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Dealing with borderline pathology

The aim of this seminar is to introduce students to the particular challenges posed by clients with borderline personality structure and to provide information about expressive psychotherapy, a therapeutic approach developed for borderline clients by Otto Kernberg and the mentalization approach developed by Fonagy. Case material , both written and in role-playing, will presented to illustrate the points made at the seminar. Participants are welcome to present their own cases as well.

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    The shadow of loss in our life

    Loss is an inevitable experience in human life and sometimes the after-effects of significant losses can touch much deeper layers of our psyche than those described by our favorite psychological theories.
    We, as therapists, do our best to help clients work through their losses, but how many of those clients can actually process the loss?
    In this seminar we will cover:

    Different types of loss ( anticipated, traumatic, diffuse) and their respective effects.

    Which clients have the capacity to work through their loss

    The conditions that either facilitate either hinder the process of mourning.

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    When does therapy end?

    At what point is a client ready to leave therapy? This important question puzzles not only beginners but also experienced clinicians and its appropriate resolution determines to a large extent the ultimate success of therapy.
    In this seminar we will discuss:
    Early indications for a client’s premature flight from therapy
    Appropriate management of issues surfacing at the end phase of therapy ( what if the client gets worse? What if the client claims that she is ultimately disappointed with therapy? Are we going to slowly wean the client or continue having regular sessions till the last minute? Are we going to schedule regular follow-ups?)
    Presentation of clinical cases where therapy gets into a rut or ends prematurely.
    Advantages and disadvantages of short term vs long-term therapy.

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    Mentalization

    Most psychotherapy models assume that the client has an inner world, a self and the ability to relate- regardless of how inadequate or blocked those may be.

    However, clinical experience has shown that we should not assume these attributes. Particularly borderline, psychotically  and psychosomatically organized clients manifest many problems in the area of mentalization and symbolization.

    In this workshop we will focus on the work of Peter Fonagy and other attachment theorists to study the mentalization process which takes place during infantile life and leads to the formation of their inner world. We will also discuss clinical interventions to use with adult clients with inadequate mentalization skills, which may help them develop further those skills and deepen their inner world.

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    What is psychotherapy? Ten crucial questions

    This workshop aims to help participants find the answers to common questions they often raise as they begin to train as therapists. We use case studies and role-playing to elucidate the nature of the issues raised in this workshop.

    What makes therapy different from other relationships?
    How long should therapy last?
    What qualities constitute a “ healing” relationship?
    What is the role of the therapist?
    Is it possible to change through therapy?
    Is it always beneficial to express our feelings?
    Do I run the risk to feel worse if I start therapy?
    What theoretical approach works best?
    How do I know that I am suitable for therapy?
    What do I need to do to become an efficient therapist?

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    Clinical Management

    We often believe that all people who ask help are suitable for psychotherapy. However, in many cases, the problems confronting the person cannot be resolved through therapy alone. How do we investigate the suitability of a prospective client for psychotherapy?
    What other resources should we look for to help this client? Are we the right person to help the specific client? What are the common mistakes made by therapists as they endeavour to help people?

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    The use of imagery in medical problems

    Imagery is a powerful clinical tool with a wide range of applications in medical and psychosomatic problems. Many patients experience considerable difficulty in affective expression and description of their inner states. Imagery can provide an alternative route of self expression which facilitates self-reflection and enhances communication of inner states.