Broken Structures: Severe Personality Disorders and Their Treatment Hardcover - 1992

From the rear cover

This landmark volume synthesizes the vast descriptive and dynamic literature on the phenomenology and treatment of severe personality disorders. Among the psychoanalytic authors whose views are included are: . the "pioneers" such as Freud, Abraham, Ferenczi, Jones, Fenichel, and Reich; the "second generation" analysts such as Klein, Anna Freud, Fairbairn, Balint, Winnicott, Guntrip, Erikson, Waelder, Greenacre, Jacobson, Menninger, and Eissler; and the contemporary theorists such as Mahler, Kohut, Kernberg, Khan, Blos, Blum, Modell, Volkan, Adler, Kramer, Bach, Meissner, Burland, Singer, and Chasseguet-Smirgel. Among the descriptive psychiatrists included are: . the founding fathers of descriptive psychiatry such as Kraepelin, Magnan, Kretschmer, Bleuler, Schneider, and Jaspers; later investigators such as Maudsley, Cleckley, Langfeldt, Leonhard, Sheldon, Hoch, and Polatin; and contemporary observers such as Fish, Winokur, Spitzer, Gunderson, Frances, Kendler, Stone, Reid, Livesley, Akiskal, Perry, and Klerman. Combining the observations of these prominent analysts and empirical researchers leads to the sound clinical profiles of eight severe personality disorders - narcissistic, borderline, schizoid, paranoid, hypomanic, antisocial, histrionic, and schizotypal - contained in this book. Akhtar provides a rich harvest of evaluative procedures and therapeutic techniques. In the initial evaluation he combines traditional history taking with a penetrating examination of the patient's sense of identity, ego defenses, object relations, and psychological-mindedness. This enables the clinician to choose the most effective therapeutic strategies. Psychoanalytic psychotherapy is discussed indetail, including the synthesis of diverse approaches as well as the addition of environmental and supportive measures. This is an important exploration of the mutual interdependence of psychiatry and psychoanalysis and makes a major contribution to the understanding and psychotherapy of the personality disorders.