Working with severe personality disorders is perhaps the most challenging task clinicians face. And while the psychoanalytic literature offers profound insights on this topic, it also can be quite daunting to many therapists.
In this interview, Kernberg first lays out the core principle of Object Relations theory, and his concept of the “borderline personality organization,” characterized by identity diffusion, that underlies severe personality disorders. He walks viewers through the Structured Interview for Personality Organization, giving therapists the opportunity to learn a highly effective and pragmatic way to begin treatment by assessing whether patients suffer from an underlying personality disorder. Kernberg goes on to describe his detailed, manualized, psychoanalytic treatment protocol, explaining the four core treatment techniques: interpretation, transference analysis, technical neutrality, and counter-transference analysis.
Weaving in examples of his own challenging cases, such as an enraged patient who brought in scissors to session and cut up all of his plants, Kernberg serves as a guide for therapists who want support in understanding and managing the dynamics of the oftentimes difficult therapeutic relationship with severely disturbed patients. He discusses how to set limits with chronically suicidal patients, how to work with aggression and violence, how to deal with countertransference reactions, and the essentiality of collegial support.
