Severe Personality Disorders 1st Edition by Bert van Luyn, Salman Akhtar, W John Livesley ISBN 0521856515 9780521856515

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ISBN 10: 0521856515
ISBN 13: 9780521856515
Author: Bert van Luyn, Salman Akhtar, W John Livesley

Severe Personality Disorders 1st Table of contents:

1 Treatability in severe personality disorders: how far do the science and art of psychotherapy carry
Factors that influence amenability to psychotherapy
Estimates of treatability
Follow-up studies in the domain of the severe personality disorders
Borderline personality disorder (BPD)
Schizotypal personality
Antisocial and psychopathic personalities
Concluding remarks on the efficacy of treatment
REFERENCES

2 The treatment of choice: what method fits whom?
Treatment choices facing the clinician
Patient heterogeneity
Diagnostic variability
Patient characteristics other than diagnosis
Which treatment model?
Match between therapist and patient in transference-focused psychotherapy (TFP)
Research on patient–therapist match
Patient A
Patient B
Summary and comparison
REFERENCES

3 Countertransference: recent developments and technical implications for the treatment of patients
The contemporary concept of countertransference
Classification of countertransference with particular implications for the treatment of severe personality disorders
Analysis and management of countertransference
Particular countertransference complications
Contemporary controversies regarding countertransference
REFERENCES

4 Beyond management to cure: enhancing the positive dimensions of personality
Introduction
The practical necessity to reduce disability
What does reduce disability and enhance well-being?
The wishes of the suffering for spiritual meaning
Stages in the path to well-being
Voyages to well-being
Obstacles to well-being in patients with severe personality disorders
REFERENCES

5 Personality disorders from the perspective of child and adolescent psychiatry
Developmental aspects of personality disorders
Heredity
Prenatal issues
Attachment
Temperament
Maltreatment
Diagnosis of personality disorders in children and adolescents
Childhood psychopathology and its relation with personality disorders
Prevention and treatment
Prevention
Treatment
Summary
REFERENCES

6 Disruptions in the course of psychotherapy and psychoanalysis
Definition
Dynamics
Unconscious guilt
Anxious retreat from ‘higher’ level conflicts
Sadomasochistic need to destroy a helpful situation
Retreat due to separation anxiety
Shift in psychic organization
Empathic failures of the therapist
Manifestations
Case 1
Case 2
Case 3
Case 4
Treatment
Holding and containing
Assuring safety and setting limits
Naming and taming
Oscillating in accordance with the patient’s level of transferences
Acknowledging one’s own role in precipitating a disruption
A developmental postscript
Case 5
Conclusion
REFERENCES

7 Managing suicidal crises in patients with severe personality disorders
Suicidal crises and suicide prevention
The setting of treatment for managing crises
Suicidal crises and chronic suicidality
An approach to the management of crises in severe personality disorders
REFERENCES

8 Borderline personality disorder, day hospitals, and mentalization
Epidemiology
Severity
Severity and context of treatment
Some common features of day hospital treatments
Milieu
Affect focus
Individual and group psychotherapy
Research and day hospital treatment
Mentalization
Mentalizing as the key to successful treatment
Mentalization: the common theme in psychotherapeutic approaches to borderline personality disorder and other severe personality disorders
Conclusions
REFERENCES

9 Pharmacotherapy of severe personality disorders: a critical review
Conceptual issues
Treating the disorder itself
Treating symptoms or symptom clusters
Treating associated Axis I disorders
Treating trait vulnerabilities
The pharmacological treatment algorithms of Soloff and APA borderline guidelines
Methodological problems
Studies on the efficacy of drugs in personality-disordered patients
Antipsychotics
Classical antipsychotics
Atypical antipsychotics
Antidepressants
Classical antidepressants
MAO inhibitors
Modern antidepressants
Selective serotonin reuptake inhibitors (SSRIs)
Mood stabilizers
Lithium
Carbamazepine
Divalproex
Topiramate
Lamotrigine
Conclusion
Benzodiazepines
Remaining groups
Opiate antagonists
Omega-3 fatty acid
Discussion
Towards a revised approach of pharmacotherapeutic interventions in patients with personality disorders
Cognitive perceptual symptoms
Psychotic-like symptoms
Dissociation
Impulsive-behavioral dyscontrol
Affective dysregulation
REFERENCES

10 Severe cases: management of the refractory borderline patient
The refractory borderline patient
Characteristics of the refractory borderline patient
Environmental factors
No alliance, no therapy
A rehabilitation perspective
Rehabilitation
Assertive community treatment
Intensive outpatient programs for refractory BPD
Engaging the refractory patient
Split treatment
The ‘neutral psychotherapist’
Integrating hospitalization admissions
Indications to hospitalize
Facilitating hospital discharge
Systems support and systems interventions
Team support
Conclusion
REFERENCES

11 Dangerous cases: when treatment is not an option
The nature of the beast
Case A
Case B
Diagnostic issues
Countertransference phenomenon
Therapeutic nihilism
Illusory treatment alliance
Fear of assault or harm
Denial and deception
Case C
Helplessness and guilt
Devaluation and the loss of professional identity
Case D
Hatred and the wish to destroy
Assumption of psychological complexity
Fascination and sexual attraction
When treatment is undertaken
Case E
Conclusions
REFERENCES
NOTES

12 Stalking of therapists
Introduction
Stalking of therapists
Studies of the stalking of therapists
Pattern of stalking of health professionals
Stalking and the therapeutic encounter
Can you predict which patient will stalk their therapist?
Avoiding and surviving stalking
Early recognition
Informing
Keeping records
Legal remedies
Looking after yourself
Conclusions
REFERENCES

13 Common elements of effective treatments
Contemporary perspectives on the treatment of personality disorder
Common or generic factors
Generic factors in the treatment of personality disorder
Building and maintaining a collaborative relationship
Maintaining a consistent treatment process
Establishing a validating treatment process
Building motivation
General treatment strategies and the organization of treatment
Generic aspects of specific interventions
Phases of change and intervention strategies
Structured approach to treatment
Therapeutic stance
Treatment contract
Consistency
Conceptual commonalities
Cognitive structure as an integrating concept
Schemata and personality
Clinical implications
Conceptualization of crises and symptoms
Changing maladaptive schemata and interpersonal patterns

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Tags: Bert van Luyn, Salman Akhtar, W John Livesley, Disorders