Mechanisms of Change in Transference-Focused Psychotherapy
TFP uses mostly techniques of psychoanalysis, particularly interpretation. These focus specifically on the here-and-now of the therapeutic relationship. However, an interpretation can only be effective, if it is prepared by a process that implies implicit procedural experience and explicit, verbal interactions between patient and therapist, that create a joint narrative of what is going on in the relationship between the two.
Non-verbal communication is of highest relevance within this process of interpretation, which involves facial expression of emotion and other embodied channels of communication. The therapists ability to allow for and identify his or her own emotional and bodily reactions to the patient is crucial for an interpretation out of empathic understanding and affective permeation with the right timing and depth.
Empirical results, theoretical concepts, and a clinical illustration will be presented.
Introduction to Transference-Focused Psychotherapy
TFP was developed by Otto F. Kernberg and is based on psychoanalytic object relations theory. A distinguishing feature of TFP in contrast to many other treatments for BPD is the belief in a psychological structure that underlies the specific symptoms a borderline individual suffers from. In other words, the focus of treatment is on a deep psychological make-up — a mind structured around a fundamental split that determines the patient's way of experiencing self and others and the environment. In such a psychological organization, thoughts and feelings about self and others are split into dichotomous experiences of good or bad, black or white, all or nothing.
TFP is a twice-per-week outpatient individual psychotherapy that combines psychodynamic principles with a structured setting and a treatment contract. The treatment focuses on the transference [the patient's moment-to-moment experience of the therapist] because it is believed that the patient lives out his/her predominant object relations dyads in the transference. Once the treatment frame is in place, the core task in TFP is to identify these internal object relations dyads that act as the "lenses" which determine the patient's experience of the self and the world. It is believed that the information that unfolds within the patient's relation with the therapist provides the most direct access to understanding the make-up of the patient's internal world for two reasons. First, it has immediacy and is observable by both therapist and patient simultaneously so that differing perceptions of the shared reality can be discussed in the moment. Second, it includes the affect (feelings) that accompanies the perceptions, in contrast to discussion of historical material that can have an intellectualized quality.
Clinic for Psychoanalysis and Psychotherapy, Medical University Vienna
The aims of this workshop
This workshop gives an introduction to Transference-Focused Psychotherapy (TFP), which is a psychodynamic treatment for Borderline Personality Disorder. TFP has been manualized and has demonstrated its efficacy in the treatment of borderline patients in randomized-controlled trials. Thus, it can be regarded empirically validated.