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dvdREVIEW: Psychoanalytic Psychotherapy for Personality Disorders:

An Interview & A Live Case Consultation with Otto Kernberg

DVD: Psychotherapy.net (2010), US$ 39.20 each DVD

Reviewers Deborah Elizabeth Davies & Werner Kierski

I very much enjoyed and felt better prepared to work with severely disturbed clients after watching the 90-minute interview with Dr. Kernberg – a leading authority on personality disorders. The straightforward camera work meant that the focus was on Kernberg and his ideas. He brought thoughtfulness and deliberation to his shared his thoughts on personality disorders – particularly borderline personality disorder – which he illuminated with clinical vignettes drawn from his long history of working with disturbed clients.

Kernberg’s consideration of personality disorders includes “dimension of severity that’s determined by the level of organization of internalized object relations.” In a discussion between the interviewer, Dr. Terrence Owens, and Kernberg, Owens’ lack of expertise in this field allows Kernberg to clarify fundamentals and enlighten Owens and the viewer. Kernberg explains the development from classic psychoanalysis to object relations as a shift from “unconscious intrapsychic conflict between drives and defenses” to a recognition that the drives and defenses are really internalized object relations. There is a refreshing directness in the way Kernrberg handles the questions posed. I found it particularly interesting and helpful when he shared his experiences with his clients: I got a felt sense of what to look for and, by hearing how he managed the sessions, felt better prepared (I guess you could say I was internalizing him as a good object).

The DVD is broken down into the following sections: discussion, theoretical foundations, assessing and diagnosing personality disorders, normal identity vs identity diffusion, utilizing transference, making interpretations, setting limits, and using collegial support.

The second DVD in the series takes a look at how Kernberg offers supervision consultations to three psychotherapists each presenting a client with borderline characteristics. The cases are very different – and so are the psychotherapists; each has a different theoretical background. The cases provide an interesting mix of complicated clients, ranging from effects of childhood trauma to sexual masochism. One thing I noticed is how many probing questions Kornberg asks of each therapist in order for him and for the viewer to understand the client better. Some of the questions are really challenginging and I thought that I would not want to be in their place. In one way, this was a welcome change to what I often experience as therapists’ avoidance of challenging each other, both in formal and informal supervision sessions. On the other hand, it was at times unclear where Kornberg was coming from and where he was going with his probing; did he want to throw the therapists off balance?

One element I found irritating when watching the DVD was the first therapist; her shrill voice, facial contortions and her hesitation when answering made her most annoying. Perhaps what was happening there was a parallel process by which she acted out her traumatised resistant client when facing a powerful adult (represented by Kernberg). Sadly, Kernberg did not pick up on that and mainly pointed out her difficulty in understanding her client.

Kernberg is one of the world’s foremost experts in working with personality disorders. On the whole, the video offers viewer, student and experienced therapist alike, a unique outside-in perspective on how this master practitioner works. Most important is to not rely not assumptions but to check with the client what is really going on.

Included with the DVD is an instructor’s manual which has a transcript of the Kernberg interview as well as a brief introduction to the material discussed and discussion questions.

Psychotherapy.net provides DVDs in psychotherapy, psychology and addictions for teaching, training, self-study and continuing education (useful for those of us trying to accumulate our CPD hours as, by completing an on-line test on the material covered by the DVD, one can obtain a certificate of attendance).