[Transference focused psychotherapy]

Abstract

Transference focused psychotherapy is a version of psychodynamic psychotherapy that is modified and specialized for patients with borderline personality disorder. It is based on psychoanalytic principles with an emphasis on object relations theory. A fundamental concept in this model is that the organization of an individual's psyche is structured around internalized versions of interpersonal relations. The relationship experiences that are internalized involve a specific representation of the self, a specific representation of the other (the object of the libidinal or aggressive drive) and an intense affect that links them. However, this movement toward integration of the internal representational world does not take place in individuals with borderline personality, who continue to experience life in a way that is based on rigid and extreme views of self and others. The goal of transference focused psychotherapy is to help individuals advance to an integrated internal world through the analysis of the patient's ongoing experience of his or her relationship with the therapist. It is assumed that the analysis of this relationship will bring to light the internal representations of self and other, and the corresponding affects, that are related to unconscious desires and motivations, and that underlie the individual's extreme and discontinuous experience in life. The therapy begins with a specific diagnostic interview and the establishment of a treatment contract with the patient before the psychotherapeutic work begins. The first goal of the therapy is to engage the patient in the process of observing and gaining awareness of the representations of self and other that guide his or her perceptions of the world. The therapy then helps the patient to understand the internal forces that have kept theses representations segregated from each other and to integrate them into a more mature and coherent sense of self and others.