In this splendid book a master psychotherapist, one of the field's most respected researchers, provides the first definitive account of psychoanalytic psychotherapy in manual format. What distinguishes this book from other guides to therapy is the way in which the author systematically demystifies the therapeutic process, taking the reader step by step through a sequence of specific intervention strategies.The book offers the essence of psychoanalytic psychotherapy by extracting the treatment principles from Freud's six papers on technique and the Menninger Foundation tradition of supportive-expressive psychotherapy. At the heart of the expressive techniques is the Core Conflictual Relationship Theme method of delineating the transference pattern and providing a focus for the therapist's responses. Both the short-term and the usual open-ended treatment are presented. Each technique is illustrated by clinical vignettes. Precise measurement scales for each technique make it easy to evaluate the therapist's performance. Therapists, clinical supervisors, and researchers will all find this book to be a valuable source of practical information and inspiration.

This manual presents an evidence-based focal psychodynamic approach for the outpatient treatment of adults with anorexia nervosa, which has been shown to produce lasting changes for patients. The reader first gains a thorough understanding of the general models and theories of anorexia nervosa. The book then describes in detail a three-phase treatment using focal psychodynamic psychotherapy. It provides extensive hands-on tips, including precise assessment of psychodynamic themes and structures using the Operationalized Psychodynamic Diagnosis (OPD) system, real-life case studies, and clinical pearls. Clinicians also learn how to identify and treat typical ego structural deficits in the areas of affect experience and differentiation, impulse control, self-worth regulation, and body perception. Detailed case vignettes provide deepened insight into the therapeutic process. A final chapter explores the extensive empirical studies on which this manual is based, in particular the renowned multicenter ANTOP study. Printable tools in the appendices can be used in daily practice. This book is of interest to clinical psychologists, psychotherapists, psychiatrists, counselors, and students.

The association between social class and psychiatric disorder has been one of the central topics of socio-epidemiological research since its inception. With remarkable consistency, numerous investigations have demonstrated an inverse correlation between social class and prevalence rates for most forms of psychopathology. The debate on the interpreta tion of these findings - social causation versus social selection processes - continues to this day. Moreover, the question as to what the psychoso cial processes are through which social class and individual psychopa thology are mediated has remained mostly unanswered. The concept of social stress may well provide new insights in this regard. One should note, in particular, the considerable conceptual and methodological progress made in life event research. Recently, the first attempts have been made to link the two concepts of social class and social stress. These developments will be retraced in this book in the light of new investigations. Descriptive epidemiological studies on the relation between social class and psychiatric disorders form the point of depar ture. Explicit reference is made to two classical studies in psychiatric epidemiology: Faris and Dunham's Chicago study and the New Haven study by Hollingshead and Redlich. Following on from there, various approaches in analytical epidemiological research are presented which attempt to determine whether - or, more precisely, to what extent - social causation or social selection processes can be said to be responsible for the higher rates of psychiatric disorders in lower social strata.

The subject of the apallic syndrome is one which has long been familiar to me, although I have not personally studied it as deeply as I would have wished. I became acquainted with this syndrome long before the last war, when my neurosurgical colleague Hugh Cairns (1952), made his pioneer contribution under the term "akinetic mutism" . This was an ar resting title, but it was one which did not altogether satisfy some of his colleagues, includ ing myself. We found it difficult to suggest an alternative. That is one reason why I wel come the expression "apallic syndrome" . Forensic practice has forced me from time to time to consider rather more deeply this distressing syndrome, and to try and marshal my ideas in a form which would satisfy my colleagues in the legal profession. More than once I have been instructed to make a medico legal assessment of these unfortunate patients. The points which have concerned my lawyer friends have not been matters of diagnosis, or of morbid anatomy, or of etiology. The fac tual problem which has been put before me was to make some approximate assessment as to the expectation of life. Vague guess-work is unacceptable in such circumstances. What the lawyers require is a precise and dogmatic answer.

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.