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J Clin Psychol. 2008 Feb;64(2):195-206. doi: 10.1002/jclp.20452.

Supportive-expressive psychotherapy for comorbid personality disorders: a case study.

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Karolinska Institute.


Supportive-expressive psychotherapy (SEP) has generated some empirical evidence supporting its effectiveness for treating a variety of Axis I disorder; however, no evidence supporting its use for patients with severe personality disorders has been published. This article describes a patient suffering from several personality disorders-avoidant, obsessive-compulsive, paranoid, narcissistic, and antisocial--using the core conflictual relationship theme (CCRT) method. Supportive-expressive psychotherapy focuses on connecting the CCRT with symptoms and maladaptive personality traits, with the goal of resolving these conflicts. Most maladaptive traits for such a complex patient are ego-syntonic, not experienced as internal conflicts, and therefore not easily accessible to therapeutic exploration. Such a patient is likely to experience the external environment as hostile once his ego-syntonic wishes are not automatically granted and thus the therapeutic alliance may suffer. This article will show the interpersonal processes that are activated when a patient is treated with time-limited, manualized psychotherapy.

[Indexed for MEDLINE]

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