Borderline personality disorder and Transference-Focused Psychotherapy
Borderline personality disorder describes people whose emotions, relationships and sense of self are unstable in a way that causes real suffering: intense attachments that turn into rage or despair, a shifting sense of who one is, impulsive or self-destructive acts, a chronic feeling of emptiness. It is treatable, and many people improve substantially with the right psychotherapy.
Transference-Focused Psychotherapy
TFP is a structured psychodynamic treatment developed by Otto Kernberg and colleagues at Weill Cornell specifically for borderline personality organization. It begins with a clear treatment contract — frequency, responsibilities, how crises are handled — and then works with the patterns that appear in the relationship with the therapist, where the split images of self and others that drive so much distress can be seen, understood and integrated. TFP has been tested in randomized trials, with improvements in self-destructive behavior, anger and overall functioning.
Dr. Bernardi is listed with TFP New York. Clinicians who want to train in TFP can find the Columbia program, where she teaches, here.
Dr. Bernardi trained in the Kernberg tradition, practices TFP, and teaches and supervises it for other clinicians. She writes regularly for the International Society of Transference-Focused Psychotherapy (ISTFP), including an annual review of the research evidence for TFP and an article on supervision. See Teaching and talks.
The role of medication
Medication can help specific targets — a co-occurring depression, severe anxiety, sleep — and we are as careful about removing medications that are not helping as about adding new ones.
Who this is for
Adults with borderline personality disorder or borderline features; people whose relationships keep ending in the same way; patients who have been through several therapies and want a treatment with a clear structure.
Questions
What is Transference-Focused Psychotherapy?
TFP is a manualized psychodynamic psychotherapy developed by Otto Kernberg and colleagues for borderline personality disorder. It uses a clear treatment contract and works with the patterns that emerge in the patient–therapist relationship to integrate unstable views of self and others.
Is borderline personality disorder treatable?
Yes. Specialized psychotherapies such as TFP and DBT lead to meaningful improvement for many patients, and symptoms often decrease substantially over time.
Where can I find TFP in New York?
Dr. Silvia Bernardi offers Transference-Focused Psychotherapy in Midtown Manhattan and the Financial District, and by telehealth for patients in New York, Florida and Milan.
Related reading
MIND FIRST sees patients in Midtown Manhattan (Grand Central) and the Financial District, and by telehealth for patients located in New York, Florida or Milan. Dr. Bernardi is licensed to practice medicine in New York, Florida and Italy.
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