October 15, 2019, Vancouver, Canada
Kenneth N. Levy, Ph.D.
International Society for the Study of Personality Disorders (ISSPD), Pre-conference workshop
This workshop will focus on application of Transference‐Focused Psychotherapy (TFP) in the treatment of borderline and narcissistic personality disorders (BPD and NPD). TFP is a comprehensive and ambitious evidence‐based treatment for patients with severe personality disorders such as BPD and NPD. TFP is a modified and manualized treatment based on Otto Kernberg and colleagues’ writings on object relations theory. Its efficacy has been demonstrated in multiple studies, both with regard to symptom change and changes in personality structure and is comparable with other treatments. As such, TFP is recognized as one of the “big five” psychotherapies for treating borderline personality disorder in a number of treatment guidelines and reviews. The broad goals of TFP are better behavioral control, increased affect regulation, more intimate and gratifying relationships, and the ability to achieve satisfactory life goals consistent with one’s capacities and interests. Specific goals are a reduction of the symptoms, including suicidality, parasuicidality, impulsive hostility, and angry outbursts, resulting in fewer emergency room visits, hospitalizations, and relationship difficulties. While based in the psychodynamic tradition, the treatment has important modifications making it of use to general clinicians today working with patients with significant personality disorder (PD) pathology. This presentation will avoid jargon and focus on experience-near language meant to resonate with the attendees at all levels of experience and of various orientations. Attendees will learn about essential elements TFP model, including: (1) assessment and providing feedback to the patient, (2) setting a collaborative treatment frame and goals, (3) dealing with challenges to the treatment frame and patient suicidality, (4) how to establish and maintain a non-judgmental stance, (5) dealing with intense affects in session, (6) recognizing transference patterns and differentiating the transference from the therapeutic alliance and the real relationship, (7) using one’s own reaction to the patient as information about the patient’s internal state and/or how the patient may affect others, (8) Clarifying the patient’s subjective experience; Tactfully bringing into awareness disparate aspects of the patient’s experience, and tactfully helping the patient understand the underlying dynamics that contribute to their experience of themselves and others; and (9) recognizing changes in the patient. In addition, the research base for TFP will be reviewed. Clinical vignettes, role plays, and videotaped psychotherapy material will be used throughout.