THE MASTERSON GROUP, P.C.

Psychoanalytic Psychotherapy
of the Personality Disorders

Descriptions of Books by James F. Masterson, M.D.

THE NARCISSISTIC AND BORDERLINE DISORDERS

In recent years psychotherapists have become increasingly concerned with the wide spectrum of the psychopathology of the self (narcissism), ranging from the deficient emotional investment in the self seen in the borderline patient to the pathologic over-investment of the self seen in the narcissistic patient.

Now this landmark volume presents an integrated developmental approach that emphasizes how these disorders differ in clinical picture, intrapsychic structure, and developmental level.

From a solid basis in both analytic reconstruction and child observation research, Masterson's integrated developmental approach weds clinical observation to theory to provide a guide to the important differences in therapeutic technique required to treat narcissistic and borderline patients. Treatment principles are illustrated by extensive case presentations.

Part I focuses on The Psychopathology of Narcissism. Masterson first describes the clinical picture of the narcissistic personality disorder, then presents the developmental theory, and finally contrasts this theory with those of Kohut and Kernberg. He then demonstrates the usefulness of the theory in making differential diagnoses (a) between the narcissistic personality disorder and the borderline disorder, (b)between both and the other major categories, and (c) between both and the patient with a narcissistic defense against a borderline syndrome.

The next three chapters present a detailed case study of a narcissistic personality disorder, including an interview-by-interview account showing the effectiveness of therapeutic interpretation of the patient's narcissistic vulnerability. Following this, a new aspect of developmental theory is presented: the psychopathology of the self of the borderline patient and how it differs from that of the narcissistic personality disorder.

Part II on The Borderline Personality Disorder revises and updates the developmental theory. New clinical material is presented to cover specific treatment issues, such as: the use of confrontation to establish a therapeutic alliance; therapeutic techniques required to maintain a patient in the working-through phase of treatment; mastery of the talionic impulse; and termination.

Part III on Reflections illustrates how misconceptions from opposite sides of the therapeutic spectrum - the psychoanalytic and the more directive therapies - can produce distortions in treatment of narcissistic and borderline patients. Finally, it summarizes the theme: "Viewing the clinical evidence through the developmental perspective, specifically the vicissitudes and reverberations of the separation-individuation phase of ego development, leads to a unique and appropriate fit between theory and clinical evidence in patients with borderline and narcissistic personality disorders. This, in turn, leads to a more specific and effective treatment."

ABOUT THE AUTHOR
James F. Masterson, M.D., is founder and director of the Masterson Group and Masterson Institute for Psychoanalytic Psychotherapy in New York City. He is also the founding father of The Society of Adolescent Psychiatry and past president of its New York Chapter. He is the author of a dozen books, including The Search for the Real Self (1988), The Emerging Self (1991), and Disorders of the Self (1995). Several of his books are required reading in courses throughout the country, and many have been translated into other languages. He has also written numerous articles and papers for leading journals both here and abroad.

Dr. Masterson maintains a private practice and is Clinical Professor Emeritus of Psychiatry at the Joan and Sanford I. Weill Medical College of Cornell University.