TFP Extended: Development and Recent Advances

2021 ◽  
Vol 49 (2) ◽  
pp. 188-214
Author(s):  
John F. Clarkin ◽  
Eve Caligor ◽  
Julia Sowislo
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Full Range ◽  
Clinical Intervention ◽  
Borderline Personality ◽  
Personality Pathology ◽  
Interpersonal Functioning ◽  
The Core ◽  
Empirically Supported ◽  
Recent Advances

Recent advances in the understanding of personality pathology have contributed to an emphasis on the core of personality pathology as deficits in self-functioning and interpersonal functioning at different levels of severity that must be assessed for clinical intervention. In concert with these conceptual and empirical advances, transference-focused psychotherapy (TFP), an empirically supported psychodynamic treatment for borderline personality disorder, has been in constant development with extensive clinical use. This article describes an object relations model for conceptualizing and assessing levels of personality organization, a transdiagnostic approach to personality pathology, and related treatment modifications, thus expanding the utilization of TFP beyond borderline personality disorder to the full range of personality dysfunction. The core of this treatment approach is a sequential interpretive process between patient and therapist. This process takes place within the context of a structured treatment frame tailored to the unique individual with problems in self-functioning and interpersonal functioning in his/her particular environment.

scholarly journals A developmental, mentalization-based approach to the understanding and treatment of borderline personality disorder

2009 ◽  
Vol 21 (4) ◽  
pp. 1355-1381 ◽  
Author(s):  
Peter Fonagy ◽  
Patrick Luyten
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Mental States ◽  
Borderline Personality ◽  
Affect Dysregulation ◽  
Self And Other ◽  
The Core ◽  
Empirically Supported ◽  
Low Threshold ◽  
Core Features

AbstractThe precise nature and etiopathogenesis of borderline personality disorder (BPD) continues to elude researchers and clinicians. Yet, increasing evidence from various strands of research converges to suggest that affect dysregulation, impulsivity, and unstable relationships constitute the core features of BPD. Over the last two decades, the mentalization-based approach to BPD has attempted to provide a theoretically consistent way of conceptualizing the interrelationship between these core features of BPD, with the aim of providing clinicians with a conceptually sound and empirically supported approach to BPD and its treatment. This paper presents an extended version of this approach to BPD based on recently accumulated data. In particular, we suggest that the core features of BPD reflect impairments in different facets of mentalization, each related to impairments in relatively distinct neural circuits underlying these facets. Hence, we provide a comprehensive account of BPD by showing how its core features are related to each other in theoretically meaningful ways. More specifically, we argue that BPD is primarily associated with a low threshold for the activation of the attachment system and deactivation of controlled mentalization, linked to impairments in the ability to differentiate mental states of self and other, which lead to hypersensitivity and increased susceptibility to contagion by other people's mental states, and poor integration of cognitive and affective aspects of mentalization. The combination of these impairments may explain BPD patients' propensity for vicious interpersonal cycles, and their high levels of affect dysregulation and impulsivity. Finally, the implications of this expanded mentalization-based approach to BPD for mentalization-based treatment and treatment of BPD more generally are discussed.

Positive Emotion in Borderline Personality Disorder

2019 ◽  
pp. 332-352
Author(s):  
Jill M. Hooley ◽  
Sara R. Masland
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Positive Emotions ◽  
Negative Emotions ◽  
Negative Mood ◽  
Severe Form ◽  
Borderline Personality ◽  
Negative Emotionality ◽  
Personality Pathology ◽  
Emotional Experiences

Borderline personality disorder (BPD) is a severe form of personality pathology characterized by high levels of negative emotionality. Because negative emotions are so central to the clinical presentation of BPD, the issue of how people with this disorder process and experience positive emotional experiences is relatively unexplored. This chapter provides an overview of what is currently known about positive emotions and BPD. Although the literature is characterized by many inconsistencies, our review suggests that people with BPD do indeed experience positive emotions. However, their recall of positive emotional experiences appears to be reduced, perhaps because such experiences are more transient, less stable, and more likely to be quickly replaced by negative emotions. Problems with the identification and accurate differentiation of positive emotions may also play a role. Such difficulties may conspire to create a psychological world for people with BPD that is characterized by a focus on negative mood and negative emotional experiences. In addition to focusing on negative affect, we suggest that it might also be clinically beneficial to make problems with positive affect a specific clinical target.

Borderline personality disorder: part 1 – assessment and diagnosis

2020 ◽  
Vol 26 (3) ◽  
pp. 159-172
Author(s):  
Jacqueline Garland ◽  
Stephen Miller
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Clinical Features ◽  
Borderline Personality ◽  
The Core ◽  
Diagnostic Practice ◽  
Assessment And Diagnosis

SUMMARYGeneral adult psychiatrists are largely responsible for the care of patients with personality disorders in community and in-patient settings, and this can be associated with diagnostic and management challenges. In the first of two articles focusing specifically on borderline personality disorder (BPD), we summarise the core clinical features of the disorder and discuss appropriate diagnostic practice.

Understanding Interpersonal Dysfunction in Borderline Personality Disorder

2017 ◽  
Vol 5 (2) ◽  
pp. 355-366 ◽  
Author(s):  
Annemarie Miano ◽  
Isabel Dziobek ◽  
Stefan Roepke
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Borderline Personality ◽  
Empathic Accuracy ◽  
Healthy Controls ◽  
Heterosexual Couples ◽  
The Core ◽  
Interpersonal Difficulties ◽  
Interpersonal Dysfunction

The core interpersonal dysfunction in borderline personality disorder (BPD) has not yet been conclusively explained. We used a naturalistic dyadic paradigm to test for the presence of functional empathic inaccuracy in BPD, which is a reduced understanding of the partner’s feelings in relationship-threatening situations. A total of 64 heterosexual couples ( N = 128) were videotaped while engaging in (a) neutral (favorite films), (b) personally threatening (personal fears), and (c) relationship-threatening (separation from partner) conversations. Females were either diagnosed with BPD or healthy controls. Empathic accuracy (EA) was measured from the recorded interactions. Healthy couples’ EA was lower during relationship-threatening compared with personally threatening situations. In contrast, women with BPD showed increased EA, relative to the controls, for relationship- versus personally threatening situations. Reduced EA in response to relationship-threatening situations is likely to be relationship protective. This mechanism appears to be defective in women with BPD, which might explain the interpersonal difficulties experienced by BPD individuals.

scholarly journals The Pathogenesis and Treatment of Emotion Dysregulation in Borderline Personality Disorder

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Andreas Laddis
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Emotion Dysregulation ◽  
Borderline Personality ◽  
Efficacy Study ◽  
Emotional Lability ◽  
Imaging Findings ◽  
The Core ◽  
Core Deficit ◽  
Key Factor

Uncontrollable emotional lability and impulsivity are a paramount phenomenon of Borderline Personality Disorder (BPD). This paper aims to review theories that entertain emotion dysregulation as the core deficit of BPD and a key factor in the etiology of BPD, in order, then, to propose the author’s own theory, which arguably transcends certain limitations of the earlier ones. The author asserts that his psychodynamic theory explains the symptoms of BPD more thoroughly and it inspires a more parsimonious interpretation of brain imaging findings. In closing, the author draws implications of the proposed theory for clinical practice. He reports an efficacy study for treatment of emotion dysregulation based on that theory.

scholarly journals Multimethod investigation of interpersonal functioning in borderline personality disorder.

2011 ◽  
Vol 2 (3) ◽  
pp. 175-192 ◽  
Author(s):  
Stephanie D. Stepp ◽  
Michael N. Hallquist ◽  
Jennifer Q. Morse ◽  
Paul A. Pilkonis
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Borderline Personality ◽  
Interpersonal Functioning
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