Borderline Personality Disorder: Its Phenomena and TreatmentInstructor: Eva Papiasvili, PhD, ABPP
1st Trimester of Year 3 of the Full Training in Psychotherapy and Psychoanalysis
(This course can be taken also as a separate certificate course, with or without the Group Supervision class)
October 11 - December 20, 2012; Thursdays, 8:15-9:30pm.
Course Calendar: (October 4- no class, due to the instructor's conference participation) October 11; 18; 25; November 1; 8; 15; (no class 11/22 - Thanksgiving); 29; December 6; 13, 20, 2012.
Location: 136 East, 55th Street, Apt. 6A, NYC, NY 10022 (SE corner of 55th Street and Lexington Ave, on a IRT line) or Virtual participation – via audio/video or audio only (New!).
Readings of Freud, Klein, Fairbairn, Winnicott, Kernberg, Segal, Masterson, Jacobson, Bowlby, and others - about Borderline character disorder patients and their developmental disruptions and pathology will be discussed.
Role-playing will also be employed, to help students to appreciate self-sabotaging behaviors of patients with BPD and to introduce boundaries and limits.
Issues of self-integration and separation-individuation will be discussed, along with the character defenses related to developmental arrest, such as primitive splitting, primitive idealization and primitive devaluation (spoiling), paranoid rage, and concepts of “border-land insanity”; “middle ground”; “between neurosis and psychosis”, “latent psychosis”, projection, introjection, projective identification, and others.
Post-graduate psychoanalytic education credits offered: 12.5hrs.
Course Syllabus:
1. Overview of the development of the definitions and diagnostic (descriptive and dynamic) conceptualizations of BPD from 1880’s to the present time DSM IV (DSM V in making):
Concepts of “Border-land Insanity”; “Middle Ground”; “Between Neurosis and Psychosis”, “Latent Psychosis”, etc. (Diagnostic concepts of: Kahlbaum, Bleuler, Kraepelin, S. Freud, Deutsch, Meyer, M. Klein, A. Stern, Schmideberg, Glover, Hoch Knight, Jacobson, L. Stone, Rado, Kernberg, Balint, M. Stone, M. Mahler, Searles, Spitzer, Masterson, Dazzi, etc.)
2. Early Object Relations Dynamic Themes pertaining to BPD in the work of Sigmund Freud (e.g. some Hysterical characters, Infantile Neurosis - Wolf Man, Narcissistic Object choices, Identification – Mourning and Melancholia, etc.) in both his Pre-Structural and Structural Theories; elaborations by Susan Kavaler Adler
3. Contribution of Melanie Klein – Theory of Developmental Positions (Schizoid-Paranoid, Depressive), Pertinent Defenses (Splitting, Projection, Introjection, Projective Identification), Role of Aggression, etc. ; H. Segal’s interpretation of M/ Klein’s concepts
4. Contributions of W.D. Fairbairn (Splitting, Internalization of bad objects, effort to connect Klein’s mechanisms with the structural model), E. Glover (multinuclear primitive ego structure) and H. Guntrip (elaboration of Fairbarn: personality structure in the context of interaction);
5. Contribution of D. Winnicott (False Self, Transitional Phenomena; “Hate in Countertransference” , Capacity to be Alone, etc.) and Thomas Ogden (e.g. Phenomena of “Interruption” and “Breaking”of psychic/mental processes; the Analytic Third); comparison to W. Bion’s concept of containment and H. Segal’s elaboration; contemporary elaboration by J. Seinfeld
6. Contributions of Edith Jacobson (self and object representations of early introjections; Affect theory); M. Balint (Basic Fault), Bowlby (Making and breaking of affectionate bonds) and attachment theories and approaches; and M. Mahler’s Separation-Individuation developmental approach (faulty rapprochement subphase in establishment of boundaries, etc.);
7. Contributions of Otto Kernberg – Structural Derivative of Object Relations, Normal and Pathological Development; Instincts, Affects and Object Relations
Psychoanalytic Classification of Character Pathology, Object Relations Centered Assessment Model and Treatment Implications; Transference and Countertransference, compared with Searles’ concept of Countertransference
8. Contribution of James Masterson: Integrated Developmental Approach in the Assessment and Treatment
9. Contribution of Susan Kavaler Adler: Blocked (and unblocking) Capacity for Mourning and Creative Mastery, etc.;
Additional Selected Pertinent Approaches to Early Trauma, Faulty Symbolization (S.Ferenczi, J.Mc Dougal, etc.) and Problematic Attachment in the contemporary Developmental Dynamic Neuroscience and Neuropsychoanalysis, concepts of Resilience (or lack of), etc, summarized by.E.D. Papiasvili
10. Integration and Synthesis
Basic Literature:
DSM IV (1994, or any subsequent edition); American Psychiatric Press, Washington, DC
Freud, S. (1895 – 1938). Case of Anna O.; Case of Infantile Neurosis; Mourning and Melancholia; etc. Standard Edition, Selected Volumes, Hogarth Press, London
Kernberg, O. (1977). Object Relation Theory and Clinical Psychoanalysis, Jason Aronson, Ney York (Excerpts)
Klein, M. (1948). Contributions to Psychoanalysis (1921-1945), Hogarth Press, London (Excerpts)
Masterson, J. (1981) The Narcissistic and Borderline Personality Disorders, Brunner Mazel, New York (Excerpts)
Stone, M. (Editor), (1986), Essential Papers on Borderline Disorders: One Hundred Years at the Border, New York University Press, NY and London (Excerpts)
Winnicott, D. (1965) The Maturational Processes and the Facilitating Environment, International Universities Press, New York (Excerpts)
(Chapters of the Excerpts may be provided by the instructor)
Journal articles& Conference presentations:
Dazzi, S. (1998) Some Thoughts Concerning Bordeline Pathology and Fear of Aloneness, J. Amer. Acad. Psychoanal., 26: 69-84
Kavaler-Adler, S. (1993) Object Relations Issues in the Treatment of the Preoedipal Character, Am. J. Psychoanal., 53: 19-34
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Projective Identification:
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Time as an Object - Object Relations view (part 3
of mini-video series)
Self Sabotage - Object Relations view
(part 4 of mini-video series)
Mourning, Developmental
vs. Pathological (part 6)
Bad Objects and Loyalty to Bad Objects - Object Relations View (part 7)
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