Chapter 5.Transference-Focused Psychotherapy for Levels of Personality Pathology Severity

Transference-focused psychotherapy (TFP) is a principle-driven, transdiagnostic psychodynamic psychotherapy for treatment of personality pathology. Although TFP was originally articulated (Clarkin et al. 1999), developed (Yeomans et al. 2015), and empirically validated (Clarkin et al. 2001, 2007; Doering et al. 2010) as an intensive individual psychotherapy for the treatment of patients with the categorical diagnosis of borderline personality disorder (BPD), the treatment has since been adapted to meet the clinical needs of a wide range of personality disorder presentations and levels of severity, ranging from subsyndromal personality pathology through severe personality disorder (Caligor et al. 2018). This evolution from a diagnosis-specific to a transdiagnostic treatment model reflects developments in the understanding of personality pathology, within which the categorical diagnosis of BPD is now seen as part of a large general factor of disordered personality functioning (Sharp et al. 2015). This general factor is characterized by deficits in self-functioning and interpersonal functioning, which may range from minor to severe, and is conceptually similar to Kernberg’s (1984) borderline personality organization. In concert with these developments, TFP and its procedures have been articulated for the treatment and improvement of self- and interpersonal functioning of individuals who present with a range of personality disorders at different levels of functional severity (Caligor et al. 2018), as well as various symptom conditions such as depression that frequently emerge in the setting of personality pathology (Simon et al. 2015).