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When a new volume by Kernberg appears, there is a stir in the psychiatric community. Love has been missed in psychoanalytic literature; Kernberg's placing “Love” in the title is misleading. The volume might be titled instead, The Collective Papers. The reader will not arrive at the topic of love until page 273. The book is quite different from Gaylin's (Gaylin, 1986) study of love or Stendhal's On Love (Stendhal, 1947).
Kernberg's studies of severe Personality Disorders continue, and lead to a dissection of how love is impaired in the Borderline, Narcissistic, and Malignant Narcissistic Disorders. Erickson's concepts of Identity and Identity Diffusion receive a thorough discussion. Patients suffering from these disorders reveal identity diffusion. There is an impairment in mirroring and insecure attachment, resulting in a pathological structure of the mind. The speculation is that there are neuronal maps and circuits that imprint the traumas. Mentalization is crippled, and the sense of Self and empathic resonance are impaired, affecting sexuality.
Kernberg treated hospitalized patients, and his group was able to do research on forms of therapy, neurobiology, and outcomes. A manual for transference-focused psychotherapy was written, and a “modified psychodynamic psychotherapy” became the treatment of choice. The overview of transference-focused psychotherapy gives the therapist a modicum of reassurance when engaged in the chaos and countertransferences that erupt during treatment. Kernberg emphasizes limitsetting and the interpretation of transference. The continuous admonition is to look for the affect. Counter-transference is not viewed as only the therapist's pathology.
Group dynamics illustrate a need for transference-focused therapy. Kernberg brings in Bion's study of unconscious basic assumptions in group processes: fight-flight, pairing, and paranoia. In this context, a chapter on Congressional behavior would be enlightening.
In the chapter on “Mentalization, Insi