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Biomedical subjects

O F Kernberg

Publications and source records attributed to O F Kernberg.

At least 19 recordsLinked to original sources
PubMed2001

Recent developments in the technical approaches of English-language psychoanalytic schools.

This paper summarizes developments in the major approaches to psychoanalytic technique derived from the ego psychology, Kleinian, British independent, self psychology, intersubjectivist, and interpersonal schools over the past fifty years. The author proposes that two major contemporary currents may be differentiated from each other, namely, the psychoanalytic "mainstream"--derived from contemporary Kleinian, contemporary Freudian, and British independent sources, and the "intersubjectivist-interpersonal-self psychology" current. In significant contrast to these two major currents within the English-language psychoanalytic approaches, the French psychoanalytic school has evolved a unique third approach to analytic technique. The author proposes that these three currents constitute the dominant trends regarding technique in contemporary psychoanalytic practice. The paper concludes with a brief outline of the characteristics of each of these technical approaches.

France↗
PubMed2001

The suicidal risk in severe personality disorders: differential diagnosis and treatment.

This article describes the clinical approach to patients with severe personality disorders who present suicidal intention and behavior, developed at the Personality Disorders Institute of the Department of Psychiatry at Cornell University Medical College and the Westchester Division of the New York Presbyterian Hospital. It describes the diagnostic evaluation of patients' suicidal potential, personality disorder, and the presence or absence of a spectrum of regressive illness. The analysis of the combined features in these three symptomatic domains determines alternative strategies of psychotherapeutic and psychopharmacological interventions. Within these strategies, transference-focused psychotherapy is described as a specific psychodynamic psychotherapy geared to treat characterologically based suicidal and parasuicidal tendencies in the context of the treatment of the patient's personality disorder.

Major Depressive Disorder↗
PubMed2001

The development of a psychodynamic treatment for patients with borderline personality disorder: a preliminary study of behavioral change.

This study examines the effectiveness of a modified psychodynamic treatment called Transference Focused Psychotherapy (TFP) designed specifically for patients, with borderline personality disorder (BPD). Twenty-three female patients diagnosed with DSM-IV BPD began twice-weekly TFP. Patients were assessed at baseline and at the end of 12 months of treatment with diagnostic instruments, measures of suicidality, self-injurious behavior, and measures of medical and psychiatric service utilization. Compared to the year prior to treatment, the number of patients who made suicide attempts significantly decreased, as did the medical risk and severity of medical condition following self-injurious behavior. Compared to the year prior, study patients during the treatment year had significantly fewer hospitalizations as well as number and days of psychiatric hospitalization. The dropout rate was 19.1%. This uncontrolled study is highly suggestive that this structured and manualized psychodynamic treatment modified for borderline patients shows promise for the ambulatory treatment of these patients and warrants further study.

Adaptation, Psychological↗
PubMed2001

The Inventory of Personality Organization: psychometric properties, factorial composition, and criterion relations with affect, aggressive dyscontrol, psychosis proneness, and self-domains in a nonclinical sample.

This report describes 2 studies of the psychometric characteristics of the primary clinical scales of the Inventory of Personality Organization (IPO; O. F. Kernberg & J. F. Clarkin, 1995), which assess reality testing, primitive psychological defenses, and identity diffusion, in a nonclinical sample. The 3 IPO scales display adequate internal consistency and good test-retest reliability. Item-level confirmatory factor analysis supported a two-factor structure of the IPO consistent with O. F. Kernberg's (1984, 1996) model of borderline personality organization. Each of the 3 IPO scales was associated with increased negative affect, aggressive dyscontrol, and dysphoria as well as lower levels of positive affect consistent with Kernberg's model of borderline personality organization. The IPO Reality Testing scale is closely related to various measures of psychotic-like phenomena.

Adolescent↗
PubMed2000

Psychoanalytic perspectives on the religious experience.

This paper carries out an analysis of the nature of mature religiosity of the basis of psychoanalytic findings and concepts, rather than attempting a philosophical and theological approach to religion. It highlights a striking correspondence between the characteristics of mature religiosity, derived from the various sources of development of the ego-ideal and the superego, and reflecting a dominance of love over hatred, of libido over the death drive as an aspect of psychological health and maturity, on the one hand, and the characteristics of the Deity in Judeo-Christian religions, on the other. At a clinical level, one of the functions of the psychotherapist is to explore the extent to which religiosity as a mature desire for a transpersonal system of morality and ethical values is available to our patients. Psychotherapy also has to help certain patients to free themselves from the use of formal religious commitments as a rationalization of hatred and destructiveness directed against self or others.

Ego↗
PubMed2000

The influence of the gender of patient and analyst in the psychoanalytic relationship.

An overview of current explorations of the influence of gender on the psychoanalytic situation is presented. The topic does not lend itself to simple generalizations because the accumulated experience of several generations of psychoanalysts is now merging with newer views of psychoanalytic technique, while at the same time psychoanalytic theory is being influenced by changing ideological crosscurrents and by new knowledge regarding the similarities and differences in the development of both genders. Major issues still open are the relationship between gender and sexuality and between erotic desire and love; the challenges of the boundary of the psychoanalytic relationship as a facilitating and containing frame for the exploration of oedipal conflicts; and the related temptations, prohibitions, and derivatives of the erotic tension in the transference-countertransference.

Culture↗
PubMed2000

A concerned critique of psychoanalytic education.

The author explores some central problems in contemporary psychoanalytic education. He compares strengths and limitations of the two dominant models of psychoanalytic training, the traditional Eitingon model and the French model, and reviews current efforts to modify these models in order to overcome their limitations. In examining problems common to both educational systems, the author highlights the following issues: a tendency to infantilise psychoanalytic candidates, a persisting trend towards isolation from the scientific community, a lack of consistent concern for the total educational experience of candidates, authoritarian management and a denial of the effects of external, social reality on psychoanalytic education. Proposed solutions to these problems include: a stress on 'step-by-step' evaluation of candidates' progression, a greater emphasis on the cognitive aspects of seminars and supervision, particularly, a systematic exploration of the psychoanalytic method and its applications, a re-examination of the usefulness of the function of the training analyst status, an integration of teaching and practical experience in systematic research, and the incorporation of contemporary educational methods as part of the strengthening of the academic ambience of psychoanalytic institutes. The author concludes with a list of fifteen questions that may provide a quick indication of how for a psychoanalytic institute has progressed with the work of educational innovation.

Curriculum↗
PubMed1999

A severe sexual inhibition in the course of the psychoanalytic treatment of a patient with a narcissistic personality disorder.

This case report illustrates how an analysis of oedipal conflicts gradually resolved a severe and extended inhibition of sexual desire that developed as a new symptom in the termination phase of psychoanalytic treatment. The enactment in the countertransference of castration anxiety, against which the patient was successfully defending himself by projective identification, produced an extended stalemate, which was resolved once the countertransference was transformed into transference interpretations. This treatment also illustrates the intimate connection between pre-oedipal and oedipal conflicts in the advanced stages of the treatment of narcissistic personalities, and the need for very careful assessment of the patient's sexual functioning before deciding on terminating the psychoanalysis of a patient with a successfully resolved narcissistic personality structure.

Anxiety, Castration↗
PubMed1999

Psychoanalysis, psychoanalytic psychotherapy and supportive psychotherapy: contemporary controversies.

The author explores the controversies involving psychoanalytic psychotherapy from conceptual, clinical and educational perspectives. He proposes an integrated concept of psychoanalytic modalities of treatment, and their subdivision into standard psychoanalysis, psychoanalytic psychotherapy and psychoanalytically based supportive psychotherapy. Indications and contra-indications for these therapeutic approaches are outlined in the light of clinical experience and psychoanalytic research on these issues. It is proposed that psychoanalytic institutes teach psychoanalytic psychotherapy to candidates in psychoanalytic training. The author stresses that we now possess a broad spectrum of psychoanalytically based approaches to patients that significantly expand the therapeutic effectiveness of our profession, and thus can strengthen the social impact of psychoanalysis.

Humans↗
PubMed1996

Thirty methods to destroy the creativity of psychoanalytic candidates.

The author explores formal aspects of psychoanalytic education relevant to the fostering or inhibiting of creativity in the work of candidates. He refers to thirty features of psychoanalytic institutes that inhibit candidates' creativity and, by implication, illustrate problems in psychoanalytic education that require our attention. These features include systematic slowing down of institutional progression of candidates, repetitive and unquestioning teaching of key papers by Freud, monolithic tendencies regarding theoretical approaches, isolation of candidates from the professional and scientific activities of the psychoanalytic society, accentuation of the hieratical relations among the psychoanalytic faculty, graduation rituals, discouragement of original contributions by candidates, intellectual isolation of institutes, lack of full presentation of clinical work by senior members of the faculty, neglect of studies of controversies regarding psychoanalytic technique, 'paranoiagenic' features of the relationship among faculty and regarding requirements for candidates, the 'convoy' system, neglect of exploration of the scientific and cultural boundaries and applications of psychoanalysis and the effects of institutional conflicts around the appointment of training analysts.

Creativity↗
PubMed1994

Validation in the clinical process.

The combined analysis of the predominant themes, (a) in the patient's communication of his subjective experience, (b) in the patient's nonverbal behaviour and linguistic style, and in (c) the countertransference, provide indications for the main focus of the analyst's interpretive work, as well as potential evidence, in the corresponding changes in those three areas, of confirmatory or disconfirmatory aspects of the patient's reaction to the interpretation, thus providing the material for validation of the interpretation in the analyst's mind. Exploring a patient's responses to his interpretive interventions in the light of these criteria permitted the author to validate one interpretation at a 'right level in the right moment', to discard other interventions as too superficial, and to characterise one interpretation as probably premature.

Adult↗
PubMed1994

Love in the analytic setting.

In the context of viewing the analytic setting as a "clinical laboratory" to study the nature of love relations, this paper starts by outlining the relationships of transference love, "normal" love, neurotic love, and oedipal love. After a description of the vicissitudes of transference love when patient and analyst are of the same sex and of opposite sex, developments of transference love regarding homosexual and heterosexual longings in neurotic and narcissistic pathology are considered. Countertransference reactions in response to transference love are explored next, with emphasis on conditions under which erotic countertransference may become particularly intense. In describing the technical management of erotic countertransference, the analyst's ability to explore his own feelings and fantasies without constraint is stressed. The usefulness of understanding the erotic countertransference in arriving at transference interpretations is illustrated by a clinical case of a female patient with a neurotic personality structure and predominantly masochistic conflicts.

Adult↗
PubMed1994

Aggression, trauma, and hatred in the treatment of borderline patients.

This article focuses on the etiology of aggressive affect, behavior, and fantasy in the treatment of patients with severe personality disorders in an effort to further our understanding of the psychopathology and treatment of these patients. In the process, the relationship between inborn disposition to aggressive behavior and the effect of severe trauma and psychosocial pathology in early childhood are examined. Various types of transferences marked by aggression and specific approaches to each of these are outlined. Particular reference is given to the management of intense hatred--as a derivative of aggression--in the transference, and of the unconscious identification with both victim and victimizer in patients who have experienced sexual or physical abuse.

Adult↗
PubMed1994

[The current status of psychoanalysis].

In this highly condensed overview, the author sketches the present state of psychoanalysis in the United States and examines its scientific status, forms of organisation and training structures. In part one, Kernberg reflects on the debate conducted in 1989 in Psychoanalytic Quarterly on the future of psychoanalysis. In part two, he presents his own view, looking at psychoanalysis as a branch of learning, its theoretical variety, psychoanalytic treatment, training for analysts, psychoanalysis as a profession and the international situation. Although Kernberg concentrates on the American scenario, in many respects his remarks also present, mutatis mutandis, an accurate picture of the psychoanalytic landscape in Europe.

Cross-Cultural Comparison↗
PubMed1994

The erotic in film and in mass psychology.

The medium of film offers a vivid demonstration of the ongoing tension between conventional morality and mature, passionate love. While film activates mass psychology and therefore conventionality, the erotic in film threatens conventional boundaries. The dialectic thus involved in erotic art in film, the conventional film, and pornography sheds light on the unconscious motivations for accepting or rejecting the erotic. The author highlights relevant psychoanalytic theories to help formulate the nature of the erotic in film as well as the structures of the erotic film, the conventional film, and pornography. After discussing several examples, he concludes that both the conventional film and pornography are unconscious allies in opposing mature, passionate love.

Erotica↗