Prior to beginning Transference-Focused Psychotherapy (TFP), “it is important for an analyst and patient to come to an agreement around the tasks and goals of the therapy,” noted Cornell Professor and psychotherapist Dr Frank Yeomans during an open lecture at DEREE-The American College of Greece.
Speaking February 12 during the lecture organized by The School of Graduate and Professional Education of DEREE – ACG, Dr Yeomans went on to define the benefits of creating a pre-treatment structure, as providing an environment conducive to the “adherence of the treatment model, and to creating the frame for psychological exploration” – especially important during “turmoil” – while he maintained that “unstructured treatments are ineffective.”
Speaking to a rapt audience at DEREE’s John S. Bailey Library Upper Level, Dr Yeomans defined TFP as “twice weekly manualized outpatient therapy. It provides structure and limit-setting with an exploratory psychodynamic approach to target the split, intrapsychic structure in order to achieve integration.”
Earlier in the day, Dr Yeomans kicked off his three-day workshop focusing on what those treatments can be, and presented case studies to professionals working in mental health practice and to graduate students. A Certificate of Participation from the DEREE – School of Graduate & Professional Education & Weill Cornell Medial College was awarded to the workshop’s participants.
DEREE Psychology Professor Fotini-Sonia Apergi, coordinator of the MS in Applied Psychology at DEREE, introduced Dr Yeomans, welcoming him on campus and thanking him for sharing his insights in an open lecture and during the three-day workshop organized by the School of Graduate and Professional Education of DEREE.
On his part, Dr Yeomans said he was pleased to be holding the workshop at DEREE-ACG and to be in Greece, “which is in the midst of a prolonged economic crisis,” and added that he hoped his insights will help professionals match resources to patients’ needs.
“There is a caricature of psychoanalysis as passive treatment,” Dr Yeomans added, “but really there is a need for both the patient and the analyst to be active.” He stressed the importance of the correct diagnosis, and once this is done and described to the patient, the importance of agreeing with them on a contract of goals and tasks. “Therapy doesn’t’ start when you meet,” noted Dr Yeomans, outlining the history-taking sessions to determine a diagnosis – possibly scheduling a family session if needed – and then a discussion of the disorder with the patient, describing the condition and treatment actions – which he described in his workshop.
Dr Yeomans also presented some of his cases during his lecture, describing how TFP is used to treat Borderline Personality Disorder (BPD), for which evidence includes: extreme high and low emotions, which are rapidly shifting; as well as patient’s relationships that are chaotic and dramatic or stormy; they act out, whether by substance abuse, having promiscuous, unprotected sex, etc, or they go through life without a clear sense of who they are. Once the diagnosis is made, the contract describes both the patient’s responsibilities – such as “be there and participate, pay a fee, and report thoughts and feelings without censoring” – and the therapist’s responsibilities, such as “attending the schedule, making every effort to understand and when useful to comment, as well as clarifying the limits of the therapist’s involvement (for patients with earlier experiences of challenging boundaries).”
Finally, Dr Yeomans described patients with Borderline Personality Disorder as those suffering from identity diffusion, where the sense of self and others is “fragmented, destroyed, superficial,” and gave other examples as well. He also discussed cases of Narcissistic Personality Disorder (NPD), a variant of BPD, and described various types of resistance to therapy, which are described in the contract, such as lying, eating disorders, a chronically passive lifestyle, and poor attendance, among many others. He warned that without a contract, patients will “create chaos, as it is a distraction from internal affect states. And so we have to set up a frame [the contract] that limits patients’ capacity to cause distractions. Those behaviors are what keeps them from thinking about what they are feeling…”
Dr Yeomans’ “Transference-Focused Psychotherapy: An Evidence-based Treatment for Borderline Personality Disorder” workshop was organized within the framework of the MS Program in Counseling Psychology & Psychotherapy of the DEREE School of Graduate and Professional Education. To find out more and to register for the spring semester starting March 2, please click here
Dr Yeomans is Clinical Associate Professor of Psychiatry at the Weill Medical College of Cornell University, Director of Training at the Personality Disorders Institute of Weill-Cornell, Lecturer in Psychiatry at the Columbia University College of Physicians and Surgeons Center for Psychoanalytic Training and Research, and Director of the Personality Studies Institute in Manhattan. He graduated from Harvard College and went on to obtain his M.D. from the Yale University School of Medicine. He completed his training in psychiatry at the Payne Whitney Clinic of the New York Presbyterian Hospital-Weill Medical College.