 Akce
Seminář o problematice práce s lidmi s hraniční poruchou osobnosti
Transference-Focused Psychotherapy (TFP)
TFP is based on psychodynamic concepts and is designed specifically
for patients with personality disorders. This twice-per-week individual
therapy is described in a treatment manual and is empirically supported.
TFP combines many of the elements in the Guidelines for the Treatment
of Borderline Personality issued by the American Psychiatric Association.
For example, TFP places special emphasis on the assessment and on the
treatment contract and frame. This part of the treatment has a behavioral
quality in that parameters are established to deal with the likely threats
that may occur both to the patient’s well-being and to the treatment.
The patient is engaged as a collaborator in setting up these parameters.
In addition, TFP may be combined with medication or other ancillary treatments
to maximize the effect.
A feature of TFP is the approach to a deep psychological structure
that underlies the specific symptoms of BPD. The focus of treatment is
on a fundamental split in the patient’s mind that divides perceptions
of self and others into extremes of bad and good. This internal split
underlies the patient’s unsatisfactory way of experiencing self, others
and the environment, and it leads to the specific symptoms of BPD, such
as chaotic interpersonal relations and impulsive self-destructive behaviors.
After the behaviors typical of borderline pathology are contained through
structure and limit setting, this split psychological structure is observed
and analyzed as it unfolds in the transference [the relation with the
therapist as perceived by the patient]. Working together, the patient
and therapist can achieve the integration of the split internal world
and the resolution of the borderline structure. These deep psychological
changes allow the patient to achieve more flexible, adaptive, and satisfying
functioning in life. TFP has been shown to decrease symptoms and to decrease
emergency room visits and hospital admissions. In addition, TFP has been
shown to increase patients’ capacity for reflective functioning, that
is, their ability to appreciate the complexity of their own self and
of others. These changes allow the patient to experience the levels of
fulfillment in work and love that every individual has the right to strive
for.
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