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Transference focused psychotherapy
Transference focused psychotherapy (TFP), is a highly structured, twice-weekly modified psychodynamic treatment based on Otto Kernberg’s object relations model of borderline personality disorder.〔Clarkin, J. F., Yeomans, F., Kernberg, O. F. (2006). Psychotherapy for borderline personality: Focusing on object relations. New York: Wiley.〕 It views the individual with borderline personality organization (BPO) as holding unreconciled and contradictory internalized representations of self and significant others that are affectively charged. The defense against these contradictory internalized object relations leads to disturbed relationships with others and with self. The distorted perceptions of self, others, and associated affects are the focus of treatment as they emerge in the relationship with the therapist (transference). The treatment focuses on the integration of split off parts of self and object representations, and the consistent interpretation of these distorted perceptions is considered the mechanism of change.
TFP has been validated as an efficacious treatment for borderline personality disorder (BPD),〔Clarkin, J. F., Levy, K. N., Lenzenweger, M. F., & Kernberg, O. F. (2007). A multiwave RCT evaluating three treatments for borderline personality disorder. American Journal of Psychiatry, 164, 922-928.〕〔Doering, S., Hörz, S., Rentrop, M., Fischer-Kern, M., Schuster, P., Benecke, C., Buchheim, A., Martius, P., Buchheim, P. (2010). Transference-Focused Psychotherapy vs. treatment by community psychotherapists for borderline personality disorder: A randomised controlled trial. British Journal of Psychiatry, 196, 389-395.〕 though too few studies have been conducted to allow firm conclusions about its value.〔Stoffers, J.M., Vollm, B.A., Rucker, G., Timmer, A., Huband, N., & Lieb K. (2012). Psychological therapies for people with borderline personality disorder. The Cochrane Collaboration. Published online: 15 Aug 2012〕 TFP is one of a number of treatments that may be useful in the treatment of BPD; however, only TFP has been shown to change how patients think about themselves in relationships.〔Levy, K.N., Meehan, K.B., Kelly, K.M., Reynoso, J.S., Weber, M., Clarkin, J.F., & Kernberg, O.F. (2006). Change in attachment patterns and reflective function in a randomized control trial of Transference Focused Psychotherapy for borderline personality disorder. Journal of Consulting and Clinical Psychology, 74, 1027-1040.〕
==Borderline personality disorder==
TFP is a treatment for borderline personality disorder (BPD). Patients with BPD are often characterized by intense affects, stormy relationships, and impulsive behaviors. Due to their high reactivity to environmental stimuli, patients with BPD often experience dramatic and short-lived shifts in their mood, alternating between experiences of euphoria, depression, anxiety, and nervousness. Patients with BPD often experience intolerable feelings of emptiness that they attempt to fill with impulsive and self-damaging behaviors, such as substance use, risky sexual behavior, uncontrolled spending, or binge eating. Further, patients with BPD often exhibit recurrent suicidal behaviors, gestures, or threats. Under intense stress patients with BPD may exhibit transient dissociative or paranoid symptoms.〔American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Text Revision. Washington DC: Author.〕
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