Video Review – Psychoanalytic Psychotherapy

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Psychoanalytic Psychotherapy CoverIn this 4-hour and 16-minute video, psychotherapist Otto Kernberg demonstrates Transference-Focused Psychotherapy (TFP) in three live sessions with a 40-year-old patient named Alfred (portrayed by an actor). TFP is an evidence-based treatment that is effective for individuals struggling with personality disorders. It is specifically helpful for individuals with borderline and narcissistic personality disorders, and focuses on treating the individual’s entire personality.

Kernberg engages in TFP with Alfred, who suffers from a personality disorder. Using a psychodynamic TFP approach, Kernberg demonstrates how therapists can conduct treatment. From the TFP perspective, personality disorders develop due to dysfunction in early life as well as genetic factors. They can specifically occur due to insecure attachment to a caregiver, severe trauma and/or severe family pathology that is transmitted in the interaction between family members. TFP focuses on helping patients change their distorted perceptions of others, internalized messages, and self-image. Dr. Kernberg builds a relationship with Alfred to demonstrate how this can be accomplished in a therapeutic setting, by using transference analysis, interpretation, and technical neutrality.

For example, during the first session, Alfred becomes suspicious of Dr. Kernberg because he perceives him as taking the side of his previous therapist. Dr. Kernberg confronts the patient about his contradictory attitudes and reinforces the realistic side of Alfred’s statement. He also interprets Alfred’s desire to leave therapy as a fear of attack and betrayal by everyone, including the therapist.

In subsequent sessions, Kernberg responds to Alfred’s distorted views of his relationships, particularly with his ex-girlfriend. Kernberg intermittently interjects his commentary for the viewer throughout the sessions. He helps explain common symptoms of personality disorders and applies them directly to what transpires within each session. He also explains each session’s progress as well as the reasoning for his questions, which helps the viewer understand the theory and how to use it.

The video is supplemented with an instructor’s manual which offers valuable tips for making the best use of the video. The instructor’s manual contains a transcript of the sessions, which helps highlight key moments in the video. It also contains discussion questions that can be used to facilitate dialogue. For example, in session two, one of the discussion questions addresses the patient’s feelings of betrayal as follows: “What do you think of Kernberg’s straightforward way of interpreting Alfred’s avoidance of feelings of betrayal? How do you imagine different clients responding to this style? How does it match or differ from your own?” The instructor’s manual also contains suggestions for activities related to the video, such as a reaction paper and role-play exercise. The instructor’s manual is useful, but a little difficult to navigate.

This video seems appropriate for a relatively higher-level mental health professional or student. It offers a unique perspective on the therapeutic techniques of TFP. Unlike reading a textbook, watching this video gives the viewer a comprehensive understanding of the theory, effectively bringing it theory to life. The video could be a useful teaching tool for instructors and learning tool for students.

Reviewed by: Nicole Berry, Barry University.

Yalom, V. (2007). Psychoanalytic Psychotherapy with Otto Kernberg, MD [DVD]. Mill Valley, CA: Psychotherapy.net.

Available at http://www.psychotherapy.net