Disorders of the Self

Book excerpt: A testament to the vitality of the Masterson Approach to the study and treatment of the disorders of the self, this incisive volume documents the evolution of Masterson's theoretical and clinical work during the past five years. It is comprised of writings by a second generation of clinicians who both carry on and expand the horizons of the Masterson Approach. Disorders of the Self addresses four new areas of great clinical importance from the perspective of developmental, self, and object relations theory. First, Ralph Klein, Clinical Director of the Masterson Institute), has combined the work of Fairburn and Guntrip with the Masterson Approach to develop and updated, broader, original and clinically useful concept of the Schizoid Disorders of the Self. The force of his approach is illustrated by the focus on the schizoid dilemma and the schizoid compromise, vividly depicted with detailed clinical applications. Candace Orcutt, Senior Faculty Member in the Masterson Institute, along with a colleague, then apply the Masterson Approach to the controversial topic of early abuse - physical and/or sexual - to the developing self. Diagnosis and treatment of narcissistic pathology is the focus of section three. Chapters further refine and expand how the disorders of the self triad - self activation leads to anxiety and depression which lead to defenses - operate in both the patient's life and in the therapeutic relationship. The authors identify and illustrate critical points in treatment, detail the technical approach to the closet narcissistic personality disorder, and address the therapeutic management of devaluation and disappointment reactions along with the countertransference reactions they evoke. The volume concludes by delving into arenas beyond individual psychotherapy for disorders of the self. An innovative approach to group therapy combines the Masterson Approach with that of W. Bion, and authors examine the complexities of drug therapy and comorbidity and their interaction with psychodynamic forces. Disorders of the Self will be a vital addition to the armamentarium of any clinician who works with personality disorders. It demonstrates the continued expansion and evolution of a profound theoretical and clinical paradigm - the Masterson Approach - aimed at penetrating and healing the disorders of the self.