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Advancing Treatment of Borderline Personality Disorder

International Society of Transference-Focused Psychotherapy

Advancing Treatment of Borderline Personality Disorder

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Let’s remember Michael Stone, our dear friend

News

Last December 2023, The TFP community lost a dear friend with the passing of Dr. Michael Stone. While I never met Dr. Stone, I had heard his name, of course, and I knew he worked at Columbia as an expert in personality pathology. I knew he had written a book on sociopathy. But I had never spoken with him. I began to sense the personal importance of Dr. Stone to the TFP community on a Zoom call about a year ago when Otto Kernberg looked at me with clear sadness and told me that our colleague and friend Michael Stone had had a stroke. Dr. Kernberg’s concern and caring for Dr. Stone were apparent. He went on to share that Michael was an extraordinary person, that he had worked in a forensic hospital, and had been able to accumulate a unique perspective on psychopathy. Otto was letting me know that I had missed out on getting to know someone who had tremendous knowledge and wit, and someone he cared for profoundly.

The Anatomy of Evil

Based on this conversation, I spent August 2023 reading The Anatomy of Evil. Dr. Stone published it in 2009, a book in which he develops a taxonomy to define and classify evil. Anatomy is the right word: the book is a massive effort of research and classification, detailed, methodically and meticulously descriptive, clinical – an almost perfectly objective showcase of heinous crimes. The book is an encyclopedic attempt to describe with the hope to help prevent, not treat; there was only a vague attempt to provide a logic, with the full and final recognition that to truly understand the mind of a psychopath is ultimately not a possible endeavor.

I enjoyed the reading and the freedom of developing my own opinion over such an extensive and all-consuming collection of details and facts. How could Dr. Stone have collected so much information in one lifetime? And why did I find that book mostly comforting; why did I not feel repulsed? The writer seemed to have had a set of emotional responses like mine; acquiring knowledge seemed to have been a comforting process; only certain details were clearly fear-inducing. From there I started to wonder why Dr. Stone would be so interested in evil and, indeed, who was Michael Stone?

This article contains exclusive content for ISTFP members.

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Silvia Bernardi

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

Neurobiological underpinning of distress related to social exclusion

News

In this issue of our research digest, we focus on a very recent article from Eric Fertuck, Ph.D. and colleagues entitled:

Rejection Distress Suppresses Medial Prefrontal Cortex in Borderline Personality Disorder.

Dr. Fertuck is an Associate Professor of Psychology at CUNY, NY, a certified TFP supervisor and therapist, a psychoanalyst, as well as a member of ISTFP. The article investigates the neurobiological underpinning of distress related to social exclusion, often a core symptom of borderline personality disorder (BPD). We chose to feature this article not simply because its result shed light on the biological underpinning of BPD, which is of course of interest for our community, but also because its methods are driven by the profound understanding of emotional processes that TFP, and psychoanalytic approaches, allow. By applying a deeper conceptual understanding of social rejection, Fertuck et al. help elucidate a biological mechanism that in the past has been investigated as a categorical, insular, function, leading to mixed results that have been difficult to replicate. We see this contribution as one of the first compelling papers utilizing awareness gained from the psychotherapy setting and psychoanalytic theory to deepen biological knowledge. This type of studies and approaches breaks the stigma of the absence of foundations in psychotherapy and psychoanalytic theory, likewise contributing to the scientific knowledge of clinical effectiveness through its different neurobiological mechanisms.

First, we will quickly review the results of Fertuck et al., to then focus on the creativity of their methodological strategy.

This article contains exclusive content for ISTFP members.

If you already are a member of the ISTFP, login to read the full text. If you are not a current member of the ISTFP and want to enjoy all of our exclusive content such as blog posts and other resources, please click one of the links below and follow the instructions provided. We look forward to welcoming you to our community.

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Silvia Bernardi
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.

Glauco Valdivieso
Glauco Valdivieso

Glauco Valdivieso is a Peruvian psychiatrist and psychotherapist who lives and works in Lima, Peru. He has been a psychiatrist since 2018, graduated from the Universidad Nacional Mayor de San Marcos and trained at the Hospital Nacional Victor Larco Herrera. He has training in Cognitive Psychotherapy, Dialectical Behavioral Therapy, Mentalization Based Therapy and Transference Focused Therapy, currently in clinical supervision. He is the co-founder and medical director of the Peruvian Institute for the Study and Comprehensive Approach to Personality (IPEP) and of the TFP PERU therapeutic division. He is the founder of the Personality Disorders Chapter of the Peruvian Psychiatric Association (APP) and head of the mental health unit at the Villa El Salvador Emergency Hospital. He is also co-founder and member of the editorial team of the Latin American Journal of Personality together with the Argentine Institute for the Study of Personality and its Disorders (IAEPD). His clinical interests are the treatment of personality disorders and mood disorders, and he wishes to contribute to research on TFP.

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