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My name is Marike Steeman, Chair of the recently established Art Committee.

In the 1990’s, a group of psychoanalytic psychotherapists in the Netherlands were educated in TFP by faculty from the Personality Disorders Institute at the Weill Cornell Medical College under the leadership of Otto Kernberg. Since then I have been a TFP therapist and, in addition, I became a TFP teacher / supervisor and board member of TFP NL (the Netherlands).

After completing a degree at the Academy of Fine Arts in my 50’s, I became interested in processes and developments in the works of visual artists. I did N=1 studies on Rothko, Mondrian, and others.

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Marike Steeman

Marike Steeman is psychoanalytic psychotherapist, teacher & supervisor TFP, member NVPP, ISTFP, chair of TFP Nederland and director of the Psy Art Foundation.

Let’s meet Silvia Bernardi from New York

Dear members, my name is Veronica Steiner and in this special edition of our members Newsletter, I have the pleasure of presenting Silvia Bernardi, a proud TFP therapist and genuine New Yorker. In this interview, you will meet a brilliant, curious woman who left her native Florence to become a psychiatrist, in New York.

Veronica: No doubt, all members will wonder why you change from beautiful Italy to dizzying New York.

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Ps. Veronica Steiner

Veronica Steiner Segal is a Chilean clinical psychologist who graduated in 1998. Since her beginnings she has been working with patients with Severe Personality Disorders in different health institutions in her country, and since 2018 she is a certified TFP therapist. In 2019 she obtained her accreditation as a teacher and supervisor. Since the same year she is coordinator of Grupo TFP Chile. She is the Executive Officer for the Board and she collaborates with the T&E Committee. She also teaches at the University of Valparaiso, in the Department of Psychiatry, where she also teaches in the Diploma of Severe Personality Disorders.
She collaborates in different courses looking for the diffusion of TFP. Together with Luis Valenciano and Pepa Gonzalez she directs an important training in TFP for Spanish speaking students, Instituto TFP Hispanoamerica.

Insights into Psychopathy: Where We Stand

The elusiveness of the Vicious Man

Psychopathy, the word itself raises fear and entails a feeling of darkness. In the coming text we will take time to explore the construct of psychopathy and better understand why it has such a profound effect on all of us. Will we find solace in the rarity of the pathology, its detectability, and treatability, or will we be haunted by the lurking presence of evil and its influence in the corruption of bonding in our societies?

Research on the question brought us to the works of Theophrastus (c. 371–287 BCE), a Greek philosopher who studied under Plato and Aristotle. During his life, he published many treatises on different subjects. His series of sketches of individuals from everyday Athenian life, “The Characters of Theophrastus (δεισιδαιμονίας Ισ᾽) ” could be considered one of the first “scientific” description of personality types. In his text, translated from ancient Greek by Charles E. Bennet and William A. Hammond, professors at Cornell University, we came across a description of “The Vicious Man”:

The Vicious Man

Viciousness is love of what is bad. The vicious man is one who associates with men convicted in public suits, and who assumes that, if he makes friends of these fellows, he will gain in knowledge of the world, and so will be more feared. Of upright men, he declares that no one is by nature upright, but that all men are alike, and he even reproaches the man who is honorable.

While Theophrastus does not talk of psychopathy proper, his portrait of “The Vicious Man” includes three characteristics that would be recognized by any of us has basics continuants of a psychopathic personality structure: love of evil, the exploitation of others for power, and a fundamental conviction of human amorality. But do we have enough evidence to say for sure that the vicious man is a psychopath?

The short answer is no. This is why we will give you an overview of the development of the construct and an insight into the roots of contemporary definition of psychopathy.

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Ps. Veronica Steiner

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 has a certified TFP therapist for the last 9 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.

Word of the president – April 2024

Dear Colleagues,

My thoughts are inspired by the rich and varied, but related, topics that our Public Relations Committee has put together in this newsletter. There is a sobering integration of many themes in the different articles. Silvia Bernardi writes of loss, embodied in the death of our colleague and friend Michael Stone. As Silvia points out, that loss is tempered to some degree by an appreciation of what Michael gave us, of the gift we had in him. Michael’s long association with us at the Personality Disorders Institute in New York is a reminder of something we may not reflect on enough: the degree to which our thinking and experience can be enriched by colleagues whose interests overlap with ours without fitting narrowly into the TFP world. Reflecting our years of association with Michael is a reminder that our community will continue to grow by both refining what we do and also by turning to close colleagues who may have somewhat differing perspectives to expand on what we do.

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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.

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Transference Focused Psychotherapy on the Web

Monitoring information on TFP in Google top search results

Dear members,

As you all know part of the mission of our society is to disseminate the model of Transference Focused Psychotherapy. This is achieved through many channels, including lectures, trainings and scientific articles. Today I suggest we take a look at where and how information about the model is communicated on the internet.

dataportal.com, a web platform dedicated on gathering data about the internet tells us that 60 % percent of people worldwide look online for information. That implies it is the same for information about treatments for personality disorders. That is why we asked the members of the Public Relations and Communications Committee to send me the first 10 results they obtain when conducting a Google search in their country for “transference focused psychotherapy” in English and in the country’s official language. In doing this, we hoped to monitor the information circulating about TFP on the internet and assess the ranking of TFP-Group websites.

Generally, information we found about transference focused psychotherapy mostly ranged from clear to adequate but, has you will see, we also came across some disturbing findings.

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Mathieu Norton-Poulin, M.Ps.

A journey through psychopathy and malignant narcissism

The loss of Dr. Michael Stone has left a void in the community of clinicians and therapists around the world, especially those who have grown professionally with his contributions to the study of Personality Disorders. His legacy strengthened the understanding, evaluation and treatment of Psychopathy and Antisocial Personality Disorder proper, one of the most challenging mental health conditions. Dr. Stone’s famous book “Anatomy of Evil” explores different causes and phenomenologies of psychopathy, creating a “scale of 22 degrees of evil severity”.

Malignant features and prognosis

Inspired by Dr. Stone’s contributions, this month newsletter features a contribution by Lenzenweger et al. In this paper, the authors utilize Dr. Kernberg’s definition of malignant narcissism to construct a composite index scale and analyze data collected in a prior study, hypothesizing that malignant features would limit the patients’ prognosis. Malignant narcissism, a syndrome encompassing symptoms of:

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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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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.

The ISTFP Ethics Committee

My name is Frank Denning, I am Chair of the Ethics Committee, and I wish to highlight the fundamental importance of ethics in the practice of Transference-Focused Therapy (TFP). In this newsletter, we will explore the role and relevance of our Ethics Committee, as well as the principles that guide therapists and professionals in this field.

First, though, I would like to acknowledge the help of my colleague Iván Arango, in putting together this introduction. Iván is a valued member of the Ethics Committee, along with Monica Carsky, Sergio Dazzi, Petra Holler, Alan Weiner and Teresa Ribalta. Had time allowed, and in keeping with the collaborative spirit of the committee, I would have consulted all the members about the content of this introduction. Hopefully, the thoughts of Iván and myself reflect the thinking of the whole committee.

Iván and I are grateful to Diana Téllez from the ISTFP Public Relations and Communication Committee, for her help in putting this introduction together.

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Frank Denning,

PhD Candidate in Philosophy, University of Manchester. Certified TFP Teacher and Supervisor. Member of ISTFP Training and Education Committee. Manchester-based Psychoanalytic Psychotherapist, working in the U.K. public health service.

Let’s remember Michael Stone, our dear friend

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?

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Silvia Bernardi

Loss and grief

Can it unite us?

Amid the current situation, marked by global conflicts, wars, and health crises, the concept of loss and grief becomes especially relevant for our community. Each of us has been confronted with this painful experience.

Grief emerges as a universal phenomenon, an inescapable constant in human experience that transcends cultures, times, and geographies. Throughout history, it has captured the attention of philosophers, physicians, psychologists, and sociologists who have sought to understand its complexities and have contributed diverse perspectives to its comprehension.

The contribution of psychoanalysis

At the intersection of these disciplines, the psychodynamic perspective emerged as especially insightful regarding the intricate process by which individuals cope with death, other major losses, and subsequent grief… mainly by recognizing that the latter does not present itself as a series of isolated symptoms but as a holistic and deeply personal experience.

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Ps. Veronica Steiner

Mathieu Norton-Poulin, M.Ps.

A word from the president – January 2024

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.

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Frank E. Yeomans, MD, PhD

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Assessing the Health of Our Society – ISTFP as we enter 2024

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?

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Mathieu Norton-Poulin, M.Ps.

The creative nature of mourning

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.

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Silvia Bernardi

Glauco Valdivieso

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The Applied TFP Committee

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.

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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.

Let’s meet Aurora Döll Gallardo

Helping Introduce TFP to Madrid and the Public Health System

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.

Third ISTFP Supervisors Congress: A Look at the Challenges and Lessons Learned in Transference Focused Therapy

The ISTFP supervisors’ congress was hosted for the third time last October 6th and 7th. This meeting of the event, held every two years, brought together over 60 therapists and supervisors from all over the world in the vibrant city of Milan, Italy, under the name of the “Gerard Dammann Conference” in honor of our deceased colleague who hosted the first of these meetings at his hospital in Münsterlingen, Switzerland in 2019. The gathering was widely anticipated as it was the first time we could finally meet face-to-face after the pandemic.

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Ps. Veronica Steiner

A word from the president – October 2023

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.

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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.

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The TFP Online Library

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.

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Mathieu Norton-Poulin, M.Ps.

The role of supervision in TFP

Transference Focused Therapy (TFP) is one of the therapies that over time has been strengthened with scientific evidence and enriched with the findings of its learning process. Just as supervision in many therapeutic currents is necessary to help with the application with the theoretical and practical elements necessary to address our patients’ needs, in the case of TFP, supervision is an essential element throughout the therapist’s life. Why is that? Supervision, which means “looking from above”, allows the therapist to see aspects of his or her experience in the session and application of technique that are not clear during the therapy itself. Simply put, too much is being experienced in the therapy session for the therapist to be aware of it all. Supervision combines attention to structure and boundary setting (the macro level, as Luis Valenciano describes it) with a careful attention to the unconscious processes that unfold in the session and how the therapist explores them with the patient in relation to the activated object relations (the micro level). All this is in the service of maximizing the mechanism: enhancing understanding of the transference and the ability to reflect of it and on the deep conflicts that become clear in reflecting on shifting transferences.

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Glauco Valdivieso

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Silvia Bernardi

The ISTFP’s Training and Education Committee