Transference-focused psychotherapy.

The centrality of a representation-based framework for understanding the emotional underpinnings of personality pathology: A commentary on “The emotional underpinnings of personality pathology: Implications for psychotherapy”.

“…Critics of this position have stressed representational and interpersonal difficulties as core, at least in some manifestations of the disorder. Likewise, we have argued elsewhere that the border in BPD is now at the intersection of representational, emotional, and interpersonal difficulties (Levy et al, 2022).…”

“…The article is attuned to a growing body of empirical evidence suggesting that categorical classification systems of personality pathology are less useful than dimensional ones, including recent factor analytic studies suggesting that a general PD factor may better characterize personality difficulties over categorical systems ( g- PD ; for a brief review of these studies, see Levy et al, 2022). Additionally, the authors exemplify the value of integrating various sources of evidence in advancing intervention research; they synthesize evidence from multiple domains, including basic science research on psychopathology, psychotherapy research, as well as their own clinical experience.…”

“…Several scholars have proposed some version of this position. The emphasis on the affective components of BPD has a long history, when the border in BPD shifted from between neurosis and psychosis to that with affective disorders (see Levy et al, 2022 for a review). Critics of this position have stressed representational and interpersonal difficulties as core, at least in some manifestations of the disorder.…”

“…Each of these theories of personality pathology have historically emphasized a role for emotional processing in the etiology and phenomenology of the disorder. Object-relations approaches, for example, posit that representations of the self in relation to another are connected by affect, and it is the quickly shifting representations of self and other which explain the instability of affect in BPD (Levy et al, 2022). On this model, the experience of strong emotions can also color representations or evoke representations associated with emotions (Levy et al, 2022).…”

“…Object-relations approaches, for example, posit that representations of the self in relation to another are connected by affect, and it is the quickly shifting representations of self and other which explain the instability of affect in BPD (Levy et al, 2022). On this model, the experience of strong emotions can also color representations or evoke representations associated with emotions (Levy et al, 2022). Mentalization-based approaches also place a strong value on processing affective experiences, in particular, the role of overwhelming affect in disrupting reflective capacity, through momentary compromise of the ability to distinguish between one’s private world and a consensual social reality (Levy et al, 2022).…”