1st Edition

Disorders of the Self New Therapeutic Horizons: The Masterson Approach

Edited By James F. Masterson, M.D., Ralph Klein, M.D. Copyright 1995
    448 Pages
    by Routledge

    448 Pages
    by Routledge

    A testament to the vitality of the Masterson Approach to the study and treatment of the disorders of the self, this incisive volume documents the evolution of Masterson's theoretical and clinical work during the past five years. It is comprised of writings by a second generation of clinicians who both carry on and expand the horizons of the Masterson Approach. Disorders of the Self addresses four new areas of great clinical importance from the perspective of developmental, self, and object relations theory. First, Ralph Klein, Clinical Director of the Masterson Institute), has combined the work of Fairburn and Guntrip with the Masterson Approach to develop and updated, broader, original and clinically useful concept of the Schizoid Disorders of the Self. The force of his approach is illustrated by the focus on the schizoid dilemma and the schizoid compromise, vividly depicted with detailed clinical applications. Candace Orcutt, Senior Faculty Member in the Masterson Institute, along with a colleague, then apply the Masterson Approach to the controversial topic of early abuse - physical and/or sexual - to the developing self. Diagnosis and treatment of narcissistic pathology is the focus of section three. Chapters further refine and expand how the disorders of the self triad - self activation leads to anxiety and depression which lead to defenses - operate in both the patient's life and in the therapeutic relationship. The authors identify and illustrate critical points in treatment, detail the technical approach to the closet narcissistic personality disorder, and address the therapeutic management of devaluation and disappointment reactions along with the countertransference reactions they evoke. The volume concludes by delving into arenas beyond individual psychotherapy for disorders of the self. An innovative approach to group therapy combines the Masterson Approach with that of W. Bion, and authors examine the complexities of drug therapy and comorbidity and their interaction with psychodynamic forces. Disorders of the Self will be a vital addition to the armamentarium of any clinician who works with personality disorders. It demonstrates the continued expansion and evolution of a profound theoretical and clinical paradigm - the Masterson Approach - aimed at penetrating and healing the disorders of the self.

    Part 1 The Self-in-Exile: A Developmental, Self, and Object Relations Approach to the Schizoid Disorder of the Self; Chapter 1 Evolution, Ralph Klein; Chapter 2 Description, Ralph Klein; Chapter 3 Developmental Theory, Ralph Klein; Chapter 4 Intrapsychic Structures, Ralph Klein; Chapter 5 Establishing a Therapeutic Alliance, Ralph Klein; Chapter 6 Shorter-Term Treatment, Ralph Klein; Chapter 7 Intensive, Long-Term Psychotherapy, Ralph Klein; Chapter 8 Safety First: Approaching Treatment of the Schizoid Disorder of the Self, Stephen Silberstein; Chapter 9 Narcissistic Defenses against a Schizoid Disorder, Barbara L. Short; Part 2 Early Trauma and the Developing Self; Chapter 10 The Influence of Early Trauma on the Developing Self, Candace Orcutt; Chapter 11 Uncovering “Forgotten” Child Abuse in the Psychotherapy of a Borderline Disorder of the Self, Candace Orcutt; Chapter 12 Integration of Multiple Personality Disorder in the Context of the Masterson Approach, Candace Orcutt; Chapter 13. It was subsequently published in the Clinical Social Work Journal, vol. 21, no. 1, Spring, 1993, ana is reprinted, with some revisions, with the permission of that publication. The author would like to thank Jean Sanville, editor of the Clinical Social Work Journal, as well as the members of the program committee of the Committee on Psychoanalysis for their invitation to present the address and for their encouragement and support.The author would also like to thank many friends and colleagues for their help in preparing this work, in particular, Dr. James Masterson, Dr. Eleanor Grayer, Andrea Stone, Dr. Shelly Nagel, Dr. Stephen Reed, and Stewart Clark. All of them took the time and trouble to make many helpful comments. In addition, I would like, in particular, to thank Dr. Candace Orcutt, whose thinking about trauma and dissociative states has had a profound influence upon my work., Karla R. Clark; Part 3 Perspectives on Treating the Narcissistic Disorder of the Self; Chapter 14 Disavowed Narcissism: Fusion and Externalizing Defenses in the Closet Narcissistic Disorder of the Self, Shirley Zuckerman Issel; Chapter 15 Mirrors of Rage: The Devaluing Narcissistic Patient, Judith Pearson; Chapter 16 Neutrality Under Attack: Devaluation in the Therapeutic Relationship, Bill Robbins; Chapter 17 Therapeutic Management of Disappointment Reactions with the Closet Narcissistic Disorder of the Self, Bill Robbins; Part 4 Other Treatment Strategies; Chapter 18 Group Psychotherapy and Disorders of the Self, Richard E. Fischer; Chapter 19 Couples Therapy of Patients with Disorders of the Self, Ken Seider; Chapter 20 Working with the Collective Marital Self, Candace Orcutt; Chapter 21 Antidepressants in Psychotherapy: Use and Abuse, David Grubb; Chapter 22 Three Bipolar Women: The Boundary between Bipolar Disorders and Disorders of the Self, David Grubb;

    Biography

    James F. Masterson, M.D., is Director of the Masterson Institute in New York City. He is also Adjunct Clinical Professor of Psychiatry at Cornell University Medical College. The author of several widely acclaimed books on personality disorders that span decades of innovative research and clinical work, he conducts workshops nationally and abroad and also maintains a private practice.

    Ralph Klein, M.D., is Clinical Director of the Masterson Institute and also Assistant Clinical Professor of Psychiatry at Columbia University College of Physicians and Surgeons in New York City. He also maintains a private practice.