PubMed Health⌕ Search

Biomedical subjects

O F Kernberg

Publications and source records attributed to O F Kernberg.

At least 55 records · Page 3Linked to original sources
PubMed1986

Identification and its vicissitudes as observed in psychosis.

I have described the mechanisms that operate in psychotic identification. One mechanism is psychotic introjection, characterized by a refusion of 'all good' self and object representations. This re-fusion threatens the destruction of the self as a consequence of the defensive blurring of these self and object representations. The second operative mechanism is projective identification, which I have defined in comparison with and in contrast to projection. Projective identification threatens the destruction of the relation with the object. The case I have described in detail illustrates these psychotic identifications, the development of psychotic transferences wherein the patient cannot differentiate herself and her thinking from the therapist and his thinking, and the struggle around a sense of personal identity at a point of resolution of the psychotic transference. This case also illustrates that an integrated self includes two types of self-representations: those centred on self differentiation and those which reflect the observing functions of the parental images internalized into the self.

Adult↗
PubMed1985

Development of a scale for measuring techniques in the psychotherapy of borderline patients.

Studies of psychodynamic psychotherapy require an instrument to measure the application of the prescribed therapeutic techniques during ongoing treatment. The authors describe the development of such an instrument, the Therapist Verbal Intervention Inventory (TVII), designed specifically for use in the study of the treatment of patients with borderline personality disorders. The TVII was designed, in addition, to test the hypothesis that psychodynamic techniques defined at a middle level of inference could be reliably rated by trained clinicians. The authors present data on the inter-rater reliabilities and inter-rater agreements obtainable with the TVII in the hands of highly experienced clinicians and in the hands of an independent group of junior clinicians trained in its use. The TVII appears to be a potentially useful tool for monitoring psychotherapy techniques in ongoing studies of the treatment of patients with severe personality disorders. Psychiatrists at the advanced resident level or immediate postresidency level have been trained to use the TVII to rate videotaped therapy sessions reliably.

Borderline Personality Disorder↗
PubMed1983

Diagnosing borderline conditions in an outpatient setting.

Application of the Gunderson-Kolb Diagnostic Interview for Borderline to a population of psychiatric outpatients suggested two complicating factors in diagnosing borderline conditions in an ambulatory setting: the reduced level of borderline symptoms and the confounding presence of recompensated psychotic patients. Overlap between the Gunderson and Kernberg borderline constructs, which is relatively high in the inpatient setting, is diminished in the outpatient setting. Contrary to expectation, distinguishing borderline patients from patients with other personality disorders was not a source of difficulty.

Adolescent↗
PubMed1982

Self, ego, affects, and drives.

I have explored the concepts of self, ego, affects, and drives, with special emphasis on terminological confusions and Freud's use of Selbst and Ich. I have also proposed a modification of the dual instinct theory in the light of the relation between affect and drives. Finally, I have proposed a developmental model on the basis of all the above considerations, and stressed its relevance for the classification of nonorganic psychopathology.

Affect↗
PubMed1981

Diagnosing borderline personality. A pilot study using multiple diagnostic methods.

The research described in this paper stemmed from the hypothesis that borderline personality organization can be differentiated from neurotic and psychotic levels of personality organization by means of three structural criteria: degree of identity integration, level of defensive operations, and capacity for reality testing. In order to elicit these criteria, the "structural" interview has been developed that focuses on the "here-and-now" patient-interviewer interaction. The patient's responses to the interviewer's attempts to clarify, confront, and interpret various aspects of the patient's interview behavior provide the basis for judgments as to the patient's structural diagnosis. Specifically, the paper reports a study of the differential diagnosis of 48 hospitalized patients in which structural diagnoses of borderline or psychotic personality organization were made according to this diagnostic interview approach. These diagnoses were compared with ones obtained from Gunderson's Diagnostic Interview for Borderlines, with psychological test diagnoses, and with clinical diagnoses based on past history and current illness. Results show substantial convergent agreement among all of the diagnostic methods and support the utility of the structural interview. In most discrepant cases, other methods reflected disagreement among themselves despite the diagnoses obtained from the structural interview, suggesting that there are some cases difficult to classify by any means. Further analysis suggests that the structural interview may be eliciting a different dimension of personality functioning in arriving at borderline diagnoses than do the other methods studied. The results also indicate that borderline structural diagnoses refer to patients described clinically as having severe character pathology, and do not overlap with patients described as having schizophrenic disorders. The structural interview appears to warrant further study, and, at the same time, shows promise as a research tool in further studies of structural diagnosis and its relevance for prognosis and treatment.

Adolescent↗
PubMed1980

Symposium on object relations theory and love. Love, the couple, and the group: a psychoanalytic frame.

After a brief summary of previous work on the intrapsychic preconditions of love relations, this paper explores the built-in contradictions between the sexual couple and its social group, their mutual equilibrium, and the formation and dissolution of couples within the group. Clinical case material illustrates how three dimensions of love relations-namely, sexual experience, object relations, and superego integration-jointly determine a couple's stability within the social group. Finally, sexual psychopathology affecting the couple's interaction with its social group is explored in terms of some frequent pathological developments.

Female↗
PubMed1980

Adolescent sexuality in the light of group processes.

Shakespeare's Romeo and Juliet is used to illustrate several connected theses regarding the relation of the couple to its surrounding social group: these include a couple's oedipal rebellion, the unconscious longing for and hatred of the idealized couple by the large group, the denial of aggression within the couple and its projection onto the group, the impotence of rationality and the conventionalization of sexuality in the large group, and the pervading dynamics of aggression in group formation. Pertinent psychoanalytic theories are briefly summarized, and this combined analysis is applied to the psychoanalyst's attitude regarding adolescent patients' love life.

Adolescent↗
PubMed1979

Regression in organizational leadership.

The choice of good leaders is a major task for all organizations. Inforamtion regarding the prospective administrator's personality should complement questions regarding his previous experience, his general conceptual skills, his technical knowledge, and the specific skills in the area for which he is being selected. The growing psychoanalytic knowledge about the crucial importance of internal, in contrast to external, object relations, and about the mutual relationships of regression in individuals and in groups, constitutes an important practical tool for the selection of leaders.

Administrative Personnel↗
PubMed1979

Two reviews of the literature on borderlines: an assessment.

The author discusses Liebowitz's (1979) and Rieder's (1979) reviews of current issues regarding the diagnosis of borderline patients. He cites the need for further research examining the basic characteristics of the borderline syndrome. He also recommends that greater attention be directed toward defining subtypes of the syndrome. The author believes that a combination of the descriptive approach of Gunderson and Kolb (1978) and his own psychostructural approach (Kernberg 1977) would prove fruitful.

Adjustment Disorders↗
PubMed1979

Psychological tests and borderline patients.

Psychological tests of 32 borderline or nonborderline (psychotic) patients were compared with the structural diagnoses arrived at on the basis of two kinds of clinical-research interviews: The DIB (following Gunderson's criteria) and the structural interview (following Kernberg's criteria). Test results were reported in terms of the diagnosis based on the full test battery, as well as in terms of the structural diagnosis implied by the presence or absence of thinking disturbances on the (structured) WAIS as compared with the (unstructured) Rorschach test. Statistically significant agreement was shown among these four approaches.

Adolescent↗
PubMed1979

Some implications of object relations theory for psychoanalytic technique.

Whereas, traditionally, object relations theory--a refinement of structural theory that links structure more closely with genetic and dynamic aspects of mental functioning--has been applied mostly to the understanding and treatment of patients with severe regression in the transference, it also has application for technique in the standard psychoanalytic situation. This paper has focused on the object relations approach to the nature of conflicts to be interpreted in the transference; the varying relationships between transference, genetic history, and early development, revealed by an object relations focus; the technique used under conditions of regression in the communicative process in the transference; and the relation of empathy and regression in the transference. Two clinical cases are presented to illustrate the points made.

Adaptation, Psychological↗