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Biomedical subjects

A W Bateman

Publications and source records attributed to A W Bateman.

6 recordsLinked to original sources
PubMed2000

Effectiveness of psychotherapeutic treatment of personality disorder.

BACKGROUND: Psychiatrists have been criticised for failing to develop adequate treatment for personality disorder. Psychotherapeutic treatments are promising, but their effectiveness is uncertain. AIMS: To investigate the evidence for effectiveness of psychotherapeutic treatment for personality disorder. METHOD: Systematic literature review. RESULTS: There is evidence for the effectiveness of psychotherapy for personality disorder. Problems of case identification, comorbidity, randomisation, specificity of treatment and outcome measurement are inadequately addressed. Authors mainly relied on cohort studies. Evidence neither suggests superiority of one type of therapy over another nor indicates which subgroups of patients should be offered psychotherapy as in-patient, day patient, or out-patient. CONCLUSIONS: New research strategies are needed to show that personality change is both measurable and clinically meaningful. Effectiveness studies using randomised controlled designs are required. The literature suggests that effective treatment should be long-term, integrated, theoretically coherent and focused on compliance.

Cohort Studies↗
PubMed1998

Thick- and thin-skinned organisations and enactment in borderline and narcissistic disorders.

In this paper the author argues that enactment is any mutual action within the patient/analyst relationship that arises in the context of difficulties in countertransference work. Such enactment is common during the treatment of borderline and narcissistic disorders. In order to delineate different forms of enactment, which in his view may be either to the detriment or to the benefit of the analytic process, the author describes a patient who was identified primarily with a sadistic mother and who threatened the analyst with a knife during treatment. Three levels of enactment involving countertransference responses are described of which two, namely a collusive countertransference and a defensive countertransference, were detrimental to the analytic process. The third level of enactment was beneficial but only because the intervention by the analyst was independent of the analytic process and yet in response to it. The author uses Rosenfeld's distinction between thin-skinned and thick-skinned narcissists to illustrate how enactment is most likely when a patient moves between thick-skinned and thin-skinned narcissistic positions. Nevertheless the move between thin and thick-skinned positions presents an opportunity for effective interpretation, allowing progress in treatment.

Acting Out↗
PubMedDate not supplied

Borderline personality in Britain: a preliminary study.

Patients admitted to a psychiatric hospital in England were interviewed using both the Present State Examination (PSE) to obtain a standardized diagnosis and the Diagnostic interview for Borderlines (DIB) to measure their borderline status. Comparison of the patients' symptom profiles showed that borderline patients were similar to neurotic patients, but had greater irritability. They were also more likely to receive a clinical diagnosis of hysterical personality disorder with neurotic depression by a British clinician.

Adult↗