By Marshall L. Silverstein
During this thought-provoking publication, Marshall L. Silverstein applies a self mental point of view, as formulated and broadened through Kohut, to figuring out character issues. He recasts them as problems of the self, grouping them into one in every of 3 styles, centering on (1) scuffling with devitalization, (2) forestalling fragmentation, or (3) looking replacement pathways to a cohesive self. He describes every one workforce and descriptions its major theoretical viewpoints, then deals a self mental reformulation of the way the habit and symptom styles characterize deficits in self-cohesion. within the first deficit development, devitalization (in schizoid, schizotypal, and avoidant character disorders), the patient's crucial challenge is protecting power while the necessity for confirmation or admiration has been missed or insufficiently stated. ordinarily, those sufferers withdraw from or react aversively to these round them, elimination themselves from probably painful rebuffs. the second one development (in paranoid, obsessive-compulsive, and borderline character problems) represents makes an attempt to prevent fragmentation. Such sufferers harbor fears that their fragile self-cohesion may possibly come undone and so they construct their lives round safeguarding themselves opposed to threats to their intactness. within the 3rd development (in based, histrionic, and delinquent character disorders), sufferers test yet usually fail to increase compensatory buildings to fix their chronically injured self-cohesion. Dr. Silverstein additionally considers 3 disturbances no longer categorized as character problems within the DSM-IV nomenclature: depressive character, somatization, and the vertical break up. This thoughtfully ready quantity, the 1st to systematically follow this theoretical framework to this huge crew of problems, bargains readers precious insights into how undermined self-cohesion compromises patients' day-by-day functioning.
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Extra resources for Disorders of the Self: A Personality-guided Approach (Personality-Guided Psychology)
Sample text
Such disturbances do not preclude other forms of psychopathology, including comorbid Axis I syndromes and Axis II personality disorders. Comorbid disorders may represent depressive, anxious, impulsive, aggressive, or other symptomatic perturbations of an underlying self disorder. The narcissistic behavior disorders in particular may resemble Axis I and Axis II disorders characterized by perversions (sexualizations) of painful affect states, addictions, delinquency, or propensity for intense outbursts of helpless anger (narcissistic rage).
Rageful reactions (narcissistic rage) are often apparent that represent the anger resulting from rebuffed expectations of affirming selfobject responsiveness from others. Narcissistic rage, if pronounced and widespread, may signal fragmenting self-cohesion, here understood as the breakdown (disintegration products) of a devitalized, underpowered self. Disintegration products may also take the form of addictions or perversions, which function to momentarily shore up the self. When insufficient mirroring is prolonged during early development, the ensuing injuries to young children's normal prideful strivings derail their hopes for themselves, frequently leading to devitalization.
Experiences of empty depression and lack of purpose or enthusiasm may ensue when normal mirroring, idealization, or twinship selfobject needs become mobilized and then are thwarted. Empathic failures of normal selfobject responsiveness typically imply that a caregiver providing selfobject functions failed to recognize and appreciate that a normal need had emerged, one that could not be overlooked or ignored but that instead needed to be accepted enthusiastically (M. Tolpin, 1978; M. Tolpin & Kohut, 1980).
