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It was a pleasure to review Frank Yeoman, John Clarkin, and Otto Kernberg's clinical guide to transference focused psychotherapy. In this review, I describe the structure and organization of the book while highlighting its elements and utility for practicing clinicians.
Borne out of over a century of combined clinical experience Yeomans, Clarkin, and Kernberg provide simply a treasure trove of theoretically informed, empirically derived methods, illustrated with clinical vignettes to demonstrate the use of transference focused psychotherapy (TFP) with patients with borderline personality disorder (BPD).
The volume is organized into sections covering personality theory, the empirical development of TFP, evaluation, and then moving to technical details of this method of treating patients with BPD. To supplement the text, videos with illustrative segments are provided online. I will review each of these sections in turn.
The first section is a description of normal and abnormal personality organization. Based on object relations theory as developed by Otto Kernberg, this chapter is a succinct review of theory underlying clinical observations in patients with BPD. The concept of psychic structures as seen in healthy versus pathological developments is examined. The centrality of defenses including splitting and projective processes as seen in BPD is explained. Kernberg's model of levels of personality organization is illustrated. The section concludes by exploring the limits of behavior-based diagnostic systems like the Diagnostic and Statistical Manual of Mental Disorders.
Chapter 2 covers the empirical development of TFP. The authors describe a six-step process of empirical development, progressing from theory-driven research on a type of pathology, specification of a treatment with manual development, preliminary outcome testing, study of change processes, study of mediators, and evaluation of how treatment generalizes to populations. As a first step to empirical validat