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Psychodynamic Psychotherapy for Personality Disorders

Psychodynamic Psychotherapy for Personality Disorders
A Clinical Handbook

Edited by John F. Clarkin, Ph.D., Peter Fonagy, Ph.D., F.B.A., and Glen O. Gabbard, M.D.
2010
507 pages
ISBN 978-1-58562-355-6
Paperback
Item #62355



This handbook is intended for clinicians with a range of expertise who employ a psychodynamic orientation in the assessment and/or treatment of patients with personality pathology. Well documented and articulate, this manual is appropriate for everyone from students of psychotherapy to experienced clinicians seeking to refine their practice. Psychodynamic Psychotherapy for Personality Disorders: A Clinical Handbook gathers in one place the psychodynamic psychotherapy thinking on each of the Axis II personality disorders. This includes the work of 22 contributing writers in addition to the three primary authors, John F. Clarkin, Ph.D., Peter Fonagy, Ph.D., and Glen O. Gabbard, M.D. The material presented here is available elsewhere but, until now, not all in one place.

The focus of the book is the psychodynamic conceptualization, assessment, and treatment of the personality disorders as currently described in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Included are 16 chapters in three sections: Defining Personality Pathology, Treatment Approaches, and Research for Future Directions. The background of models of personality and its pathology comprises Section I. Section II contains chapters on the treatment of specific personality disorder constellations. These treatment chapters provide information on the relevant empirical research, patient phenomenology and psychodynamics, treatment strategies, and techniques, woven together with clinical illustrations and vignettes. Section III includes a summary of the existing treatment outcome research and a glimpse of the diagnostic procedures in the near future. Each of the chapter authors has had extensive clinical, and sometimes research, experience with the assessment and treatment of one of the personality disorders described.

Psychodynamic Psychotherapy for Personality Disorders: A Clinical Handbook is, as titled, a practical handbook and guide to clinicians with real-world applications.


  • Every patient a clinician treats has personality issues, if not a personality disorder. This book provides strategies and techniques for addressing personality issues
  • DSM-IV-TR is proceeding to DSM-V. This collection of papers provides up-to-date information on how the personality disorders will be handled in the upcoming DSM-V
  • The authors provide summaries of key concepts and suggested readings of particular value to residents and students in other disciplines

The authors suggest that new research and reviews indicate, to the surprise of many, that psychodynamic treatments are effective for these personality disorders, and its impact is as great as, that of cognitive-behavioral treatments.

Preface. Part I: Personality Pathology: Defining the Focus of Intervention. An object relations model of personality and personality pathology. Attachment and personality pathology. Neurobiology of personality disorders. The Shedler-Westen assessment procedure: making personality diagnosis clinically meaningful. Part II: Psychodynamic Treatment Approaches. Psychotherapeutic treatment of cluster A personality disorders. Mentalization-based treatment and borderline personality disorder. Transference-focused psychotherapy and borderline personality disorder. Therapeutic action in the psychoanalytic psychotherapy of borderline personality disorder. Narcissistic personality disorder. Treatment of histrionic personality disorder. Psychodynamic treatment of antisocial personality disorder. Cluster C personality disorders: prevalence, phenomenology, treatment effects, and principles of treatment. Psychodynamic approaches integrated into day treatment and inpatient settings. Treatability of personality disorders: possibilities and limitations. Part III: Research and Future Directions. Evidence for psychodynamic psychotherapy in personality disorders: a review. Psychodynamic treatment planning and the official diagnostic system: toward DSM-5. Index.

"Personality Disorders are among the most prevalent mental disorders, both in the community and in clinical practice. Psychodynamic psychotherapy is an essential element of their treatment, and is frequently the treatment of choice. Clarkin, Fonagy and Gabbard have assembled the world's leading experts (a group that includes themselves) in this comprehensive survey of psychodynamic theory, personality pathology, specific therapies for personality disorders, and evidence concerning their efficacy. Anyone who works with these patients will want this review of research, the current state of treatments, and prospects for the future. An essential reference for any mental health professional who deals with personality disorders."—Robert Michels, M.D., Walsh McDermott Univ Professor of Medicine & Psychiatry, Cornell Univ, Training & Supervising Analyst, Columbia Univ Center for Psychoanalytic Training and Research

Elizabeth Allison, D.Phil.
Anthony Bateman, M.A., F.R.C.Psych.
Anna Buchheim, Ph.D.
Eve Caligor, M.D.
John F. Clarkin, Ph.D.
Diana Diamond, Ph.D.
Peter Fonagy, Ph.D., F.B.A.
Glen O. Gabbard, M.D.
Gy�rgy Gergely, Ph.D.
Mardi J. Horowitz, M.D.
Otto F. Kernberg, M.D.
Falk Leichsenring, D.Sc.
Uma Lerner, M.D.
Patrick Luyten, Ph.D.
Leigh McCullough, Ph.D.
J. Reid Meloy, Ph.D., A.B.P.P.
John M. Oldham, M.D., M.S.
William E. Piper, Ph.D.
Gerhard Roth, Ph.D. (philosophy), Ph.D. (zoology)
Jonathan Shedler, Ph.D.
Paul I. Steinberg, M.D., F.R.C.P.C.
Michael H. Stone, M.D.
Lane Strathearn, M.B.B.S., F.R.A.C.P., Ph.D.
Martin Svartberg, M.D., Ph.D.
Mary Target, Ph.D.
Drew Westen, Ph.D.
Paul Williams, Ph.D.
Jessica Yakeley, M.B. B.Chir., M.R.C.Psych.
Frank E. Yeomans, M.D., Ph.D.

John F. Clarkin, Ph.D., is Clinical Professor of Psychology in Psychiatry, Weill Cornell Medical College, New York, New York, and New York Presbyterian Hospital-Cornell Medical Center in White Plains, New York.

Peter Fonagy, Ph.D., F.B.A., is Freud Memorial Professor of Psychoanalysis and Director of the Sub-Department of Clinical Health Psychology, University College London, as well as Chief Executive of the Anna Freud Centre in London, England.

Glen O. Gabbard, M.D., is Brown Foundation Chair of Psychoanalysis and Professor of Psychiatry, Baylor College of Medicine in Houston, Texas.