Director of the Personality Disorders Institute, New York Presbyterian Hospital, Westchester Division. He is Professor of Psychiatry at Weill Medical College of Cornell University and Training and Supervising Analyst, Columbia University Center for Psychoanalytic Training and Research.
Psychodyn Psychiatry. 2021 Winter;49(4):506-531. doi: 10.1521/pdps.2021.49.4.506.
The author describes the differences between standard psychoanalysis and transference-focused psychotherapy (TFP) and reviews particular difficulties that psychodynamically trained clinicians have in learning TFP. In delineating differences between standard psychoanalysis and TFP, the author discusses mutual influences between standard psychoanalytic techniques and techniques of TFP. TFP is an extension and modification of standard psychoanalysis, but with quantitative modifications geared to the treatment of the most severe segment of personality disorders that tend not to be treatable by standard analysis. TFP includes some features that are directly facilitated by psychoanalytic education, such as the importance of free association and the organization of interpretations in terms of the analysis of defense, motivation, and impulse. On the other hand, TFP provides new strategies, enhancing standard psychoanalytic treatment, when it modifies technical neutrality under certain circumstances, allows for the analysis of "incompatible realities," and accelerates interventions under conditions of severe acting out when technical neutrality is not possible to maintain. The author demonstrates the advantages of systematic training in TFP within psychoanalytic institutes as a true enrichment of technical training. He proposes that psychoanalysis as a profession consists of a broad spectrum of treatment approaches based upon the combined utilization of psychoanalytic techniques, with specific modifications to be organized in specific forms of psychoanalytic psychotherapy. TFP may be the closest modification to standard psychoanalysis proper and is clearly defined and manualized. This has permitted empirical research that has already demonstrated the effectiveness of TFP.
作者描述了标准精神分析和转移焦点心理疗法（TFP）之间的差异，并回顾了精神动力学训练的临床医生在学习 TFP 时所面临的特殊困难。在描述标准精神分析和 TFP 之间的差异时，作者讨论了标准精神分析技术和 TFP 技术之间的相互影响。TFP 是标准精神分析的扩展和修改，但具有针对人格障碍最严重部分的定量修改，这些部分往往无法通过标准分析治疗。TFP 包括一些直接得益于精神分析教育的特征，例如自由联想的重要性以及根据防御、动机和冲动分析来组织解释的重要性。另一方面，当在某些情况下修改技术中立性、允许分析“不兼容的现实”并在严重行为发作的情况下加速干预时，TFP 提供了新的策略，增强了标准精神分析治疗。当技术中立性不可能维持时。作者展示了在精神分析机构中进行 TFP 系统培训的优势，认为这是对技术培训的真正丰富。他提出，精神分析作为一种职业，由基于联合使用精神分析技术的广泛治疗方法组成，具体修改将以特定形式的精神分析心理疗法组织起来。TFP 可能是最接近标准精神分析本身的修改，并且定义明确，手册化。这使得已经证明 TFP 有效性的实证研究成为可能。
