The author describes the differences between standard psychoanalysis and transference-focused psychotherapy (TFP) and reviews particular difficulties that psychodynamically trained clinicians have in learning TFP. In delineating differences between standard psychoanalysis and TFP, the author discusses mutual influences between standard psychoanalytic techniques and techniques of TFP. TFP is an extension and modification of standard psychoanalysis, but with quantitative modifications geared to the treatment of the most severe segment of personality disorders that tend not to be treatable by standard analysis. TFP includes some features that are directly facilitated by psychoanalytic education, such as the importance of free association and the organization of interpretations in terms of the analysis of defense, motivation, and impulse. On the other hand, TFP provides new strategies, enhancing standard psychoanalytic treatment, when it modifies technical neutrality under certain circumstances, allows for the analysis of “incompatible realities,” and accelerates interventions under conditions of severe acting out when technical neutrality is not possible to maintain. The author demonstrates the advantages of systematic training in TFP within psychoanalytic institutes as a true enrichment of technical training. He proposes that psychoanalysis as a profession consists of a broad spectrum of treatment approaches based upon the combined utilization of psychoanalytic techniques, with specific modifications to be organized in specific forms of psychoanalytic psychotherapy. TFP may be the closest modification to standard psychoanalysis proper and is clearly defined and manualized. This has permitted empirical research that has already demonstrated the effectiveness of TFP.
