Page numbers printed in boldface type refer to tables or figures.
Acting outcountertransference and intensity of,74
narcissistic personality disorder and,178, 179
transference analysis and,12, 41
Affective dominancesupervision and,116–117
TFP and interpretation of,40, 95–106
transference analysis and,11
Affect systems, and neurobiology,4–5, 16–18
AggressionFreud’s concept of death drive and,4, 21
group psychology and,225
love relationships of narcissistic patients and,173, 182
“negative” affect systems and,16–17
schizoid personality disorder and,140
supervision and,120
symbiotic transference and,87
transference analysis and,9–10
Albright, Madeline,227, 230
“Alternative DSM-5 Model for Personality Disorders” (American Psychiatric Association 2013),64
Amygdala, and schizophrenia,151
Anorexia nervosa,154
Anthony, E.J.,194, 197
Antisocial personality disordergroup psychology and,210, 225, 226–227
syndrome of perversity in narcissistic patients and,182
Applebaum, Ann and Steve,195
Assessment, of reality testing,147–148.
See also Diagnosis; Evaluation
Austen Riggs Psychiatric Clinic (Massachusetts),200
Bao-Lord, B.,225
Barchas, Jack,201
Barranger, M. and W.,105
“Basic assumption groups,”215–217
Bauer, Steven,200, 201
Behavior.
See also Acting out; Aggression
inappropriate or problematic in love relationships,174
malignant narcissism and antisocial,223, 225, 226–227
transference analysis and patterns of,9–14
“Benign delusional syndromes,” and schizophrenia,153
Bion, Wilfred,95, 96, 100, 118, 194, 197, 202, 207, 208, 215–217, 219
Blackmail, and love relationships,173–174
Body dysmorphic syndrome,154
Bollas, C.,26
Bonding, and sexual relations,174
Borderline personality disorder.
Seealso Borderline personality organization
case example of,73–75, 159–161
eye contact in Zoom sessions,102
love relationships and,171–172
narcissism and,76, 223
MBT for,110–111
role reversals and interpretation of,40
Borderline personality organization (BPO).
See also Borderline personality disorder
development of integrated self and,66
dyadic relationship and,109–110
dynamic unconscious and,25, 29
inpatient psychotherapeutic treatment and,203
outcome of psychoanalysis or TFP,150structural aspects of transference in,72–75, 85–86
supervision and,121, 123, 127
Bosnia, and group psychology,229
Boston Psychopathic Hospital,192
Boundaries, and love relations,170, 174–175
Britton, R.,86
Bureaucracy, and group psychology,228
“Burnout” syndrome, and hospital staff,198
Busch, Fred,43, 247
Caligor, Eve,36, 58, 248
Canetti, E.,222–223
Caretaker, love relationships and role of,172
Carr, Arthur,200
Case examplesof borderline personality disorder,73–75, 159–161
of narcissistic personality disorder,78–79, 87–88, 139, 161–162, 182–187
of neurotic personality structure,70–72
of paranoid schizophrenia,89–90, 154–156
of psychotic personality disorder,154–162
of schizoid personality disorder,83–85, 136–142, 143, 144
Castle Hospital (London),193
Chavez, Hugo,230
Chestnut Lodge Clinic,192
Child and adolescent psychoanalysis,248–249
Children, and boundaries of love relationships,174–175
Chinese Cultural Revolution,225
Clarkin, John,201
Cognitive-behavioral therapy,199
Columbia University,200
Community-based psychiatry movement,199
Community meetings, and inpatient treatment,196, 208
Community relations, and psychoanalytic centers,244
Competence, of psychoanalysts definition of professional,234, 235, 236
evaluation of,246–247
standards for certification,244–245
Conflicts, and love relationships of narcissistic patients,170–171, 179.
See also Organizational structure and conflict
Containment, and basic techniques of psychoanalysis,37
Cornell University.
See Personality Disorders Institute
Countertransferenceborderline personality disorder and intensity of,74
difference of utilization in standard psychoanalysis versus TFP,44–45
fundamental technical instruments of psychoanalysis and,36–37, 63
schizoid personality disorder and,82, 84–85, 144, 145
supervision and,115, 119
training in standard psychoanalysis and TFP,56–57
transference analysis and,10–11
Couples therapy,171
Creativity, and study of unconscious,241–242
Crowds, and mass psychology,214
Culture, influence of psychoanalysis on,233–234.
Seealso Social systems
Dead mother syndrome, and dismantling of transference,90–91
Defenses, object relations theory and systematic interpretation of,65, 66
Dependency, and Bion’s theory of basic assumption groups,216–217
Depression.
See Major depression with psychosis; Psychotic depression
Developmentof affective memory accumulation,7
of dynamic unconscious,24–25
Diagnosis.
See also Assessment; Initial evaluation
psychotic personality organization and,163–164
supervision and,118
training in TFP and,46–47
Dialectic behavior therapy,199–200
Dishonesty, and leadership of mass movements,225–227
Dream analysis,45, 97
Drives, and drive theoryFreud’s theory of,4, 20–21, 65
modification of classical motivational psychoanalytic theory and,4–5
Drug-induced psychosis,154
DSM-5, and schizoid personality disorder,134
Dulz, B.,204
Dyadic relationship, and TFP,106–112
Dynamic psychotherapy for higher personality pathology (DPHP),69Dynamic unconscious,5, 22–29
Education, and research,242–243.
See Psychoeducation; Training
Ego, superego, and id, concepts of in object relations theory,6, 8, 27, 66
Ego-syntonic aggression, and malignant narcissism,223
Empathy, and supervision,126–127
Envy, and love relations of narcissistic patients,175–176, 178, 179, 182
Evaluation, of professional competence,246–247.
See also Initial evaluation
“Expressive” psychotherapy,63
Expressive-supportive psychotherapy (Ex-SupP),69Ezriel, H.,194, 197, 202, 207, 208
Fairbairn, W.,80, 81, 134, 142, 193
Fantasynarcissistic sexual pathology and,176
schizoid personality disorder and,135, 144, 145
Fenichel, Otto,96
Fight-flight reactions,17, 216
Foulkes, S.H.,194, 197
Free associationclassical psychoanalytic technique and,8
fundamental technical instruments of psychoanalysis,36–37
training in TFP and,47–48
transference analysis and,11, 13
Freud, Anna,42
Freud, Sigmund,4, 16, 20–21, 24, 65, 91, 95, 214–215, 219, 220–221, 238, 245
Gender identity, and love relationships,166
Genetics, and schizophrenia,151
Genocide, and group psychology,228, 229
German depth psychology-oriented psychotherapy (TPOPSY),69Germanygroup psychology and Nazi era,227, 228, 229
history of inpatient psychoanalytic treatment in,191–192, 204–211
psychoanalysts on faculty of universities in,242
Grandiosity, and narcissistic personality disorder,74–79, 146, 177, 178
Gratitude, and love relationships of narcissistic patients,177
Great Britain, and inpatient psychoanalytic treatment of personality disorders,192, 193
Green, André,21, 53, 91
Group meetings, and inpatient treatment,196, 197, 206
Group psychologydangers of to society,227–231, 238
development of theories of,214–222
leaders of and malignant narcissism,222–227
Group psychotherapy, and TFP,200, 202–203, 207–208
Group supervisionimportance of in learning process,128–129, 247
transference/countertransference issues and,115
Guntrip, H.,80, 134, 142
Haran, Catherine,200, 201
Hartocollis, Peter,195
Harvard University.
See Boston Psychopathic
Hospital Hippocampus, and neurobiology of affect system,19, 22
Historical trauma, and group psychology,226
Histrionic personality disorder,98–99
Hitler, Adolf,225, 227, 229, 230
Homeostatic mechanisms, and affect activation,17
Horwitz, Leonard,195
Hospital, analysis of as social system,192–193, 206, 210.
See also Inpatient treatment
Hunt, Howard,200
Hypochondriasis,154, 159
Id.
See Ego
Idealization, and love relationships,171, 172
Identity.
See also Gender identity; Self
group psychology and,215, 218, 219–220, 221, 225
psychoanalysts and professional,248
Ideology, and group psychology,219, 221–222, 226, 228, 229
Impulses, object relations theory and systematic interpretation of,65
Infantile amnesia,5, 24
Initial evaluation, and differences between standard psychotherapy and TFP,38–39
Inpatient treatment, psychoanalytic approaches to for severe personality disorders,191–211
Intensive psychotherapy, and psychotic transferences,88–89
Internet, and group psychology,228.
See also Zoom
Interpretationaffective dominance and,95–106
differences between standard psychoanalysis and TFP,39–40
fundamental technical instruments of psychoanalysis,36–37
schizoid personality disorder and,82
ISIS (terrorist organization),226
Jacobson, Edith,51–52, 149, 151
Johnson, V.E.,166
Jones, Maxwell,194, 198
Joseph, Betty,41, 64, 144
Judicial system, and group psychology,228
Kennedy, Lawrence,195
Kernberg, Otto F.,62–63, 67, 195
Kernberg, Paulina,195
Klein, Melanie,7, 25, 28, 134, 135, 142, 148, 193–194, 200–201, 221
Kürner, J.,246
Language, personality disorders and systematic distortion of,47–48.
See also Verbal communication
Leaders, and leadershipgroup psychology and,215, 216–217, 218–220, 221, 222–231
psychoanalytic centers and,247–248
LibidoFreud’s description of affect systems and,4
“positive” affect systems and,16–17
transference analysis and,9–10
Loewald, Hans,39, 100
Love relationships.
See also Social relationships
narcissistic personalities and,167–187
technical neutrality and training in TFP,55–56
Main, Thomas F.,193, 194, 195
Major depression with psychosis,151, 154
Malignant narcissism.
See also Narcissistic personality disorder
leadership of mass movements and,222–231
love relationships and,173
Managed care, impact of on psychiatric care,199, 201
Manic syndrome,154
Marx, Karl,222
Mass movements, and Freud’s theory of group psychology,214–215
Masters, W.H.,166
McWilliams, N.,134
Memory.
See also Working memory
dynamic unconscious and,22–23
object relations theory and development of affective,7
Menninger, Roy,195
Menninger Clinic,192, 195, 198
Menninger study,63
Mentalization, and dyadic relationship in TFP,106–112
Mentalization-based therapy (MBT)borderline personality disorganization and,110–111
dominant techniques of,69transference interpretation in TFP and,50–51
Mental status interview, and reality testing,147
Michels, Robert,200
Microanalysis, and grandiose self in narcissistic personality disorder,78
Moscovici, S.,222, 238
Multi-culturalism, and group psychology,230
Narcissistic personality disorder.
See also Malignant narcissism; Negative narcissism
affective dominance and,97
case examples of,78–79, 87–88, 139, 161–162, 182–187
grandiosity and,74–79, 146, 177, 178
leadership and group psychology,223
love relationships and sexual relations,167–187
modifications in psychoanalytic technique for,29
transference analysis and,12, 13
transference structures and,75–79, 87–88
Negative narcissism, and Freud’s concept of death drive,21
Neurobiologyaffect systems and,4–5, 16–18
dynamic unconscious and,22–29
representation of self and others,18–20
revisions of psychoanalytic theory and,29–30, 237–238
schizophrenia and,151–153
Neurotic personality organizationaffective dominance and,96–98
case example of classic psychoanalytic treatment for,70–72
internalized object relationships and,110
outcome of psychoanalysis or TFP,150supervision and,120, 122–123
Neurotransmitters, and schizophrenia,152–153
New York State Psychiatric Institute,200
Novotnik, Peter,195
Nursing staff, and inpatient treatment of personality disorders,208–209, 210
Object relations theorybasic psychoanalytic concepts of drive derivatives and defensive impulses,65
concept of self and,6, 8, 18–20
defense mechanisms of BPO,66
overview of theory and technique of TFP,3–8
reality testing and,148
transference analysis in TFP and,8–14
Obsessive-compulsive personality disorder,127
Ogden, T.H.,28
Organizational structure and conflict, as specialization,249
Panksepp, J.,24
“Parallel process,” and supervision,118, 121
Paranoid personality disorder,13, 222, 223
Paranoid psychosis,154, 157
Paranoid-schizoid positiongroup psychology and,221
Klein’s description of,7, 66, 135, 142, 221
schizoid personality disorder and,134, 135–136, 141, 142, 144, 146
Paranoid schizophreniacase examples of,89–90, 154–156
intensive psychotherapy for,89–90
Paranoid transference, and narcissistic patients,179–180
Personality disorders.
See also Antisocial personality disorder; Borderline personality disorder; Histrionic personality disorder; Narcissistic personality disorder; Obsessive-compulsive personality disorder; Paranoid personality disorder; Psychoanalysis and psychoanalytic theory; Psychotic personality disorder; Schizoid personality disorder
advantages of TFP in initial evaluation of,39
affective dominance and,98, 99, 102
countertransference reactions and,44–45
psychoanalytic approaches to inpatient treatment of,191–211
supervision in severe cases of,122
systematic distortion of language in,47–48
transference analysis and,10, 42
Personality Disorders Institute (Cornell University),64, 144, 160, 166, 201
Perversity, syndrome of,182
Powerlove relationships and,172–173
mass movements and,215, 227
Prefrontal cortex, and neurobiology,19, 23, 24, 151–152
Professional development, and psychoanalytic centers,244
Projective identification, and inpatient treatment,196
Psychoanalysis and psychoanalytic theory.
See also Countertransference; Interpretation; Object relations theory; Personality disorders; Technical neutrality; Training; Transference analysis; Transference-focused psychotherapy (TFP); Transference structures
countertransference utilization and,44–45
current crisis in,233–236
development as psychoanalyst and,127
differences between standard and TFP,36–45, 57–58
dynamic unconscious and,22–24
Freud’s theory of death drive,20–21
group psychology and,214–222
implications of transference structures for,62–68
inpatient treatment of severe personality disorders and,191–211
modified approaches to,236–237
neurobiology and,16–18, 29–30, 237–238
potential solutions to theoretical challenges,237–249
representation of self and others,18–20
specialization within treatment approaches,113–114
use of term “standard,”36, 62–63, 64, 91–92
Psychoanalytic centers, and research,243–244, 247–248.
See also Menninger Clinic; New York Psychiatric Institute; Personality Disorders Institute
Psychodynamic psychotherapy,121–122, 142–144
Psychoeducation, and inpatient treatment,210
Psychopathic transferences,13
Psychopharmacology, for psychosis and schizophrenia,152–153, 199
Psychosis.
See also Psychotic personality disorder; Psychotic personality organization; Psychotic transferences; Schizophrenia
development of psychopharmacology for,199
use of term,147
Psychosocial environment, and affect systems,18
Psychotic depression,151, 154
Psychotic functioning, use of term,147
Psychotic personality disorder,153, 154–162
Psychotic personality organizationcase examples of,162, 163–164
outcome of psychoanalysis or TFP,150reality testing and,151, 153–154
Psychotic transferencescase examples of psychotic personality disorder and,154, 158, 159, 161, 162–163
transference structure and,88–90, 157
use of term,85,
87Reality testingassessment of,147–148
differentiated from relationship to reality,148
psychotic personality disorder and,147, 153–154, 163
representation of self and,149, 151
transference analysis and,41–42
Regressionleadership of large groups and,224–227
transference analysis and,12–13
Relational psychoanalytic approach, and interpretation of countertransference,64
Religion, and psychotic personality disorder,153
Repetition compulsion, and supervision,117
Research, and development of psychoanalytic theories and techniques,241, 242–244
Resistance, and classification of basic techniques of psychoanalysis,37
Rey, J.H.,80
Rice, A. Kenneth,195
Rioch, Margaret J.,195
Role reversalsborderline personality disorder and interpretation of,40
dyadic relationship and,108, 109
love relationships and,172–173
Rosenfeld, Herbert,89, 151, 192
Roth, Gerhard,29
Rwanda, and group psychology,229
Schizoid personality disorderaffective dominance and,101
case examples of,83–85, 136–142, 143, 144
descriptive characteristics of,133–136
dynamic unconscious and,26
modifications in psychoanalytic technique for,29
psychodynamic considerations in treatment of,142–144
transference structures and,79–85
TFP for treatment of,144–146
Schizophrenia.
See also Paranoid schizophrenia
case examples of psychotic personality disorder and,156–158
dynamic unconscious and,26
intensive psychotherapy for,89
neurobiology and,151–153
outcome of psychoanalysis or TFP for,150, 153
paranoid-schizoid mechanisms and defensive operations of,148
Schwartz, M.,192–193
Searles, Harold,88–89, 90, 157, 158
“SEEKING” system,17
“Selected fact,” affective dominance and concept of,96
Selfborderline transference and,73development of integrated,66
dynamic unconscious and,23–24, 27
narcissistic personality disorder and grandiose,74–79, 177
neurobiology of affect systems and,18
neurotic transference and,71object relations theory and concept of,6, 8, 18–20
psychotic transference and,87reality testing and,149, 151
schizoid personality disorder and,80,
81symbiotic transference and,85,
86Self-representation, and transference analysis,40–41
Semelin, Jacques,227, 229, 230–231
Seminars, on psychoanalytic and psychotherapeutic technique,129
Separation-panic, and negative affect systems,17
September 11, 2001 terrorist attack,219
Sexual life.
See Love relationships
Silence, and affective dominance,103–104
Skills training, and inpatient treatment,210
Snyder, Timothy,227, 231
Social organizations, malignant narcissism and leadership of,224, 230
Social media, and group psychology,228
Social relationships, and schizoid personality disorder,80, 83, 134–135, 144.
See also Love relationships
Social systems.
See also Culture
group psychology and,219, 221, 227, 238
hospital as,192–193, 206, 210
Social workers, role of in inpatient treatment,209
Sociology, and psychoanalytic theory,238–239
Solms, Mark,24
Somatization, and transference analysis,12
Soviet Union, and group psychology,228
Spillius, Elizabeth,153
Stalin, Joseph,225, 229
“Standard” psychoanalysis, use of term,36, 62–63, 64, 91–92
Standards for certification,244–245
Stanton, A.M.,192–193
Stone, Michael,89, 153, 200–201
Sullivan, Harry,192
Superego.
See Ego
Supervision.
See also Training
different approaches to psychoanalytic treatment and,113–117
frequent problems in,117–126
limitations of,126–129
role of in psychoanalytic education,247
Supportive psychotherapy (SPY),68,
69Sutherland, J.D.,194, 195, 197, 202
Symbiotic transferences,13, 85–88
Symbols, and “protosymbols” of mass movements,220
Task groups, and inpatient treatment,196
Tavistock Clinic (London),194–195
Technical neutralitydifferences between standard psychoanalysis and TFP,42–43
fundamental technical instruments of psychoanalysis and,36–37, 63
group psychotherapy and,203
schizoid personality disorder and,145
supervision and,122
training in TFP and,54–56
transference analysis and,11, 12
TFP.
See Transference-focused psychotherapy
Therapeutic alliance, and basic techniques of psychoanalysis,37.
See also Therapeutic relationship
Therapeutic community, and traditional medical model,198
Therapeutic frame, and transference analysis,11
Therapeutic relationship.
See also Therapeutic alliance
assumption of normal as precondition for TFP,100
supervision and,119
Ticho, Ernst and Gertrude,195
Totalitarian systems, and group psychology,228
Total object relationship, and BPO,73
Total transference, TFP and concept of analysis of,41, 55
Training, of psychoanalytic therapists.
Seealso Supervision
definition of professional competence and,234, 235, 236
differences between standard psychoanalysis and TFP,45–57
evaluation of competence,246–247
inclusion of modified approaches in,236–237
new curriculum proposed for,245–246
recent changes in,234–236
requirement for personal psychoanalysis,247
specialization and,248–249
Transference analysis.
See also Psychopathic transferences; Psychotic transferences; Symbiotic transferences; Total transference; Transference structures
differences between standard psychoanalysis and TFP,40–42
fundamental technical instruments of psychoanalysis and,36–37, 63
psychosis induced in course of,154
representation of self and others,20
schizoid personality disorder and,145, 146
supervision and,115
theoretical approach of TFP and,8–14
training in TFP and,52–54
Transference-focused psychotherapy (TFP)affective dominance and,40, 95–106
basic psychoanalytic techniques and,240
BPO and,29, 73, 75,
150countertransference utilization and,44–45
differences between standard psychoanalysis and,36–44, 57–58
dominant techniques of compared to other methodologies,69dyadic relationship and mentalization,106–112
group therapy and,202–203
Menninger study and development of,63
neurotic personality organization and,150overview of theory and techniques of,3–8
Personality Disorders Institute and development of,201
psychotic personality organization and,150schizoid personality disorder and,144–146
schizophrenia and,150training issues and,45–57
transference analysis and,8–14
Transference psychosis.
See Psychotic transference
Transference structures.
See also Transference analysis
application of psychoanalytic techniques and,62–68
BPO and,72–75
dead mother syndrome and dismantling of,90–91
narcissistic personality disorder and,75–79
neurotic personality organization and,70–72
schizoid personality disorder and,79–85
symbiotic transferences and,85–88
Traumatization, unconscious conflicts and early experiences of,7, 24, 25, 26, 28, 52
Trust, and love relations,170
Tuckett, David,41, 246
Turquet, Pierre,217–219, 221, 227
Unconscious intrapsychic conflict, revision of classical theory of,4–5.
See also Dynamic unconscious
United Nations,231
“Us” versus “them,” and group psychology,216, 220
Value systems, and technical neutrality,55
Verbal communication, and advantages of standard psychoanalytic training for TFP therapist,47–48.
See also Language
Volkan, Vamik,219–221, 238
Wallerstein, R.,63
Working memory.
See also Memory
affect systems and function of,18
dynamic unconscious and,23
Yale Psychiatric Hospital,193
Yeomans, Frank,201
Yugoslavia, and group psychology,229
Zoom, and psychoanalytic treatment,101–102
