretical courses offered by TFP-Group Mexico, the TFP course provided by the TLP group in Barcelona, and has attended seminars led by Dr. Otto Kernberg. These experiences have enriched her understanding of TFP and facilitated valuable connections with experts in the field.

Currently, Mariana’s professional activities include private psychiatric consultations, supportive psychodynamic therapy at the Fray Bernardino Psychiatric Hospital and collaborative research projects. She actively participates in research focused on studying behaviors and risk factors in young people with HIV, as well as research projects related to Borderline Personality Disorder and its clinical features.

One of the most profound impacts of TFP on Mariana’s practice has been the development of a holistic understanding of her patients’ symptoms and the cultivation of stronger therapeutic relationships. TFP allows her to use transference as a valuable source of information, providing insights into relational dynamics. She considers it vital to the success of psychiatric management and psychotherapeutic interventions when working with patients with significant psychopathology, such as Borderline Personality Disorder. It has transformed Mariana’s overall therapeutic practice by fostering deeper reflection in her interactions with patients.

Mariana’s dedication to TFP goes beyond her clinical practice. She aspires to conduct research that demonstrates the effectiveness of TFP in the Mexican population, recognizing the need for its wider adoption. Currently, the studies focus on gender differences in clinical presentation and symptoms among individuals with Borderline Personality Disorder in Mexico City.

Regarding the advantages and disadvantages of TFP, she emphasized its reflective and introspective nature, which allows for deeper engagement with patients and addresses the chronic sense of emptiness and identity diffusion. However, she acknowledged that TFP requires a longer training period and comes with a certain level of complexity.

That is why she actively participates in supervision, recognizing its pivotal role in her professional development. She is convinced that supervision has been invaluable in guiding her through challenging cases, providing diverse perspectives, and offering emotional support. It has also contributed to her understanding of significant moments in a therapist’s life and their influence on countertransference and transference dynamics.

Practicing TFP in Mexico presents unique challenges due to the complex social and economic context of the country. However, Mariana remains steadfast in her commitment to promote the use of TFP, conduct research, and provide high-quality care to her patients. She is truly an inspiration to all of us as we strive to provide the best possible care in less than ideal situations. Mariana’s story shows us how important it is to include some teaching about TFP in psychiatry residency programs. From that initial contact with TFP, Mariana has gone on to practice both standard and applied TFP and to begin important research.

I hope you had as much pleasure to meet her as I did.

Warm regards,

Diana

Diana Téllez Quiroz, PhD

Diana Téllez has been working as a psychodynamic psychotherapist in Mexico since 2005. In 2009, she successfully completed a master’s degree program in psychotherapy for children, adolescents, and adults. She went on to earn a PhD in Psychoanalytic Psychotherapy from the Mexican Psychoanalytic Association in 2012.

She’s a certified TFP Teacher-Supervisor and has clinical practice in TFP since 2011.  Since 2016, she is responsible for the Psychology department at a public hospital part of the Mexican Social Security Institute (IMSS) in Mexico City. She is also an active member of the Academic Committee of Mexico involved in the organization of multiple trainings and supervisions in TFP.

Author’s website

As a member of the ISTFP Public Relations and Communication committee, I have the privilege of connecting with professionals from diverse backgrounds who share their experiences and challenges in implementing Transference Focused Psychotherapy (TFP) in various therapeutic settings worldwide. One recurring challenge that has emerged is the persistent misconception that TFP lacks scientific validity. In this series of articles, my objective is to provide fellow members with the necessary tools to debunk this myth.

Thank you for randomized control trials

In my experience, one of the most effective strategies to address the challenge of perceived lack of scientific validity in Transference Focused Psychotherapy (TFP) is to begin communications by highlighting TFP as a psychodynamic treatment for personality disorders that has been validated by randomized control trials (RCTs). This approach tends to engage the interest of a wide range of audiences.

I hold great respect and gratitude for fellow members who have dedicated themselves to the development of these RCT’s and who continue to plan new RCT’s. Conducting such trial, which play an indispensable role in establishing the credibility of TFP requires a great deal of effort. Especially when pretigious entities like the Cochrane database of systematic reviews use those RCT’s to determine which treatments have the most empirical support. I was happy to see that in 2012 Transference Focused Psychotherapy was considered a promising treatment for BPD along with Dialectic Behavioral Therapy, Schema Therapy, and Mentalisation Based Therapy. Unfortunately, in Cochrane’s new iteration of the review (2020), only DBT and MBT are mentioned as promising treatments. For this reason, the ISTFP is actively pursuing new RCT’s. To ensure that all members have easy access to the existing data, I have included links to all the RCTs at the end of this article.

However, even after presenting evidence of the treatment’s effectiveness, we often encounter a recurring weakness, which is the questioning of our theoretical foundation. I understand that some of you may disagree, emphasizing that our capacity to draw from the extensive psychoanalytic literature is indeed one of our greatest strengths. I completely agree , but we also have to recognize that in an evidence-based world, this reliance on psychoanalytic literature can sometimes undermine our credibility in the eyes of many.

Kernberg’s theory of personality

We are fortunate that Dr. Kernberg, the founding father of Transference Focused Psychotherapy (TFP), has successfully expanded the roots of psychoanalysis to create a psychodynamic treatment that integrates contemporary advancements in neurology with core concepts of psychoanalysis. In this series of articles, we will delve into the scientific evidence that substantiates the fundamental principles of Transference Focused Psychotherapy. Moreover, my aim is to present this information in a manner that is accessible to everyone, so it can be used in many contexts. To facilitate this, I will include links not only to scientific papers but also to the relevant images I have utilized.

Given the extensive nature of the topic, I will employ the following papers as guiding lights to navigate our exploration:

Kernberg, Otto. F (2016): What is personality?, Journal of Personality Disorders, Volume 30(2), 145-156

Otto F. Kernberg M.D. (2001) Object Relations, Affects, and Drives: Toward a New Synthesis, Psychoanalytic Inquiry, 21:5, 604-619

In the first paper, Kernberg provides a clear depiction of personality as a dynamic “umbrella” organization comprising various major component systems.

1. Temperament
2. Object relations
3. Character
4. Identity
5. Ethical value system
6. Cognitive capability (More precisely, attention and effortful control)

When I read the article, I was captivated by the elegant simplicity of the description, which not only established a connection with neurology but also provided bridges with other sciences.

For the time being, our exploration will focus on examining the temperamental components of this organization, deferring the investigation of its dynamic to a later point.

Mathieu Norton-Poulin, M.Ps.

Mathieu Norton-Poulin is a psychologist in private practice in Gatineau, Québec. He graduated from Laval University in 1995 and started his training in transference focused psychotherapy in 2005. Member of the TFP-Québec group he as been practicing as a certified TFP therapist for the last 11 years. Since 2009 he organized several training events and has given lectures on TFP for medical doctors and college students. He maintains a blog where he write, in plain words, articles to explain TFP to the general public.

Read author’s Blog

Dear fellow members of the ISTFP,

My thought after reading the excellent newsletter that our Public Relations Committee has put together is: “Never Bored!”

Why are we never bored? The articles included in the newsletter remind us of:

1. The increasing need for our services.
2. The never-ending efforts of our members to meet the need.
3. The challenge of sharing our knowledge and skills with colleagues from different parts of the world and from different cultures, and the opportunity to learn from them.

In addition, the newsletter, in its informal poll of what others think of TFP, tells us that we should reflect on some internal representations people outside our community have of TFP… and how to modify those representations when they contain inaccuracies. I found this poll very helpful since it contained information that I have been, to some extent, in denial of (like everyone, I have my defenses).

Frank E. Yeomans, MD, PhD

Frank E. Yeomans, MD, PhD, is a Clinical Professor of Psychiatry at the Joan and Sanford I. Weill Medical College and Graduate School of Medical Sciences of Cornell University. He is a Senior Consultant in and teaches internationally for the Personality Disorders Institute, and is in private practice in White Plains and New York City.