You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
Otto Kernberg's latest book, “Severe Personality Disorders” reminds me in many ways of Otto Fenichel's classie, Psychoanalytic Theory of the Neurosis. Kernberg's brilliance and comprehensive understanding of his material is evident throughout. His presentation of the material is thorough, systematic, and authoritative and yet the book is difficult to digest and absorb.
Among the strengths of the book are Kernberg's stress on the significance of the lost art of differential diagnosis in treatment planning. Since to Kernberg there should be a correlation between degree and nature of pathology and the variants of supportive and expressive modes of psychotherapeutic intervention, the initial interviews are so structured as to provide a framework lor future courses of action. Kernberg's description of proper technique in theoretical understanding of a continuum of narcissistic and borderline character types is persuasive. In focusing on negative, treatment-destructive resistances and engaging the patient in progressively more mature dialogue, Kernberg demonstrates a clinical genius that expertly balances interpretation and clarification. Among the additional bonuses here are Kernberg's synthesis of previous contributors (Kohut, Jacobson, Mahler), his highly creative speculations on the significance of affect in self-object internalizations, his specific instructions on how to structure treatment for suicidal, difficult, and unresponsive patients, and how to use hospitalization and a third party as additional therapeutic parameters if necessary.
With this impressive array of invaluable information made available to us, let me turn now to why, like Fenichel's magnum opus, I view this book as too good not to own, but a little difficult to use.
The great popularity of Greenson's book, The Techniques and Practice of Psychoanalysis was due to the author's inclination to cite many clear clinical illustrations along the way so that the reader could quickly identify or disagree with