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18 - Psychoanalytic/Psychodynamic Approaches to Personality Disorders

from Part V - Treatment

Published online by Cambridge University Press:  24 February 2020

By
Peter Fonagy ,
Anthony Bateman ,
Patrick Luyten ,
Elizabeth Allison  and
Chloe Campbell
Edited by
Carl W. Lejuez  and
Kim L. Gratz
Carl W. Lejuez
Affiliation:
University of Kansas
Kim L. Gratz
Affiliation:
University of Toledo, Ohio
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Summary

This chapter gives an account of the different psychoanalytic traditions and their approaches to PD: the Kleinian/Bionian model, the British object relations perspective, Kohut’s self psychology, the structural object relations model, the interpersonal-relational approach, and mentalizing theory. The chapter goes on to describe two contemporary psychodynamic treatments, along with their evidence base: transference-focused therapy and mentalization-based treatment. Recent developments in the authors’ thinking in relation to PD are then described, partly in the context of recent work in the area of a general psychopathology or “p” factor. In particular, the authors discuss personality disorder in relation to epistemic trust, and suggest that psychopathology might be understood as a form of disordered social cognition, perpetuated by the obstacles to communication that these social cognitive difficulties create. It is postulated that effective therapeutic interventions for PD possess the shared characteristic of stimulating epistemic trust and creating a virtuous circle of improved social communication.

Keywords

personality disorderborderline personality disordergeneral psychopathology factorpsychoanalysisobject relationsKleinBionFairbairnKohutKernbergSullivanmentalizationmentalization-based treatmentepistemic trust
Type
Chapter
Information
The Cambridge Handbook of Personality Disorders , pp. 427 - 439
Publisher: Cambridge University Press
Print publication year: 2020

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