Neurobiological underpinning of distress related to social exclusion

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.

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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.

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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