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Abstract
Transference‐focused psychotherapy and mentalization‐based treatment are new psychoanalytic treatment forms for borderline patients. How do these forms of treatment differ and how are they alike? What interventions do they yield in clinical practice? In the past few years two methods of psychoanalytic treatment for borderline patients have been developed: transference‐focused therapy and mentalization‐based treatment. This paper explores the similarities and differences between them, with a special focus on how the different theories lead to different interventions in clinical practice. TFP takes the central problem to be the disorder in object relations, while MBT focuses on the self as agent. Further differences concern notions of the role of aggression, the presence of mental representations and the position of the therapist. Interventions formulated by therapists of both frames of reference in response to some therapy fragments differed substantially. Both theories share a desire to develop a psychoanalytical technique suitable for borderline patients, and both stress the central importance of the handling of the transference and of working in the here‐and‐now, as well as the necessity for effect research.
Notes
1. Kernberg introduced the term borderline personality organization to refer to a broad spectrum of personality disorders between the neurotic organization and the psychotic organization. Clinically speaking, they are people with a non‐specific ego weakness, disturbed interpersonal relationships, problems with commitment to work and love, some pathology in sexual relations and super‐ego pathology (Yeomans et al. Citation2002).
2. Participants in the round table talks were: Margit Deben and Jan Stoker as experts in the field of MBT, Cees Kooiman and Rob Janssen in the field of TFP, and Jos Dirkx and Piet Rijnierse as psychiatrists with experience in treating borderline patients in an outpatient setting and a clinical psychotherapy setting, respectively. Annelies Verheugt‐Pleiter and Thijs De Wolf served as chairpersons.
3. The theory and technique of the treatment according to Linehan is beyond the scope of this paper, but when compared to TFP (central disorder concerns object relations) and MBT (central disorder concerns self as agent), Linehan calls the central disorder in borderline personality organization the disorder in affect regulation.