Levels of personality organization and internal relational patterns

Background

This study aimed to determine whether level of personality organization is associated with a relational pattern present in an autobiographical narrative about an important interpersonal relationship. The main goals were to explore whether and how the components of the internal relationship pattern, and whether and how the configurations of the components, are related to personality organization, when integrated personality organization (IPO) is taken into account.

Participants and procedure

Assessment of the relational patterns was based on the Core Conflictual Relationship Theme (CCRT) – wishes (WS), responses from others (RO), and responses of the self (RS) – as identified from participants’ self-narratives about important relationships (N = 90).

Results

One-way analysis of variance revealed significant differences between groups with different levels of personality organization, according to one wish of self (WS2 To oppose, hurt, control), five responses of others (RO4 Bad; RO5 Rejecting; RO6 Helpful; RO7 Likes me; RO8 Understanding), and three responses of self (RS1 Helpful; RS4 Oppose and hurt others; RS8 Anxious). Considering the configurations of WS + RO + RS, the results indicate that in the borderline personality organization (BPO) group, the WS Libidinal + RO Frustrating + RS Negative pattern is most prevalent, while in the neurotic personality organization (NPO) and IPO groups, the WS Libidinal + RO Fulfilling + RS Negative and the WS Libidinal + RO Fulfilling + RS Positive configurations are most frequent.

Conclusions

The study supports the thesis that component relationship patterns and their configurations might be related to personality organization. The main differences were found between BPO and IPO with NPO placed between them, in a way congruent with Kernberg’s theory.

Adolescents in psychodynamic psychotherapy: changes in internal representations of relationships with parents

This study explored whether and how internal representations of adolescents' relationship with their parents--a fundamental concept in psychodynamic theory--changed in the course of a year of treatment and whether the observed changes were related to changes in symptoms. Seventy two adolescents (ages 15-18; 30 in treatment and 42 in a non-treatment "community group") underwent Relationship Anecdote Paradigm (RAP) interviews according to the Core Conflictual Relationship Theme method (CCRT; Luborsky & Crits-Christoph, 1998) and completed outcome measures at two time points. A novel data-driven approach to clustering CCRT categories was used to characterize internal representations. The potential contribution of this approach to the CCRT method is discussed. The results indicate that adolescents' internal representations of their relationships with their parents changed significantly throughout treatment, and were related to changes in symptoms.

Expressive language disturbance in borderline personality disorder in response to emotional autobiographical stimuli

Clinicians recognize expressive language disturbances in borderline personality disorder (BPD) as a feature attenuating psychiatric history-taking. Neuroimaging studies demonstrate activation of key differentiating neural networks characterizing a traumatic memory system in BPD patients. Yet there are few BPD studies evaluating expressive language disturbances in response to emotionally salient, clinically relevant stimuli and no controlled studies. The aim was to examine expressive language disturbances in response to a clinically relevant emotional stimulus, the Adult Attachment Interview (AAI). Twenty BPD participants and 20 age-, sex-, and education-matched controls were administered the AAI. Verbatim transcripts were analyzed by four computerized measures designed to evaluate various linguistic components of speech (i.e., overall expressive language impairment, lexical complexity, syntactic complexity, and semantic complexity). BPD participants evidenced significantly greater levels of overall expressive language impairment and reduced syntactic and lexical complexity, but not semantic complexity scores. Detailed linguistic profiles demonstrated specific deficits linked to BPD.

Contributions of psychodynamic approaches to treatment of PTSD and trauma: a review of the empirical treatment and psychopathology literature

Reviews of currently empirically supported treatments for post-traumatic stress disorder (PTSD) show that despite their efficacy for many patients, these treatments have high nonresponse and dropout rates. This article develops arguments for the value of psychodynamic approaches for PTSD, based on a review of the empirical psychopathology and treatment literature. Psychodynamic approaches may help address crucial areas in the clinical presentation of PTSD and the sequelae of trauma that are not targeted by currently empirically supported treatments. They may be particularly helpful when treating complex PTSD. Empirical and clinical evidence suggests that psychodynamic approaches may result in improved self-esteem, increased ability to resolve reactions to trauma through improved reflective functioning, increased reliance on mature defenses with concomitant decreased reliance on immature defenses, the internalization of more secure working models of relationships, and improved social functioning. Additionally, psychodynamic psychotherapy tends to result in continued improvement after treatment ends. Additional empirical studies of psychodynamic psychotherapy for PTSD are needed, including randomized controlled outcome studies.

The History and Empirical Status of Key Psychoanalytic Concepts

Over the past century, the ideas set out in psychoanalytic theory have permeated the field of psychology as well as literature, art, and culture. Despite this popularity, analytic theory has only recently received empirical support. In this chapter, we seek to highlight several fundamental concepts of analytic theory (the unconscious, drives, defenses, object relations, Oedipus complex) and psychodynamic treatments (transference, countertransference, interpretations, resistance). The first section of the chapter offers a comprehensive definition and historical background for each concept. This foundation is followed by a review of the empirical evidence supporting the reliability and validity of these concepts, their impact on treatment, and their broader influence on the future of psychology.