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

Area of Science:

• Psychology
• Psychotherapy Research

Background:

• Supportive-expressive psychotherapy (SEP) has demonstrated efficacy for Axis I disorders.
• Limited evidence exists for SEP's application in severe personality disorders.

Observation:

• This case study details a patient with multiple personality disorders (avoidant, obsessive-compulsive, paranoid, narcissistic, antisocial).
• The core conflictual relationship theme (CCRT) method was employed to explore the patient's interpersonal patterns.
• Ego-syntonic maladaptive traits presented challenges, as they were not perceived as internal conflicts.

Findings:

• SEP aims to link CCRTs with symptoms and personality traits for conflict resolution.
• Patients with severe personality disorders may perceive external hostility when their ego-syntonic wishes are unmet.
• The therapeutic alliance can be strained due to these interpersonal dynamics.

Implications:

• This article elucidates interpersonal processes within time-limited, manualized psychotherapy for complex patients.
• Understanding these dynamics is crucial for adapting SEP to severe personality disorders.
• Further research is needed to validate SEP's effectiveness in this population.