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By Otto Kernberg

During this booklet a number one psychoanalytic clinician and theoretician offers his recommendations at the most modern psychodynamic advancements and insights regarding remedy of critical character issues. Dividing his discussions into sections, one on psychopathology and the opposite on psychotherapy, Dr. Otto Kernberg examines borderline character illness, narcissism, sexual inhibition, transference and countertransference, suicidal behaviour, and consuming issues. In each one bankruptcy he integrates the tips of eu and Latin American psychoanalytic thinkers, bringing them to the eye of English-speaking readers. This e-book contains a choice of lately released magazine articles. Their assortment into one quantity makes on hand Dr. Kernberg's current considering on a huge topic.

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Extra resources for Aggressivity, Narcissism, and Self-Destructiveness in the Psychoterapeutic Relationship: New Developments in the Psychopathology and Psychotherapy of Severe Personality Disorders

Sample text

Kernberg , , ). What makes the analysis of internalized object relations in the transference Theory of Personality Disorders of patients with severe personality disorders more complex (but also permits the clarification of such complexity) is the defensive primitive splitting of internalized object relations (O. Kernberg , a). In these patients, the tolerance of ambivalence characteristic of higher-level neurotic object relations is replaced by a defensive disintegration of the representations of self and objects into libidinally and aggressively invested part-object relations.

27 28 Psychopathology chemical and neurohormonal systems may be related to significant aspects of personality pathology, particularly proneness to aggressive and reckless behavior, pointing to the importance of genetic and constitutional determinants of temperament (Stone b)—the inborn disposition to a certain level of intensity, rhythm, and threshold for affective response. Temperament also includes genetically and constitutionally determined behavioral and cognitive patterns, such as some gender-role-specific traits.

Most patients with severe histrionic or borderline personality disorder and severe self-destructive, self-mutilating, suicidal, or antisocial trends evince strong elements of envy in the context of the intense activation of hatred. On the other hand, what might be called the purest manifestation of hatred—with the relative absence of envy per se—may be seen in patients who have been physically traumatized and in some victims of sexual abuse or incest. What is striking in this context is that the greater the envy, the more the envied person is perceived as one who possesses highly desirable or “good” qualities.

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