By Otto Kernberg
During this booklet a number one psychoanalytic clinician and theoretician offers his suggestions at the most recent psychodynamic advancements and insights relating to therapy of serious character issues. Dividing his discussions into sections, one on psychopathology and the opposite on psychotherapy, Dr. Otto Kernberg examines borderline character illness, narcissism, sexual inhibition, transference and countertransference, suicidal behaviour, and consuming issues. In every one bankruptcy he integrates the tips of eu and Latin American psychoanalytic thinkers, bringing them to the eye of English-speaking readers. This booklet features a number of lately released magazine articles. Their assortment into one quantity makes on hand Dr. Kernberg's current pondering on a massive topic.
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Extra resources for Aggressivity, Narcissism, and Self-Destructiveness in the Psychoterapeutic Relationship: New Developments in the Psychopathology and Psychotherapy of Severe Personality Disorders
The vicissitudes of internalized object relations and the development of affective responses emerge as basic components of a contemporary psychoanalytic approach to the personality disorders. Affects always include a cognitive component, a subjective experience of a highly pleasurable or unpleasurable nature, neurovegetative discharge phenomena, psychomotor activation, and, crucially, a distinctive pattern of facial expressions that originally serves a communicative function directed to the caregiver.
But clinicians, theoreticians, and researchers in this field continue to be troubled by the issue of whether aggression is inborn—an “instinct” or “drive”—or secondary to frustration and trauma. In short, is aggression the result of early experience or of constitution and genetics? Studies have shown that early exposure to violence and to physical, psychological, and sexual abuse, particularly incest, is significantly more frequent in patients with severe personality disorders and in children at high risk for psychopathology than in patients with milder personality disorders and the population at large (Paris a).
I believe that there is an indissoluble connection between the internalization of early object relations and affect states, the dyad of self-representation and object representation and its affective context. Drive neutralization, according to this concept, implies the integration of originally split idealized and persecutory internalized object relations, leading to an integrated concept of the self and of significant others and the integration of derivative affect states from the aggressive and libidinal series into the toneddown, discrete, elaborated, and complex affect disposition of the phase of object constancy.
Aggressivity, Narcissism, and Self-Destructiveness in the Psychoterapeutic Relationship: New Developments in the Psychopathology and Psychotherapy of Severe Personality Disorders by Otto Kernberg