This course covers the diagnosis and treatment of personality disorders. Personality disorders represent a complex and often misunderstood category within the field of mental health. These conditions, characterized by enduring patterns of cognition, emotion, and behavior, can significantly impact an individual's life, relationships, and overall well-being. Understanding personality disorders is crucial for mental health professionals.

DATE CREATED: September to December 2023

COURSE LEARNING OBJECTIVES:

1. Identify and describe the prevalence of Borderline Personality Disorder (BPD) in both the general population and psychiatric care settings.
2. Explain and illustrate the core psychodynamic traits of BPD, including black-and-white thinking and conflicted self-perceptions.
3. Apply the key principles of psychodynamic treatment for BPD in clinical practice, focusing on patient selection, boundaries, and managing transference and countertransference.
4. Describe and interpret the essential qualities necessary for patients to benefit from long-term psychotherapy in the context of BPD.
5. Develop and demonstrate strategies to navigate patient regressions, resistance, and fears while promoting emotional growth and self-discovery in therapy for BPD.
6. Differentiate and categorize examples of "healthy" narcissism and "pathological" narcissism in clinical contexts.
7. Identify and describe the specific challenges in treating Narcissistic Personality Disorder (NPD), integrating this knowledge into clinical practice.
8. Examine and summarize the key elements and stages of transference-focused psychotherapy for NPD, aiming to apply these concepts in clinical settings.

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PART 1
CLINICAL UPDATE
Understanding Borderline Personality Disorder: A Closer Look at Psychodynamic Approaches
September 28, 2023
Mark L. Ruffalo, MSW, DPsa
Editor in Chief, The Carlat Psychotherapy Report. Psychotherapist in private practice in Tampa, Florida. Instructor of Psychiatry at the University of Central Florida College of Medicine and Adjunct Instructor of Psychiatry at Tufts University School of Medicine.
Dr. Ruffalo has no financial relationships with companies related to this material.
Review Full Editorial Information

After reading this article, you should be able to:

1. Identify and describe the prevalence of Borderline Personality Disorder (BPD) in both the general population and psychiatric care settings.
2. Explain and illustrate the core psychodynamic traits of BPD, including black-and-white thinking and conflicted self-perceptions.
3. Apply the key principles of psychodynamic treatment for BPD in clinical practice, focusing on patient selection, boundaries, and managing transference and countertransference.

Read the article here.

References in order of appearance in this article

Leichsenring F, Heim N, Leweke F, Spitzer C, Steinert C, Kernberg OF. Borderline Personality Disorder: A Review. JAMA. 2023;329(8):670-679. doi:10.1001/jama.2023.0589

Zimmerman M et al, Rothschild L, Chelminski I. The prevalence of DSM-IV personality disorders in psychiatric outpatients. Am J Psychiatry. 2005;162(10):1911-1918. doi:10.1176/appi.ajp.162.10.1911

Zimmerman, M., Rothschild, L., & Chelminski, I. (2005). The prevalence of DSM-IV personality disorders in psychiatric outpatients. The American journal of psychiatry, 162(10), 1911–1918. https://doi.org/10.1176/appi.ajp.162.10.1911

Paris J. (2019). Suicidality in Borderline Personality Disorder. Medicina (Kaunas, Lithuania), 55(6), 223. https://doi.org/10.3390/medicina5506022 

Soeteman, D. I., Hakkaart-van Roijen, L., Verheul, R., & Busschbach, J. J. (2008). The economic burden of personality disorders in mental health care. The Journal of clinical psychiatry, 69(2), 259–265. https://doi.org/10.4088/jcp.v69n0212

Clarkin, J. F., Levy, K. N., Lenzenweger, M. F., & Kernberg, O. F. (2007). Evaluating three treatments for borderline personality disorder: a multiwave study. The American journal of psychiatry, 164(6), 922–928. https://doi.org/10.1176/ajp.2007.164.6.922

Clarkin JF, Meehan KB, De Panfilis C, Doering S. Empirical Developments in Transference-Focused Psychotherapy. Am J Psychother. 2023;76(1):39-45. doi:10.1176/appi.psychotherapy.20220017

Stern B, Yeomans, F. The concept of personality disorders in general and borderline personality disorder. Accessed July 23, 2023. https://borderlinedisorders.com/borderline-personality-disorder-overview.php

McWilliams N. Psychoanalytic Diagnosis: Understanding Personality Structure in the Clinical Process. 2^nd ed. Guilford; 2011.

Kernberg OF, Selzer, MA, Koenigsberg, HW, Carr AC, Applebaum AH. Psychodynamic Psychotherapy of Borderline Patients. Basic Books; 1989.

Stone M. H. (2016). Long-Term Course of Borderline Personality Disorder. Psychodynamic psychiatry, 44(3), 449–474. https://doi.org/10.1521/pdps.2016.44.3.449

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PART 2
EXPERT Q&A
Treating Severe Personality Disorders in Psychotherapy
November 29, 2023
Dan H. Buie, MD 
At the time of this interview, Dr. Buie was a psychiatrist, psychoanalyst, and associate professor of psychiatry at Tufts Medical School, Boston, MA. He has since passed away.

Interview by Marcia L. Zuckerman, MD.
Board member of The Carlat Psychiatry Report; outpatient psychiatrist, Tufts Community Counseling, Medford, MA, and in private practice; clinical assistant professor in psychiatry, Tufts School of Medicine. 

Dr. Buie had no disclosures. Dr. Zuckerman has no disclosures with companies related to this material. 

Review Full Editorial Information

After reading this article, you should be able to:

1. Describe and interpret the essential qualities necessary for patients to benefit from long-term psychotherapy in the context of BPD.
2. Develop and demonstrate strategies to navigate patient regressions, resistance, and fears while promoting emotional growth and self-discovery in therapy for BPD.

 Read the article here.

References in order of appearance in this article

Markowitz JC. Supportive Evidence: Brief Supportive Psychotherapy as Active Control and Clinical Intervention. Am J Psychother. 2022;75(3):122-128. Doi:10.1176/appi.psychotherapy.2021.20210041

Stone MH. Long-Term Course of Borderline Personality Disorder. Psychodyn Psychiatry. 2016;44(3):449-474. Doi:10.1521/pdps.2016.44.3.449 

Li W, Lai W, Guo L, et al. Childhood maltreatment and subsequent depressive symptoms: a prospective study of the sequential mediating role of self-esteem and internalizing/externalizing problems. BMC Psychiatry. 2023;23(1):179. Published 2023 Mar 20. doi:10.1186/s12888-023-04654-7

McWilliams N. Psychoanalytic Diagnosis: Understanding Personality Structure in the Clinical Process. 2^nd ed. Guilford; 2011.

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PART 3
CLINICAL UPDATE
Navigating Narcissistic Personality Disorder
December 4, 2023
Frank Yeomans, MD, PhD
Adjunct Associate Clinical Professor of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons. Psychiatrist in private practice.
Dr. Yeomans has no financial relationships with companies related to this material.
Review Full Editorial Information

After reading this article, you should be able to:

1. Differentiate and categorize examples of "healthy" narcissism and "pathological" narcissism in clinical contexts.
2. Identify and describe the specific challenges in treating Narcissistic Personality Disorder (NPD), integrating this knowledge into clinical practice.
3. Examine and summarize the key elements and stages of transference-focused psychotherapy for NPD, aiming to apply these concepts in clinical settings.

Read the article here.

References in order of appearance in this article:

Kampe L, Bohn J, Remmers C, Hörz-Sagstetter S. It's Not That Great Anymore: The Central Role of Defense Mechanisms in Grandiose and Vulnerable Narcissism. Front Psychiatry. 2021;12:661948. Published 2021 Jun 11. doi:10.3389/fpsyt.2021.661948

Monaghan C, Bizumic B. Dimensional models of personality disorders: Challenges and opportunities. Front Psychiatry. 2023;14:1098452. Published 2023 Mar 7. doi:10.3389/fpsyt.2023.1098452

Kealy D, Laverdière O, Pincus AL. Pathological Narcissism and Symptoms of Major Depressive Disorder Among Psychiatric Outpatients: The Mediating Role of Impaired Emotional Processing. J Nerv Ment Dis. 2020;208(2):161-164. doi:10.1097/NMD.0000000000001114

Tanzilli A, Muzi L, Ronningstam E, Lingiardi V. Countertransference when working with narcissistic personality disorder: An empirical investigation. Psychotherapy (Chic). 2017;54(2):184-194. doi:10.1037/pst0000111

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CE CREDIT: 1 general

FEES: $20 for single activity, $79 for Annual subscription including additional materials

REFUND POLICY: purchasers and subscribers may cancel at any time for a full refund if not completely satisfied.

Course interaction
This reading-based online course is self-paced/non-interactive. Course questions can be directed to the author by email: asktheeditor@thecarlatreport.com. After purchase, login to the website here: https://www.thecarlatreport.com/user/login, enter your profile by clicking “welcome, [your first name] in the top right, and then choose the “purchased materials” tab on your profile. This course material will be accessible using the “view content” link to the right of the title.

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Course completion & CE info Course completion requirements
To earn CE credit, social workers must purchase access, read the material, and complete the posttest (with a passing score of 80%) and course evaluation. Posttests may be retaken one time.

Certificates of completion will be emailed upon course completion.

The Carlat CME Institute, #1908, is approved as an ACE provider to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Regulatory boards are the final authority on courses accepted for continuing education credit. ACE provider approval period: April 30, 2024 to April 30, 2025. Social workers completing this course receive 1 general continuing education credits.

For questions, concerns, or to request special accommodations, please call: 866-348-9279

Course Topic: Diagnosis and treatment of personality disorders
Course Date: Starting May 1, 2024
CE Credit Type: Enduring material - General CE
TARGET AUDIENCE: Social Workers