Psychotherapy for Borderline Personality Disorder


Book Description

Borderline Personality disorder is a severe personality dysfunction characterized by behavioural features such as impulsivity, identity disturbance, suicidal behaviour, emptiness, and intense and unstable relationships. Approximately 2% of the population are thought to meet the criteria for BPD. The authors of this volume - Anthony Bateman and Peter Fonagy - have developed a psychoanalytically oriented treatment to BPD known as mentalization treatment. With randomised controlled trialshaving shown this method to be effective, this book presents the first account of mentalization treatment for BPD. The first section gives an overview of BPD, including discussion of nosology, epidemiology, natural history, and psychosocial aetiology. It additionally summarises the present state of our research knowledge about effective psychotherapeutic treatments and use of medication. The second section outlines the authors' theoretical approach and contrasts it with other well known methods, including DBT, CAT, and CBT. In the extensive final section, the authors outline their clinical approach starting with how treatment is organised. A detailed account of the transferable features of the model is provided along with the main strategies and techniques of treatment. Numerous clinical examples are given to illustrate the core techniques and detailed information provided about how to apply aspects of the mentalization based treatment approach in everyday practice. Aimedat mental health professionals, along with counsellors, psychotherapists, and psychoanalysts, the book will be a valuable tool, providing an effective means of treating those suffering from Borderline Personality Disorder.




Mentalization Based Treatment for Personality Disorders


Book Description

Loss of mentalizing leads to interpersonal and social problems, emotional variability, impulsivity, self-destructive behaviours, and violence. This practical guide on MBT treatment of personality disorders outlines the mentalizing model of borderline and antisocial personality disorders and how it translates into an effective clinical treatment.




Mentalization-Based Group Therapy (MBT-G)


Book Description

Mentalization-based treatment (MBT) has gained international acclaim as an efficient treatment for patients with borderline personality disorder. The approach is also helpful for other personality disorders and conditions that are difficult to treat, e.g. addiction and eating disorders. MBT consists of a psychoeducational, an individual, and a group therapy component. This is the first comprehensive manual for mentalization-based group therapy. The author has developed the manual in close cooperation with Anthony Bateman and a team of group analysts. It covers all the aspects of MBT which are necessary to produce an informed and qualified group therapist. The book covers the theory behind mentalization and borderline personality disorder (especially its evolutionary roots), the structure of MBT and a discussion of previous experiences with group psychotherapy for borderline patients. The core of the book explains the main principles of MBT-G and provides a powerful means for ensuring that therapists adhere to these principles in a qualified way. The last part contains a full transcript from a real MBT group composed of borderline patients. As the first book dedicated to Group MBT, this book is a valuable and unique addition to the Mentalization literature.




The Handbook of Mentalization-Based Treatment


Book Description

Pioneering research has been carried out over the last decade on mentalization and the promotion of mentalizing capacity - the ability to interpret the behavior of oneself and others as based on intentional mental states, such as needs, desires, feelings, and beliefs. This book is a consolidation of current knowledge and clinical applications, bringing together a group of international experts who have been on the ground floor of theory and research to clarify the concept, review pertinent neurobiological and psychosocial research, and explore its diverse clinical applications. Four sections will cover Conceptual Foundations, Developmental Psychopathology, Intervention and Prevention. A biopsychosocial approach will be used, integrating new research in neuroimaging with psychodynamic and cognitive perspectives. Clinical issues covered will include parent–child interactions, personality disorders, traumatic brain injury, bullying and at-risk children.




Handbook of Mentalizing in Mental Health Practice


Book Description

This new edition of Handbook of Mentalizing in Mental Health Practice reflects a vibrant field undergoing development along a number of dimensions important for mental health. As evidenced by the number of experts contributing chapters that focus on specialized approaches to mentalization-based treatment (MBT), the range of mental disorders for which this therapy has proved helpful has substantially increased, and now includes psychosis. Second, the range of contexts within which the approach has been shown to be of value has grown. MBT has been found to be useful in outpatient and community settings, and, more broadly, with children, adolescents, couples, and families, and the social contexts where they are found, such as in schools and even prisons. Finally, the framework has been shown to be generalizable to an understanding of the social context of mental health. The model advanced in this book goes beyond an understanding of the development of mentalizing and aims to provide an understanding of its role in a range of social processes.Key concepts, themes, and approaches clearly articulated throughout the book include the following: Mentalizing is a transdiagnostic concept applicable to a range of mental health conditions, including trauma, personality disorders, eating disorders, depression, substance use disorder, and psychosis. The chapters devoted to these disorders emphasize MBT skills acquisition and techniques for introducing mentalizing into psychotherapy. Mentalizing plays an important role in understanding how teams, systems, and services interact to facilitate or undermine interventions and service delivery. Chapters on mentalizing in teams and wider systems are included to help clinicians reduce negative impacts on clinical care and support reliable and responsive pathways to treatment. In an effort to encourage clinicians to integrate mentalizing into their clinical practice, empirical research on the developmental origins of mentalizing and how a focus on mentalizing can improve outcomes for patients is incorporated throughout the volume. Improved mentalizing increases resilience to adversity, perhaps protecting individuals from relapse, and improves therapeutic outcomes. The relevant research, as well as proven techniques for promoting resilience and trust, are discussed at length in the book. Finally, as an established component of the literature on neurobiology and higher-order cognition, mentalizing benefits from a number of different strands of research, ranging from neurobiology through child development to adult psychopathology. The book fully explores these relationships and their ramifications. Authoritative, comprehensive, and cutting-edge, the Handbook of Mentalizing in Mental Health Practice is the single most important resource for clinicians and trainees learning about -- and incorporating -- MBT into their therapeutic repertoire.




Mentalization-Based Treatment for Adolescents


Book Description

Mentalization-Based Treatment for Adolescents (MBT-A) is a practical guide for child and adolescent mental health professionals to help enhance their knowledge, skills and practice. The book focuses on describing MBT work with adolescents in a practical way that reflects everyday clinical practice. With chapters authored by international experts, it elucidates how to work within a mentalization-based framework with adolescents in individual, family and group settings. Following an initial theoretical orientation embedded in adolescent development, the second part of the book illuminates the MBT stance and technique when working with young people, as well as the supervisory structures employed to sustain the MBT-A therapist. The third part describes applications of MBT-A therapies to support adolescents with a range of presentations. This book will appeal to therapists working with adolescents who wish to develop their expertise in MBT as well as other child and adolescent mental health professionals.




Treatment of Severe Personality Disorders


Book Description

In Treatment of Severe Personality Disorders: Resolution of Aggression and Recovery of Eroticism, the influential psychoanalyst and psychiatrist Otto Kernberg presents an integrated update of the current knowledge of personality disorders, their neurobiological and psychodynamic determinants, and a specific psychodynamic psychotherapy geared to resolve the psychopathology of these conditions -- namely, the syndrome of identity diffusion and its influence on the capacity for emotional wellbeing and gratifying relationships with significant others. The author updates the findings of the Personality Disorders Institute of the Weill Cornell Medical College Department of Psychiatry, which are derived from the empirical research and clinical investigation of severe personality disorders, and addresses the effectiveness of transference-focused psychotherapy, a specific psychodynamic treatment for these disorders developed at the Institute. The volume focuses particularly on an essential group of techniques common to all psychoanalytically derived treatments and clarifies the corresponding differential features of various psychodynamic treatment approaches. In prose both precise and evocative, the author: Examines the classification of personality disorders, the way competing viewpoints have influenced the evolution of DSM-III and DSM-IV, and the impact of new knowledge on the classification of DSM-5, with emphasis on how conflicts between scientific and political considerations have hindered the classification of personality disorders in the past. Illustrates in detail how present knowledge of neurobiological structures and neurotransmitters intertwines with the psychodynamic determinants of how psychic experience is organized. Explores psychodynamic psychotherapies and contemporary developments and controversies in the field. For example, the role of interpretation in borderline pathology is examined using a clinical case, and a new formulation of supportive psychodynamic psychotherapy is described. Addresses severe narcissistic pathology -- its diagnosis, prognosis, and treatment. Specifically, the book presents an overview of treatment options for severe narcissistic personality disorder, explores the distortions in verbal communication that may arise during psychotherapy with these patients, and focuses on the differential diagnosis of antisocial behavior. Examines the diagnosis and treatment of sexual pathology, and explores the vicissitudes of the love lives of patients with severe personality disorders. Concludes with a chapter on the essential preconditions in the education of psychodynamic psychotherapists to carry out the challenging and complex psychotherapeutic work in this field. In describing both the limits and the advances in therapeutic effectiveness, the Treatment of Severe Personality Disorders: Resolution of Aggression and Recovery of Eroticism performs a great service, and it will surely become a classic of the psychoanalytic literature.




Mentalizing in Clinical Practice


Book Description

This timely and ambitious book helps clarify the meaning and clinical applications of the mentalization construct. The authors propose that mentalizing is the central corrective process of all psychotherapies.




Mentalization-Based Treatment with Families


Book Description

Examining clinical practice with families through a mentalizing lens, this innovative book is filled with practical therapeutic strategies and in-depth case illustrations. The expert authors focus on ways to help parents, children, and adolescents to overcome blocks in how they relate to one another by gaining a deeper understanding of--and openness to--each other's experiences and points of view. The volume draws on the empirically supported mentalization-based treatment (MBT) model and interweaves it with systemic concepts and interventions. It includes guidance for setting up sessions and engaging clients; addressing emotional and behavioral difficulties that frequently lead families to seek treatment; and implementing playful activities, exercises, and games that equip family members to change problematic relationship patterns.




Transference-Focused Psychotherapy for Borderline Personality Disorder


Book Description

Transference-Focused Psychotherapy for Borderline Personality Disorder: A Clinical Guide presents a model of borderline personality disorder (BPD) and its treatment that is based on contemporary psychoanalytic object relations theory as developed by the leading thinker in the field, Otto Kernberg, M.D., who is also one of the authors of this insightful manual. The model is supported and enhanced by material on current phenomenological and neurobiological research and is grounded in real-world cases that deftly illustrate principles of intervention in ways that mental health professionals can use with their patients. The book first provides clinicians with a model of borderline pathology that is essential for expert assessment and treatment planning and then addresses the empirical underpinnings and specific therapeutic strategies of transference-focused psychotherapy (TFP). From the chapter on clinical assessment, the clinician learns how to select the type of treatment on the basis of the level of personality organization, the symptoms the patient experiences, and the areas of compromised functioning. In order to decide on the type of treatment, the clinician must examine the patient's subjective experience (such as symptoms of anxiety or depression), observable behaviors (such as investments in relationships and deficits in functioning), and psychological structures (such as identity, defenses, and reality testing). Next, the clinician learns to establish the conditions of treatment through negotiating a verbal treatment contract or understanding with the patient. The contract defines the responsibilities of each of the participants and defines what the reality of the therapeutic relationship is. Techniques of treatment interventions and tactics to address particularly difficult clinical challenges are addressed next, equipping the therapist to employ the four primary techniques of TFP (interpretation, transference analysis, technical neutrality, and use of countertransference) and setting the stage for and guiding the proper use of those techniques within the individual session. What to expect in the course of long-term treatment to ameliorate symptoms and to effect personality change is covered, with sections on the early, middle, and late phases of treatment. This material prepares the clinician to deal with predictable phases, such as tests of the frame, impulse containment, movement toward integration, episodes of regression, and termination. Finally, the text is accompanied by supremely instructive online videos that demonstrate a variety of clinical situations, helping the clinician with assessment and modeling critical therapeutic strategies. The book recognizes that each BPD patient presents a unique treatment challenge. Grounded in the latest research and rich with clinical insight, Transference-Focused Psychotherapy for Borderline Personality Disorder: A Clinical Guide will prove indispensable to mental health professionals seeking to provide thoughtful, effective care to these patients.