Supportive-expressive psychotherapy for comorbid personality disorders: a case study

✍ Scribed by Bo Vinnars; Jacques P. Barber

• Publisher: John Wiley and Sons
• Year: 2008
• Tongue: English
• Weight: 164 KB
• Volume: 64
• Category: Article
• ISSN: 0021-9762
• DOI: 10.1002/jclp.20452

✦ Synopsis

Abstract

Supportive‐expressive psychotherapy (SEP) has generated some empirical evidence supporting its effectiveness for treating a variety of Axis I disorder; however, no evidence supporting its use for patients with severe personality disorders has been published. This article describes a patient suffering from several personality disorders—avoidant, obsessive–compulsive, paranoid, narcissistic, and antisocial—using the core conflictual relationship theme (CCRT) method. Supportive‐expressive psychotherapy focuses on connecting the CCRT with symptoms and maladaptive personality traits, with the goal of resolving these conflicts. Most maladaptive traits for such a complex patient are ego‐syntonic, not experienced as internal conflicts, and therefore not easily accessible to therapeutic exploration. Such a patient is likely to experience the external environment as hostile once his ego‐syntonic wishes are not automatically granted and thus the therapeutic alliance may suffer. This article will show the interpersonal processes that are activated when a patient is treated with time‐limited, manualized psychotherapy. © 2008 Wiley Periodicals, Inc. J Clin Psychol: In Session 64: 1–12, 2008.