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By Otto Kernberg

During this e-book a number one psychoanalytic clinician and theoretician offers his innovations at the newest psychodynamic advancements and insights on the topic of therapy of critical character issues. Dividing his discussions into sections, one on psychopathology and the opposite on psychotherapy, Dr. Otto Kernberg examines borderline character sickness, narcissism, sexual inhibition, transference and countertransference, suicidal behaviour, and consuming issues. In each one bankruptcy he integrates the guidelines of ecu and Latin American psychoanalytic thinkers, bringing them to the eye of English-speaking readers. This publication contains a choice of lately released magazine articles. Their assortment into one quantity makes on hand Dr. Kernberg's current considering on an enormous topic.

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Read or Download Aggressivity, Narcissism, and Self-Destructiveness in the Psychoterapeutic Relationship: New Developments in the Psychopathology and Psychotherapy of Severe Personality Disorders PDF

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Extra info for Aggressivity, Narcissism, and Self-Destructiveness in the Psychoterapeutic Relationship: New Developments in the Psychopathology and Psychotherapy of Severe Personality Disorders

Sample text

Under milder conditions, unconscious identification with the hated object and its characterological translation into antisocial tendencies, cruelty, contempt, and sadism may be present in many forms. A restricted, encapsulated sadistic perversion may represent one outcome of these conflicts. As Stoller () pointed out, sexual excitement always includes an element of aggression, and an organized perversion typically expresses the need to undo in fantasy an experienced trauma or humiliation from the past in the sexual realm.

Kernberg , ). The loss of reality testing reflects the lack of differentiation between selfrepresentations and object representations under conditions of peak affect states, that is, a structural persistence of the symbiotic states of development— their pathological hypertrophy, so to speak. The primitive defenses centering around splitting attempt to protect these patients from the chaos in all object relations that stems from their loss of ego boundaries in intense relationships with others.

The introjection of the image of a spoiled, destroyed breast leads to a sense of internal emptiness and destruction, which may damage the previous introjection of the good breast that was lost, so that the effects of envy and the related development of greed corrode both the good external and the good internal object. The clinical study of patients with narcissistic personality disorder regularly reveals envy (unconscious and conscious) as a major affective expression of aggression. As we move from the better-functioning narcissistic pathology to severe narcissistic personality disorders with overt borderline functioning, that is, with generalized lack of impulse control, anxiety tolerance, and sublimatory channeling, the intensity of aggression mounts, reaching its height in the syndrome of malignant narcissism.

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