Transference focused psychotherapy (TFP) is a modified psychodynamic treatment given by Otto F Kernberg which is specifically and majorly used on patients with borderline personality disorder. It focuses on perception of self and deals with developing constructive behaviours in patients. A patient with borderline personality disorder usually has impulsiveness, extreme mood swings, unstable interpersonal relationships and self-image issues. The transference focused psychotherapy helps the clients to identify the maladaptive patterns of interaction as well as ideas associated with self-destruction. In the therapeutic setting the client unknowingly transfers emotions and expectations to the therapist and such transference is an expected part of the therapeutic process and is used to gradually break down self-destructive behaviours.
There are several benefits to the use of transference focused psychotherapy. This therapy helps in lowering anxiety as well as depressive symptoms. TFP also improves social interaction which in turn helps in the progress of interpersonal relationships. Suicidal ideation is also significantly reduced by slowly learning to confront one’s emotional reactions. This treatment process also focuses on the fragmented parts of self and object representations and this is changed by altering the distorted perceptions existing within the client. This therapeutic technique helps the client to reduce symptoms like impulsiveness, anger, intense and rapid emotional changes etc.
Object relations theory is a crucial component in the transference focused therapy which is a belief that human behaviour is largely a product of social interactions and relations rather than of biological urges and emotions. The nature of relationships we develop through childhood interactions determines our perception of self and others in our adult life as well. Patient with borderline personality disorder develops an unhealthy object representation during childhood which makes them experience a lack of coherence in their sense of self-identity as well as leads to irrational patterns of behaviour toward others. Thus, it’s necessary to address the recognition of internal factors and emotional states as part of the dysfunctional childhood relationships which need to be accepted. Building awareness regarding problematic behaviours is another crucial factor in transference focused therapy.
Transference focused psychotherapy is a type of traditional psychotherapeutic technique that has its roots in psychoanalytic theory. In TFP the patient explores how past experiences influence their present circumstances and is more focused on ‘here and now. The therapist uses reality testing as a part of an objective evaluation of a patient’s emotions which helps them assess their level of difficulties. The therapist also analyses the patient’s level of aggression and the type of defences they use in order to manage conflicting impulses. The therapist also looks at the client’s level of stability and consistency through their lifestyle and choices including values and interests, to assess their sense of internal stability. The moral code of the patient along with their understanding of role and purpose is also explored by the therapist to evaluate their level of self-acceptance. Lastly, psychoeducation is also used to set goals by slowly changing their destructive patterns of behaviour.
Transference focused therapy thus, cannot function without the active participation on the part of the client. The client needs to recognize, confront and accept the distortions regarding internal conflicts. This technique requires massive patience and some effort to integrate their thoughts about themselves and others in the environment. Over time, the patient grows the capacity to trust others in the environment and their aspects regarding self-reflection are enhanced which contributes to openly being able to regulate emotions and engage in healthier interactions.
– Urveez Kakalia & Debanjana Banerjee.