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PubMed1992

Diagnosis and treatment of personality disorders.

This article touches on four current areas of controversy in the field of the personality disorders -- definition, etiology, assessment, and treatment. There is a tremendous amount of disability, personal distress, and public health expense as a result of the personality disorders. We are seeing steady progress in each of these areas. The implications of this progress are enormous, and the interest in this area is widespread, not just among psychiatric health professionals or among patients and their families and friends, but also among the public at large.

Combined Modality Therapy↗
PubMed1994

Genetic and environmental variation in Eysenck Personality Questionnaire scales measured on Australian adolescent twins.

The Eysenck Personality Questionnaire was administered to 1400 Australian twin pairs aged 11 to 18, and the data were analyzed by a multivariate normal model using the software FISHER. For each scale, attempts were made to transform to normality, about a mean modeled separately for each sex as a quadratic function of age. Variances and covariances were estimated for each sex-zygosity group as a monotone function of age. Evidence for genetic sources of variation were assessed in part by fitting models which allowed for age-dependent, sex-specific, and correlated additive genetic factors, and age-dependent and sex-specific environmental factors, under the assumption that effects of environmental factors common to twin pairs are independent of zygosity. Evidence for genetic factors independent of age and sex was most compelling for Psychoticism and Neuroticism. For Extraversion, if genetic factors exist they would be mostly sex-specific and age-dependent. For the Lie scale there was evidence for, at most, a small component of genetic variation.

Adolescent↗
PubMed1983

Inventors of new selves.

This paper delineates a pattern of personality organization in which an individual is self-defined as having an identity that has been produced independently of all prior experiences. Usually there is a history of several radical changes of self-concept, in the conscious sense. Two psychodynamic bases of this pattern are discussed: one involving a flight from engulfment in others' perceptions and definitions, and the other involving a flight from a sense of irrevocable inner badness. In both cases, the childhood origins appear to be located in the pathogenic responses of caretakers during the phases of separation and individuation. Patients showing this pattern present special problems for the psychoanalyst. The main hazard one encounters in treating such people is that the patient will respond to the analyst's efforts to illuminate his or her personality structure and psychic origins with a sudden redefinition of the self and a breaking off of therapy. We have presented some treatment recommendations based on our experiences working with such people that involve substantial modifications of classical analytic technique. Central in these recommendations is the emphasis we have placed on the potential value of the analyst's empathically guided personal openness in the conduct of therapy.

Adult↗
PubMed1989

Transformations of identity: referent location, agency, and levels of integration in the progress from potential self to existential identity.

The study traces the genesis of existential despair and empty depression in personality disordered individuals to the impact of a premature definition of the self in terms of an other-centered referent. Three aspects of identity are discussed: self identity, role identity, and existential identity. Their respective potential contribution to self-integration is examined.

Depressive Disorder↗
PubMed1983

The structure of psychosomatic symptoms.

1. According to our findings, a psychosomatic structure is not an alternative to neurosis. The syndrome of alexithymia appears to be, in our cases, a transitional phase, the dynamics of which can be understood and treated by psychotherapy. In the course of psychotherapeutic treatment, alexithymia always disappears. 2. However, a special psychotherapeutic technique is advisable, one different from that applied in classical neurosis. 3. For this reason the term psychosomatic structure can be used as a way of expressing a variation of neurosis. 4. Modern concepts of psychosomatic disease describe pathological personalities that are different from the classic pseudoneurotic type because of their narcissistic and pregenital structures. These structures can be concealed underneath a facade of genital and psychoneurotic defense. 5. The old relationship between psychosomatosis and psychosis can be better understood on the basis of our findings, which reveal a borderline structure and splitting mechanisms in many psychosomatic patients. 6. Psychosomatic pathology can be better understood today by relating it to the structure of the psychosomatic family. 7. It appears that if, on the one hand, psychosomatic diseases of a more hysterical picture are frequent among preindustrial cultures and in low-income classes, on the other hand psychosomatic syndromes of a narcissistic and borderline type are characteristic for our civilization.

Humans↗
PubMed1986

Separation crisis in a family with a borderline adolescent.

The case discussed illustrates the crisis value of separation strivings in borderline families. Dynamic and interpersonal issues were approached from a focus on (a) patterns of projective identification; (b) parental definitions interfering with the child's ego structure formation; and (c) the deterioration of a borderline personality toward frankly schizophrenic functioning under the double pressure of the developmental task of separation and binding parental maneuvers.

Adult↗