Connexion
Volume XXXIII, Number 1, Spring 2008

TRANSFERENCE FOCUSED PSYCHOTHERAPY : QUÉBEC-NEW YORK, part 2

Presentation

André Renaud. Transference focused psychotherapy : Québec-New York, part 2, p. 7

Dossier : TRANSFERENCE FOCUSED PSYCHOTHERAPY : QUÉBEC-NEW YORK, part 2

Jill C. Delaney, Frank Yeomans, Michael H. Stone, Catherine Haran. Some Factors Affecting Treatment Outcome in a Randomized Clinical Trial of Borderline Patients, p. 15

Pamela A. Fœlsch, Anna E. Odom, Otto F. Kernberg. Treatment of Adolescents with Identity Diffusion : A Modification of Transference Focused Psychotherapy, p. 37

Diana Diamond, Frank Yeomans. The Patient Therapist Relationship : Implications of Attachment Theory, Reflective Functioning and Research, p.61

Louis Diguer, Olivier Laverdière, Dominick Gamache. For an empirical approach to object relations, p.89

Diana Diamond, Frank Yeomans. Narcissism, its Disorders and the role of TFP, p.115

Communication brèves

Viva Iny, Marie Claire Dumont, Parcours singulier d’une mère courageuse : rêves, traumatismes et résilience, p. 141

Entretien

Denise Marchand. À propos de la parution de l’ouvrage Thérapies multifamiliales, Des groupes comme agents thérapeutiques, sous la direction de Solange Cook-Darzens, Érés, coll. «Relations», 2007. Entretien avec Solange Cook-Darzens, p.157




Some Factors Affecting Treatment Outcome in a Randomized Clinical Trial of Borderline Patients
Jill C. Delaney, Frank Yeomans, Michael H. Stone, Catherine Haran

At the Personality Disorders Institute we have been investigating the efficacy of Transference-Focused Psychotherapy (TFP), a twice weekly manualized psychodynamic psychotherapy for borderline personality disorder compared to Dialectical Behavior Therapy (DBT) and Supportive Psychotherapy (SP) in a randomized clinical trial of 90 borderline patients. We will first present some developmental foun­dations of BPD, followed by a discussion of the theoretical foundations of TFP. We will then discuss patient characteristics that have an impact on outcome. We will present both clinical and empirical data in a discussion of individual cases that were representative of a sample of borderline patients treated in Transference-Focused Psychotherapy (TFP).

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Treatment of Adolescents with Identity Diffusion : A Modification of Transference Focused Psychotherapy
Pamela A. Fœlsch, Anna E. Odom, Otto F. Kernberg

This paper is an introduction to a treatment for adolescents with identity diffusion that has been modified from a therapy that has been found to be effective in the treatment of adults with significant identity diffusion, namely, Transference Focused Psychotherapy. The central role of differentiating normal Identity Crisis from Identity Diffusion in adolescents, essential to accurately identifying those adolescents appropriate for this treatment, is articulated. The primary modifications of TFP for adolescent treatment described involve changes in frequency and duration of some of the specific techniques (e.g. increased clarification ; more work in the extra-transferential relationships before directly addressing the transference), tactics (e.g. inclusion of family during the assessment phase and treatment contract setting phases of treatment ; inclusion of supportive interventions in the environment while maintaining the analytic stance in sessions), and strategies (e.g. the goal of removing blockages to the development of normal identity integration, not "forced maturation"). This treatment aims to improve adolescent’s relationships with friends, parents, and teachers ; help clarify life goals ; acquire positive self-esteem ; and be better prepared for entering love relation¬ships.

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The Patient Therapist Relationship : Implications of Attachment Theory, Reflective Functioning and Research
Diana Diamond, Frank Yeomans

This paper illustrates the centrality of attachment issues in a manualized psychodynamic psychotherapy for BPD, Transference-focused psychotherapy (TFP). The focus is on how the psychotherapist’s awareness of these issues may advance the understanding of psychopathological processes mediated by attachment disorganization, and in particular how the patient-therapist match may foster or impede disorganized attachment.

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For an empirical approach to object relations
Louis Diguer, Olivier Laverdière, Dominick Gamache

In this article, the authors address the concept of object relations and its place within psychodynamic theories regarding personality and, more specifically, in Kernberg’s conceptualization of personality disorders and organization. The authors attempt to demonstrate the relevance of an empirical approach to object relations by presenting some of the instruments that are most considered. The Object Relations Rating Scale (ORRS ; Diguer, 2001), a new assessment instrument that is different from the others in that it assesses the therapeutic interaction as a whole, and that it is coherent with Kernberg’s model of intervention and considers the overall relational manifestations. Finally, the authors present satisfying metrological ratings of this new instrument.

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Narcissism, its Disorders and the role of TFP
Diana Diamond, Frank Yeomans

In this paper, the authors present an overview of a range of psychoanalytic understandings of narcissistic pathology with an emphasis on the model and system of classification described by Kernberg. They discuss how the concept of a fundamental split between object relations dyads can contribute to major pathology of superego development and functioning and to the defensive establishment of the false grandiose self that are central to pathological narcissism. The authors also review therapeutic modifications that can help clinicians effectively treat patients with narcissistic pathology and describe distinctions in levels of narcissism that influence both how to approach treatment and prognosis.

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