In this paper, Dr. Masterson gives an understanding of the intrapsychic structure of Narcissistic Personality Disorder and how it finds clinical expression through the disorders of the self triad. Clinical cases are presented to illustrate how the therapeutic intervention of mirroring interpretation of narcissistic vulnerability helps the patient to convert transference acting-out to therapeutic alliance and transference, thereby creating the condition for psychoanalytic psychotherapy.
Topical Panel 17 from the Evolution of Psychotherapy 2000 - Schizophrenia / Severely Disturbed Patients
Featuring Ray Corsini, PhD, Jay Haley, MA, Otto Kernberg, MD, and Michael White, BASW.
Moderated by Ruth McClendon, MSW.
EP00 Dialogue 04 - Personality Disorders - Otto Kernberg, M.D., and James Masterson, M.D.
Given a topic, to become aware of the differing approaches to psychotherapy, and to identify the strengths and weaknesses in each approach.
Moderated by Michael Yapko, Ph.D.
Cognitive Therapy has been extended in recent years to the treatment of severe mental disorders, such as bipolar disorders, schizophrenia and anorexia nervosa. This workshop will focus on strategies for relieving problems associated with severe disorders. Participants will be expected to present clinical problems and role-play patients illustrative of the specific problems that they encounter.
This workshop comprises three elements: A one-hour videotape demonstrating the use of mirroring interpretation of narcissistic vulnerability to establish a therapeutic alliance, discussion of the tape, and supervision of cases presented by the audience.
The focus of this workshop is on problems in therapy: overdependency, ''negative transference,'' acting out, therapeutic impasse and resistance. The same dysfunctional beliefs that maintain psychological disorders interfere with therapeutic change. Specific strategies pinpoint these beliefs as well as the cognitive distortions. This workshop will describe treatment variations for the difficult disorders such as borderline personality, chronic depression and severe agoraphobia.
This workshop summarizes the strategy and tactics of psychodynamic psychotherapy with these patients. The role of interpretation, transference analysis, technical neutrality and countertransferenece will be emphasized. Specific technical approaches will be summarized, particularly contract setting, management of suicidal threats, paranoid regression and dishonesty in patients' communication. Finally, supportive psychotherapy with those patients who cannot be treated with an exploratory approach will be outlined.
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.
Dialogue 08 from the Evolution of Psychotherapy 1990 - Personality Disorders and Therapeutic Neutrality, featuring James Masterson, MD,and Donald Meichenbaum, PhD.
Moderated by Joseph Barber, PhD.