A psychoanalytic classification of character pathology.
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Biomedical subjects
Publications and source records attributed to O F Kernberg.
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The author in this paper discusses conceptual, clinical and educational issues of the contemporary controversies regarding the relationship between psychoanalysis, psychoanalytic psychotherapy and psychodynamically oriented supportive psychotherapy. He argues in favor of a strict definition of techniques as the best way leading to a clear-cut differentiation of the three modalities of treatment. Within this frame he discusses interpretation, transference analysis and technical neutrality as the most important aspects and their respective use in the various psychodynamic therapies. Finally he emphasizes that teaching in psychoanalytic and supportive psychotherapies should be part of the psychoanalytic training program of psychoanalytic institutes.
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The author gives in this paper an overview of current psychodynamic psychotherapy of patients with Borderline personality organization. Parallel to his own concept different treatment strategies by Adler, Volkan and Searles within the psychoanalytic framework are discussed. Finally recent developments of his own group are described. Emphasis lies on structuring the psychodynamic psychotherapeutic process of Borderline patients according to the developmental level the patient presents in each session and to treat symptoms belonging to so-called earlier levels (e.g primitive aggression, psychotic or paranoid transferences) before working through of more advanced conflicts.
The phenomenon of love and the various forms it takes can be illustrated by looking at the specific forms manifesting themselves in the transference situation. The author sets out these various forms of "transference love", classifying them not only in terms of different diagnostic types of patient but also in terms of sex-specific features. He describes how, over time, transference love seeks a love object outside the psychoanalytic setting for the fulfillment of the desires awakened in the course of the therapeutic relationship. In addition, Kernberg illuminates the way in which the analyst and his/her counter-transference is involved in this process. The dynamics of the interplay between transference love and the counter-transference process is then discussed with reference to a specific case.
Love means the ability to combine idealization and erotic fulfillment and to establish a profound object relation. The author examines the clinical features of erotic desire, its ecstatic and aggressive aspects and the way they are bound up with transcending the limits of the self, its genetic roots and the unconscious object relations underlying the sexual couple. In Kernberg's view, embarking on the adventure of a love relationship involves both identifying with and overcoming the oedipal parent-couple at one and the same time. He sees breaches in love relationship as stemming from the discontinuity of the relation between mother and child. A mature super-ego, developing from a transformation of primitive constraints and guilt feelings as a result of aggression, is conducive to love and emotional commitment to the love object, while a sound ego-ideal is a fundamental requirement for the ability to fall in love. The article concludes with a discussion of the relationship between couples and groups.