Supportive psychoanalytic therapy for personality disorders.

Overview

Theoretical rationale, research, and clinical process from supportive psychoanalytic therapy for personality disorder patients are presented, with detailed discussion of clinical examples. Elements of the supportive therapy used in the Weill Cornell randomized controlled trial for borderline patients are described, including monitoring the frame of therapy and the emergency priorities of suicidal or treatment-threatening behavior; development and management of the therapeutic relationship; enhancing awareness, tolerance, and management of affect; facilitating growth of identity through support and modeling by the therapist; and avoiding explicit verbal interpretation of unconscious transference fantasy. Awareness of transference is used by the therapist to avoid injury to the patient's self esteem and to maximize tact in addressing the patient's defenses and maladaptive behaviors.