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EP90 Invited Address 12a - Establishing a Therapeutic Alliance with Borderline and Narcissistic Patients - James Masterson, MD

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Topic Areas:
Invited Addresses |  Borderline |  Narcissism |  Personality Disorders |  Attunement |  Therapeutic Relationship |  Psychotherapy
Evolution of Psychotherapy |  Evolution of Psychotherapy 1990
James F. Masterson, MD |  Helen Singer Kaplan, MD, PhD
1 Hour 29 Minutes
Audio Only
Original Program Date:
Dec 16, 1990
Never expires.



The importance of therapeutic alliance is described. Therapeutic alliance, transference, and transference acting-out are defined and distinguished from each other and the therapeutic task of helping the patient to convert transference acting-out to therapeutic alliance and transference is outlined. The differences in the form and content of the intrapsychic structure are described to show why different therapeutic techniques are necessary to establish the therapeutic alliance: Confrontation with the borderline and mirroring interpretation of narcissistic vulnerability with the Narcissistic Personality Disorder. A brief case illustrates each. 

Educational Objectives:

  1. To learn how developmental object relations theory differentiates the Borderline Personality Disorder from Narcissistic Personality Disorder
  2. To learn the clinical differentiation of these two disorders
  3. To learn how the therapeutic technique of confrontation establishes a therapeutic alliance with the Borderline Personality Disorder, and Narcissistic mirroring interpretation establishes a therapeutic alliance with the Narcissistic Personality Disorder 

*Sessions may be edited for content and to preserve confidentiality*



James F. Masterson, MD's Profile

James F. Masterson, MD Related Seminars and Products

James F. Masterson (M.D., Jefferson Medical School, 1951) was Director of the Masterson Group, P.C., which specializes in the treatment of adolescent and adult character disorders. Additionally, he was Director of the Masterson Institute (formerly Character Disorder Foundation); attending psychiatrist at New York Hospital, Payne Whitney Clinic; and Adjunct Clinical Professor of Psychiatry at Cornell University Medical College. Masterson has authored seven books and edited two volumes, mostly on the topic of psychoanalytic approaches to character disoreders and adolescents. His seminal work on the borderline personality has made him one of the most influential and studied practitioners of modern psychoanalytic methods.

Helen Singer Kaplan, MD, PhD's Profile

Helen Singer Kaplan, MD, PhD Related Seminars and Products

Helen Singer Kaplan (February 6, 1929 – August 17, 1995) was an Austrian-American sex therapist and the founder of the first clinic in the United States for sexual disorders established at a medical schoolThe New York Times described Kaplan as someone who was "considered a leader among scientific-oriented sex therapists. She was noted for her efforts to combine some of the insights and techniques of psychoanalysis with behavioral methods."[1] She was also dubbed the "Sex Queen" because of her role as a pioneer in sex therapy during the sexual revolution in 1960s America, and because of her advocacy of the idea that people should enjoy sexual activity as much as possible, as opposed to seeing it as something dirty or harmful. The main purpose of her dissertation is to evaluate the psychosexual dysfunctions because these syndromes are among the most prevalent, worrying and distressing medical complaints of modern times. [2]