Possible triggers: The article mentions clients provoking angry feelings in the therapist and other things that might upset some people. Sorry, it was a long time ago when I first read this.

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Posted a part of this article for someone else who asked about medications for Borderline and thought it might be useful for a new thread. This author is pretty good; I've read some of his other stuff.

PsychiatryOnline | FOCUS: The Journal of Lifelong Learning in Psychiatry | Psychodynamic Approaches to Personality Disorders

There is discussion about countertransference, resistance, defense mechanisms, and other things we talk about on here.

A growing body of research confirms that psychodynamic/psychoanalytic psychotherapy is efficacious in the treatment of personality disorders (21).

CLINICAL SYNTHESIS | July 01, 2005
Psychodynamic Approaches to Personality Disorders
Glen O. Gabbard, M.D.
FOCUS 2005;3:363-367.

It's brief, but there are links to other articles at the end.

[archipelago]

Thanks for posting this. There are lots of people who believe that psychodynamic or psychoanalytically informed approaches are not "evidence based" and are next to useless. It is very hard to get them to open their minds. There is evidence, it is just not usually in the forms that other kinds of research produces.

There is research that suggests that a psychodynamic approach has longer lasting and deeper effect than DBT for BPD, even though most people assume that DBT is the only treatment for BPD.

[ThisWayOut]

I will have to look into that, as I detest DBT (too much like my f.o.o. environment to be able to be meaningful to me). As much as I hate the bpd lable, I get it often, so I might as well look into this thing

[doyoutrustme]

I like the psychodynamic approach. The changes I have made are lasting, because I grew into the new habits rather than trying to force myself to change and hope my heart catches up.

[Depletion]

Thanks for the article, very interesting stuff. I'm always hopping that my T pays attention to her countertransference but I'm not really sure if she cares about it or not because she's eclectic, although she did mention that she is some what psycodynamic when we started. I kind of wish I could ask her but I don't know, it feels kind of invasive.

On another note it always nice to see these kind of research articles that support a particular therapeutic method, but I wish the article would be more clear about why it thinks it's approach works.

[archipelago]

The part I read, and maybe this was not the main article but in the notes, did explain why a psychoanalytically informed approach works with personality disorders. Overall people think it is because this approach (and there are many forms of it) generally focuses on characterological change, not just behavioral change.

But more specifically the idea is that in personality disorders the kinds of defenses seen are well explained by Object Relations, which holds that people internalize early relations as parts of their psychic structure and then later replay these early, usually dysfunctional relations. Since psychoanalytic approaches attend to what is played out between the client and therapist in terms of transference/countertransference, it is equipped to detect and then attend to these projections of early dysfunctional ways of acting and relating. That is very basic but the general idea of it.

I changed the thread title so that maybe we can make a thread about psychodynamic psychotherapy evidence. Feel free to add articles and links.

There are a lot more out there. I'll come back to this thread later but right now have to quit procrastinating at stuff that needed done a week ago.

eta
That didn't work. The title changes in the posts, but not on the main thread.

[archipelago]

Here is a passage from an article by Shedler that surveys all the research on psychodynamic. This part is about personality disorders.

Findings concerning personality disorders are particularly intriguing. A recent study of patients with borderline personality disorder ( Clarkin, Levy, Lenzenweger, & Kernberg, 2007) not only demonstrated treatment benefits that equaled or exceeded those of another evidence-based treatment, dialectical behavior therapy ( Linehan, 1993), but also showed changes in underlying psychological mechanisms (intrapsychic processes) believed to mediate symptom change in borderline patients (specifically, changes in reflective function and attachment organization; Levy et al., 2006). These intrapsychic changes occurred in patients who received psychodynamic therapy but not in patients who received dialectical behavior therapy.
Such intrapsychic changes may account for long-term treatment benefits. A newly released study showed enduring benefits of psychodynamic therapy five years after treatment completion (and eight years after treatment initiation). At five-year follow-up, 87% of patients who received “treatment as usual” continued to meet diagnostic criteria for borderline personality disorder, compared with 13% of patients who received psychodynamic therapy ( Bateman & Fonagy, 2008). No other treatment for personality pathology has shown such enduring benefits.

Originally Posted by ThisWayOut

I will have to look into that, as I detest DBT (too much like my f.o.o. environment to be able to be meaningful to me). As much as I hate the bpd lable, I get it often, so I might as well look into this thing

People are often misled into believing that DBT is the only treatment for bpd. Glad you are looking into it.

Originally Posted by archipelago

Here is a passage from an article by Shedler that surveys all the research on psychodynamic. This part is about personality disorders.

Findings concerning personality disorders are particularly intriguing. A recent study of patients with borderline personality disorder ( Clarkin, Levy, Lenzenweger, & Kernberg, 2007) not only demonstrated treatment benefits that equaled or exceeded those of another evidence-based treatment, dialectical behavior therapy ( Linehan, 1993), but also showed changes in underlying psychological mechanisms (intrapsychic processes) believed to mediate symptom change in borderline patients (specifically, changes in reflective function and attachment organization; Levy et al., 2006). These intrapsychic changes occurred in patients who received psychodynamic therapy but not in patients who received dialectical behavior therapy.
Such intrapsychic changes may account for long-term treatment benefits. A newly released study showed enduring benefits of psychodynamic therapy five years after treatment completion (and eight years after treatment initiation). At five-year follow-up, 87% of patients who received “treatment as usual” continued to meet diagnostic criteria for borderline personality disorder, compared with 13% of patients who received psychodynamic therapy ( Bateman & Fonagy, 2008). No other treatment for personality pathology has shown such enduring benefits.

Here's where you can find the original article that Archipelago quoted here:

Writings | Jonathan Shedler, PhD

The efficacy of psychodynamic psychotherapy.
Shedler J.
Am Psychol. 2010 Feb-Mar;65(2):98-109.

[archipelago]

Thanks, skies. I am so used to people doubting that it is a very pleasant surprise to see someone supporting and bothering to look up the exact reference and post a link. I have the article and am not good at posting links or tracking all this down.

It's a thorough and powerful article. It just doesn't cover research data in a boring way. He actually lists qualities or techniques that originate in psychoanalysis that are "borrowed" by other approaches though no one really acknowledges that. So bitter fights say between analytic types and behavioral types break out, when no one really knows what all the terms are that people are fighting about. This article makes a lot of that very clear so even if you end up not choosing psychodynamic therapy, you have a list of specific things that therapists do that work.

I am so used to people doubting that it is a very pleasant surprise to see someone supporting and bothering to look up the exact reference and post a link.

Tell me about it.

I came across that article a long time ago, so I've been sort of a 'fan' of Jonathan Shedler for some time now. I guess I am invested in sharing this information because no one ever told me this stuff, and I definitely feel I did not receive the appropriate treatment for a number of years.

Not getting the appropriate treatment has adversely impacted my life. I didn't get into the right type of therapy until I was in my late 30's, which is why I sometimes positively comment about people on this forum who are in treatment at a young age.

If someone benefits from taking the time to read some of this information, then it's all good.

[feralkittymom]

I'm on my netbook just now which freezes too often to do much serious searching, but R.F. Summers and J.P. Barber, together and separately, have written extensively on psychodynamic approaches in an evidence-based manner for personality disorders, depression, PTSD, etc.

[archipelago]

I appreciate the information. I'll look them up since I haven't come across their names before. I know there is a group out of Boston that does research as well. And Fonagy has done an RCT on psychodynamic treatment of personality disorders. There are also two related areas: attachment and infant neuroscience. These are both used in current psychoanalytic therapy approaches and have lots of research support.

There is also this:
Leichsenring, F, and S Rabung. 2008. Effectiveness of Long-term Psychodynamic Psychotherapy:A Meta-analysis. JAMA 300 (13). 1551-1565.
Effectiveness of Long-term Psychodynamic Psychotherapy: A Meta-analysis

I found it interesting since I'm in long-term psychodynamic therapy myself.