December 2024
·
38 Reads
·
51 Citations
This page lists works of an author who doesn't have a ResearchGate profile or hasn't added the works to their profile yet. It is automatically generated from public (personal) data to further our legitimate goal of comprehensive and accurate scientific recordkeeping. If you are this author and want this page removed, please let us know.
December 2024
·
38 Reads
·
51 Citations
December 2024
December 2024
·
9 Reads
·
1 Citation
December 2024
·
15 Reads
·
1 Citation
November 2024
·
22 Reads
The International Journal of Psychoanalysis
This paper explores the concept of drives as basic motivational neurobiological structures determining the organization of psychic life. I express my agreement with Mark Solms' radical reformulation of the general principles organizing human behaviour at the neurobiological and psychodynamic levels, his combination of Friston's computational information theory and Panksepp's affect systems. I agree with him that the affect systems described by Panksepp constitute the primary drives and that the conflicts between affect systems are the origin of unconscious intrapsychic conflict. I disagree with Solms in my proposition that, while the original unconscious conflicts indeed reflect conflicts between antagonistic affects, I believe that the integration of affect systems into internalized object relations determines a significant motivational shift: now unconscious conflicts are between complex organization of idealized and persecutory object relations at oedipal and preoedipal levels, and no longer between affect systems themselves. At the various developmental levels, the integrated fusion of affective components of these conflicts in effect evolves into libido and aggression as supraordinate motivational systems, but they no longer can be considered biological drives.
August 2024
·
8 Reads
SETTING
Vengono proposte definizioni di organizzazioni specifiche per gli sviluppi del transfert nelle strutture del carattere nevrotico, borderline, narcisistico, schizoide, simbiotico e psicotico. A queste distinte organizzazioni di sviluppo del transfert corrispondono le caratteristiche alla base delle relazioni oggettuali interiorizzate che derivano da implicazioni conflittuali delle rappresentazioni del Sé e dell'oggetto scissi, idealizzati e persecutori. Le strutture di transfert descritte hanno implicazioni per l'applicazione della tecnica psicoanalitica corrispondente. I casi clinici illustrano la relazione tra struttura di personalità, organizzazione del transfert e tecniche psicoanalitiche.
June 2024
·
112 Reads
Psychodynamic Psychiatry
This article explores the problems of the frequent loss, in the course of treatment, of the initial goals and motivation for treatment by both patient and therapist, and the connected lack of clarity of the real initial motivation for treatment on the part of both participants. It is strongly proposed that a true coincidence of at least one important initial motivational goal of patient and therapist is essential to assure the success of psychotherapy and that particular care is required to establish such agreement. On this basis, the goals of therapy may be expanded in the course of the therapist's experience, countertransference, and the patient's changing reality during treatment, and the existential and philosophical value systems of the therapist may play an important role in such widening of the therapist's expectations for the patient.
January 2024
·
3,286 Reads
·
58 Citations
World psychiatry: official journal of the World Psychiatric Association (WPA)
Borderline personality disorder (BPD) was introduced in the DSM‐III in 1980. From the DSM‐III to the DSM‐5, no major changes have occurred in its defining criteria. The disorder is characterized by instability of self‐image, interpersonal relationships and affects. Further symptoms include impulsivity, intense anger, feelings of emptiness, strong abandonment fears, suicidal or self‐mutilation behavior, and transient stress‐related paranoid ideation or severe dissociative symptoms. There is evidence that BPD can be reliably diagnosed and differentiated from other mental disorders by semi‐structured interviews. The disorder is associated with considerable functional impairment, intensive treatment utilization, and high societal costs. The risk of self‐mutilation and suicide is high. In the general adult population, the lifetime prevalence of BPD has been reported to be from 0.7 to 2.7%, while its prevalence is about 12% in outpatient and 22% in inpatient psychiatric services. BPD is significantly associated with other mental disorders, including depressive disorders, substance use disorders, post‐traumatic stress disorder, attention‐deficit/hyperactivity disorder, bipolar disorder, bulimia nervosa, and other personality disorders. There is convincing evidence to suggest that the interaction between genetic factors and adverse childhood experiences plays a central role in the etiology of BPD. In spite of considerable research, the neurobiological underpinnings of the disorder remain to be clarified. Psychotherapy is the treatment of choice for BPD. Various approaches have been empirically supported in randomized controlled trials, including dialectical behavior therapy, mentalization‐based therapy, transference‐focused therapy, and schema therapy. No approach has proved to be superior to others. Compared to treatment as usual, psychotherapy has proved to be more efficacious, with effect sizes between 0.50 and 0.65 with regard to core BPD symptom severity. However, almost half of the patients do not respond sufficiently to psychotherapy, and further research in this area is warranted. It is not clear whether some patients may benefit more from one psychotherapeutic approach than from others. No evidence is available consistently showing that any psychoactive medication is efficacious for the core features of BPD. For discrete and severe comorbid anxiety or depressive symptoms or psychotic‐like features, pharmacotherapy may be useful. Early diagnosis and treatment of BPD can reduce individual suffering and societal costs. However, more high‐quality studies are required, in both adolescents and adults. This review provides a comprehensive update of the BPD diagnosis and clinical characterization, risk factors, neurobiology, cognition, and management. It also discusses the current controversies concerning the disorder, and highlights the areas in which further research is needed.
November 2023
·
28 Reads
PTT – Persönlichkeitsstörungen Theorie und Therapie
November 2023
·
37 Reads
·
2 Citations
Neuropsychoanalysis
... TREATMENT-RESISTANT DEPRESSION AND PERSONALITY DISORDERS affective experience and management, defensive functioning and distress tolerance, and cognitive processing and reality testing (Caligor et al., 2007;Kernberg, 2016). McWilliams (2004), Kernberg (2016), and others underscored the significance of comprehending subjective, dynamic experiences, the role of unconscious processes, and the assessment of defensive functioning in understanding the individual. ...
December 2024
... Comorbid BN and ADHD have been investigated extensively over the past years [6,7], and comorbidity rates are estimated at 31% [8] to 35-37% [9]. BN and ADHD show common aberrations regarding neurobiological and neuropsychological factors including impulsivity [10]. ...
January 2024
World psychiatry: official journal of the World Psychiatric Association (WPA)
... It is a major privilege to have the thoughts of Dr. Otto Kernberg (2023) regarding the separation distress hypothesis of depression and its update review in the target article. I appreciate his many gracious comments. ...
November 2023
Neuropsychoanalysis
... Während aus dieser monadisch-intrapsychischen Sichtweise der Übertragung gefragt wird, was im gegenwärtigen Erleben wiederholt wird, fügt die dyadisch-interpersonelle Sichtweise die Frage hinzu, was gerade im Moment geschieht. Diese Übertragungsdeutung im Hier und Jetzt bezieht sich primär auf das durch aktuelle Stimuli entstehende gegenwärtige Erleben (Herold et al. 2008) und kann auch ohne das Ziehen einer Parallele auskommen. Diese dyadisch-interpersonelle Auffassung der Übertragung beachtet auch den Einfluss des Therapeuten im Übertragungsgeschehen (Herold et al. 2008, Mertens 2004. ...
October 2022
... These impairments are manifested along with psychopathological symptomology as self-destructive behavior, suicidality, dissociation, impulsivity, aggression, mood shifts, and a high number of comorbid disorders (DSM-5;American Psychiatric Association, 2013). Psychotherapy is the firstline treatment for people with BPD (Leichsenring et al., 2023;Storebø et al., 2020). ...
February 2023
JAMA The Journal of the American Medical Association
... Furthermore, Kramer et al. (17) observed that EEG-vigilance regulation presented differently in BPD. However, neurophysiological studies on BPD addressing the childhood adverse events, fundamental causes of BPD onset, and the mentalization challenges have been notably limited (18)(19)(20). ...
January 2023
... However, severe symptoms, debilitating psychosocial impairments, high comorbidity, and treatment resistance, or inability to engage in outpatient psychotherapy require an inpatient admission (Dulz et al., 2023;Kröger et al., 2013). Recently, a manual for TFP in the inpatient sector was developed (Dulz et al., 2022). Based on this manual, we investigated the effectiveness of TFP in the inpatient sector. ...
October 2022
... For instance, mentalization-based treatment (MBT; Bateman & Fonagy, 2010) enhances reflective capacity in aid of stabilizing an individual's sense of self by helping them make sense of themselves and others. Transference-focused psychotherapy (TFP; Caligor et al., 2018) reorganizes unrealistic internalized images of self and other with the aim of building a more coherent sense of self and mutually rewarding interpersonal interactions. Dialectical behavior therapy (DBT; Linehan, 1993) provides individuals with several skills that increase self-awareness and self-regulation, including mindfulness, distress tolerance and emotion regulation. ...
April 2018
... TFP refers to a psychodynamic treatment method pioneered by Otto F. Kernberg during the 1970s and 1980s [53]. Not only does TFP focus on achieving adequate personality organization and regaining the sense of self, but it mainly focuses on the impulsive and destructive symptoms of BPD. ...
December 2021
Psychodynamic Psychiatry
... Predictions also (largely) derive from the social order insofar as they are learned (Holmes & Nolte, 2019). Even predictions associated with bodily homeostasis originate in the relationship with the primary caregiver (Fotopoulou & Tsakiris, 2017), and Pankseppian hyperpriors are object relational insofar as they imply a certain type of object (Kernberg, 2022;Solms, 2021b). For Lacan, the social order-the Other (family, culture, etc.)-is the repository of signifiers (Lacan, 1953-1954, Lacan, 1964. ...
Reference:
Jouissance is Surplus Prediction Error
November 2021
Neuropsychoanalysis