Daniela Saralegui is a young member of the ISTFP since 2020. She is a member of Grupo TFP Chile. She is a clinical psychologist, has a master’s degree in Adolescents from the University of Valencia, and has TFP training from TFP Latin America. Upon meeting her, we discovered an inquisitive girl who was involved in various activities. She is a university professor, attends to patients, and devotes much of her time to research, particularly in the field of TFP supervision.

Her first contact with the structural approach was during her undergraduate training at the university.

I learned Otto’s theory at the university, and from the beginning, it seemed orderly and made sense to me. Although they only taught me the structural theory and nothing about TFP, I came to that a little later. Once I was out of university, I started working at a psychiatric hospital in my country. I had no approach, and I really did not know where to start; it was somewhat chaotic. I thought the appropriate thing was to be eclectic and put a little bit of everything together… so sometimes it was cognitive-behavioral, other times it was psychodynamic, and sometimes I did a third-generation therapy.

It was a mess, and what was impressive was that my supervisor at that time was not concerned, and it bothered me a bit, but not enough. The breaking point came when I had around 20 patients, and one of them was getting worse and worse, going from crisis to crisis, and no matter how much I took the case to supervise, nothing changed.

This led me to a personal crisis, feeling that this was very difficult or not for me… that’s how I came to a supervisor who did TFP, and little by little, the situation became more organized, and so did my internal feelings. I discovered an approach that worked with the type of patient that I was treating. This was my start, and since then, I have trained in various seminars, congresses, and in TFP Latin America, and of course in supervisions, essential to be able to do it well.

Daniela Saralegui

Daniela tells us that this initial “chaos” gave way to a more orderly and structured way of working with clear objectives and easy-to-follow stages. For her, the challenge had not been simple, “being a manualized therapy is a double-edged sword for me. On the one hand, it organizes me, but on the other, I must be careful, given my way of being, I can become a bit rigid, I must always be alert not to lose my spontaneity and closeness, luckily always looking at myself in the session, and in supervision helps me with this.”

This professional start of Daniela marked and fixed her particular interests and challenges. A doubt arose in her about what helped novice therapists like herself. This, coupled with her passion for research, especially qualitative research, embarked on a major project: Investigating Supervision. She is leading the development of a line in this area, focused on researching therapist training, along with Luis Valenciano from Murcia and Verónica Steiner from Chile. “My interest is in conducting empirical research on training, and at the moment, I am starting with supervisions. It is not simple; I would say that this line is divided into three sections.

First, we carried out an exploratory review of what is written in this field; the truth is that quite little, and what there is more from the experiential point of view of the supervisee or from a theoretical point of view. This review examines supervision within the psychoanalytic world. We realized that since the 1980s, different authors have suggested empirical research, but it has remained there, as suggestions

We have decided to take this step and are currently conducting an analysis that will allow us to systematize the dynamics or patterns that occur in a supervision between the supervisee and supervisor. Specifically, we are developing a microanalysis of a supervision session using qualitative methodology and conducting discourse analysis. It has been quite a bit of work, as we are triangulating our analysis with that conducted by research assistants who are working with us. We are also training an artificial intelligence model for emotion recognition, which we hope will contribute to analyzing psychotherapy sessions as well.

Daniela’s project aims to develop a tool that can help therapists better identify and understand the emotions of the supervisee and supervisor during supervision sessions. By collecting and analyzing data from facial expressions, tone of voice, and other nonverbal indicators, the goal was to create an accurate and efficient model of emotion recognition. The objective is that this model can be used to help therapists adapt their interventions to the emotional needs of each supervisee, thus improving therapeutic outcomes.

In addition, Daniela is working on the concept of “intangibles,” which refers to the skills and knowledge that are not easily measurable but are fundamental to the success of supervision in clinical practice. Daniela believed that these “intangibles” are an important part of supervision and are directly related to the quality of care provided to patients. Therefore, she is developing an innovative approach to supervision that includes the evaluation of these “intangibles, ” along with other, more measurable skills and knowledge.

“All of the innovative research I have developed has been driven by my supervisors, Verónica and Luis, with whom we now work in a research laboratory where we jointly develop studies that seek to support our teaching models with empirical evidence.”

Undoubtedly, Daniela’s work is much more than a simple career. She has a passion to help therapists improve the quality of care they provide to their patients, especially in her country, where psychotherapy focused on transfer is still unknown. Daniela hopes to make a real contribution to clinical practice and the training of new therapists, so that they can avoid the mistakes she made when she began as a therapist.

In summary, Daniela is committed to the development of new tools and approaches to improve the clinical practice and training of therapists. Her work on emotion recognition and “intangibles” in supervision is an example of her innovative approach to and dedication to the constant improvement of patient care. Undoubtedly, Daniela is a therapist with a great future, and will be a true leader in her field. Daniela hopes to make a real contribution to Transference Focused Psychotherapy.

I hope that this helps therapists who are starting out, so that hopefully no one goes through the disorder I went through, and I hope that it also helps to spread awareness of this technique in my country, which is still unknown. Although in recent years this has been slowly changing, and more and more people are seeking us out, consulting with us, and wishing to refer patients, however, it is a vicious circle, there are people who are trained, but this is complemented with supervision, and there are few supervisors, meaning we are in a moment of being trapped, I hope this will be resolved so that with more people trained we can begin to develop the technique in other contexts, and who knows, perhaps someday have a presence in the public system of my country.

Daniela Saralegui

On May 13, an event an oral “Festschrift” was held, in which the part of the ISTFP community connected to Cornell and special guests gathered with Otto Kernberg to celebrate his retirement as Director of the Personality Disorder Institute of New York Presbyterian-Weill Cornell Medical College.

More than 90 colleagues and members of his family paid heartfelt tribute through special words dedicated by Nancy Mc Williams, John Oldham, Salman Akhtar, Mark Solms, and Stephan Doering.

Undoubtedly, it was a moment of many mixed emotions.

Many voices honouring the same man

A lot can be said about Otto, his versatility and his skills in different fields make it difficult to choose how to pay tribute to him. Not surprisingly, everyone who spoke at the Festchrift chose a similar path, by addressing not only his long career and inspiration for many mental health professionals and therapists, but also his human qualities.

The Festschrift turned out to be an event full of emotions and memories. Inevitably, everyone present started to recall how and when they met Otto and what an important part of our professional development and work he has been.

Otto is a master in building bridges between different worlds.

John Oldham

John Oldham highlighted Otto’s mastery in building bridges between different worlds, between the world of psychoanalytic theory, the world of the clinic, the world of medicine, last but not least the world of research. This is only possible through particular traits that characterize his persona, such as his determination, and the ability to visualize a clear goal to guide his work. Nancy Mc Williams mentioned how difficult it is to summarize the contributions of someone who has dedicated himself to the study of so many phenomena associated with mental health, art, politics, neuroscience, supervision, education, love and aggression. She decided to show us who Otto through a personal anecdote. 

When I needed help, Otto treated me with a perfect combination of respect, consideration and honest criticism

Nancy McWilliams

It was 1991 and Nancy was writing a book as an introduction to psychoanalytic thinking. With this goal, she decided to ask Otto Kernberg, whom she had not met in person yet, for help. We all know how generous Otto is, so he did not hesitate to dedicate an hour of lunch, several pieces of advice and text recommendations to her. From there, a close relationship was forged that lasts to this day. Nancy recalls that day with various emotions such as “that lunch was the perfect combination of respect, consideration and honest criticism”.

Otto is an example of generosity of knowledge, kindness and a great capacity to forgive

Salman Akhtar

Similarly, Dr. Salman Akhtar took us back to 1978, when he met Otto for the first time at a lecture. Dr. Akhtar recalls “I did not understand a single word he said”. Hearing that, several Festschrift attendees smiled in complicity, as they surely identified with Dr Akhtar’s experience. In 1978, although he did not understand much of what Otto was talking about, he could tell that Dr. Kernberg was an eminence, and that his thinking was enticing. He decided to start reading his books. However, it was not until 5 or 6 years later that he was able to meet Otto in person, Dr. Akhtar defines the following 40 years of his career as “constant dedication”, highlighting Otto’s great generosity, referring to him as “generosity of knowledge, kindness, great capacity to forgive”. 

Dr. Akhtar, with an unmatched skill of language, highlighted above all Dr. Kernberg’s ability to delicately and precisely use irony, as well as his great capacity to unite and synthesize. He said, “What could someone born Jewish in Vienna, raised in Chile, a Catholic country, living in Topeka, Kansas do? Well, he could dedicate himself to synthesizing”. And yes, Otto is a synthesizer of different thoughts, a unifier of theories, a builder, but above all a noble, generous, and very respectful man.

Not an ideal, but surely an inspiration

And so one by one they spoke and paid tribute to Otto, all agreeing on his refusal to be idealized and his attachment to reality, because the reality is that on that Friday, May 13, everyone spoke of a dedicated Otto Kernberg, humble, generous with his knowledge, able to support and make us feel that we can all go far, and ahead of his time, trusting and supporting women long before others. So much knowledge transmitted with unmatched simplicity.

Many of us are fortunate to live in times where Otto is still a great teacher giving the best he has, to witness some of his qualities and employ them in life, and why not say it, it is because of him that many of us are today in this great family that is the ISTFP.

Thank you Otto!

Meeting Glauco feels like an adventure, as he wears many hats, he is passionate about his work as a head of Mental Health Unit of Hospital de Emergencias Villa El Salvador, but above all he is passionate about studying.

He has studied a master’s degree in Health Management, and is currently pursuing two more master’s degrees, one in Clinical Epidemiology and the other in Personality Disorders.
He is also trained and certified in Rational Emotive Behavior Therapy (REBT), Dialectical Behavior Therapy (DBT) and Transference Focused Therapy (TFP).

Dedicated to the study and treatment of complex patients

Glauco has dedicated almost his entire professional career to the study and treatment of complex patients. Along his path he met several years ago with “patients who had many problems, with chronic complications, various comorbidities and with whom the technical tools that I had did not work”. He began to search for evidence-based therapies in the literature and came across TFP. “That’s when I understood that there were more than just symptoms, there was a human side of the patients, I realized what it means to address and look at the entire identity of a person, their interpersonal difficulties and above all a way to understand and work with strong emotional crises of patients that I found very difficult to handle with other approaches”.

The discovery of TFP

In his search to find what would be useful to help his patients, he started finding articles by Dr. Otto Kernberg and Richard Hersh, among others. He was quickly struck by the emphasis of the therapeutic contract, highlighting that contracting not only “puts the patient first” but also provides great care and protection to the therapist as a person. This was new and very appealing for Glauco who decided to definitely dig deeper into the study of patients with personality pathology with TFP.

Confronting prejudice

Glauco says that what he found most challenging about TFP has been the prejudice of some colleagues and the scientific community of his country, still focused on classical analytic techniques. “I see that as a therapy that still carries great stigma and this cannot be appealing to young therapists seeking training”. “Somehow”, Glauco says, “this stigma is passed on to patients. We cannot continue to work without diagnoses, without goals, without clarity of what is being done, wasting patients’ time and adding to their suffering. Our patients come with great fears and we must start by explaining to them what we do with clarity, we must start by making them lose their fear of this technique”.

The challenges of managing transference and countertransference

As he started his training in TFP, Glauco was met with another challenge: the management of transference and counter transference. “I realize that once I understand the dominant dyad it is difficult for me to make it explicit to the patient, I realize that I fear the patient’s reaction and this fear makes me lose control of the session”. On the other hand, Glauco tells us that since he has been practicing TFP he has also gained several benefits, today he has clearer personal limits, “it has helped me to put forward conditions and agreements to the patient for making clear how the process will be from the beginning, I know what my role and what the patient’s role is”.

The future of TFP

We asked him about what are the challenges that TFP will face in the future. He thinks the stigma around the technique is the biggest challenge for trainees and patients. He says “It cannot be seen as a hard technique, but neither should we fall into being overvalidating with patients who don’t respect limits, we must be seen as therapists with a technique in which the patient really works and strives to get ahead”.

To conclude, Glauco mentioned the importance of diffusing knowledge about TFP “I think we are growing, more and more people are interested, but we must continue and go out to the world and continue to spread knowledge”.

Veronica Steiner