Overview

The book seeks to translates Kleinian object relations theory and practice and Bionian theory of thinking into cognitive and behavioral concepts and application to treat mild and moderate borderline patients. The author breaks down the Kleinian paranoid-schizoid and depressive positions into seven stages to help therapists identify, process and target core clinical components of the two stages. The Kleinian and Bionian concepts and practices are also translated into concrete unfulfilled physical, emotional and social needs of the infant/child so that the therapist can identify, process and meet these specific needs of the patient in the clinical settings. To help the therapist and patient assess, monitor and determine the target of treatment, DSMV diagnostic criteria is employed during each of the seven stages along with other short measures. The therapist seeks to first identify, process and regulate the patient's persecutory anxiety and consequent splitting and projection by helping them reclaiming them as their own. Patients then begin to introject the goodness of the significant other by to regulating their envious attacks on their dependency and hate of the other. By reducing their envy and hate, they are now able to learn about love from the other which helps them to bring together the split bad and good parts of the other together in their mind. They are now ready to integrate the bad and good parts of the other and their own as not two separate parts but that of the whole person. The hateful and loving parts of the other as well as themselves are the same person. They are now ready to face the ambivalence between love for the other, and hate for their independence of them. As they do so, they begin to face their aggression by showing concern for the other. They feel guilty and remorse for the hurt and damage they have inflicted upon the very person they love and mourn for the loss. The ensuing sadness and yearning leads to recalling the goodness of the other, and feelings genuine gratitude and urge to repair and restore the damaged others. Repeated internal and emotional processes of repairing and restoration leads to symbol formation - the process of substitution the hate and destruction of the loved object with more benign objects. Symbol formation leads to higher levels of cognition and affectivity that facilitates sublimation. Unprocessed negative emotions are sublimated into constructive activities such as exercising, painting, meditating, writing and so on. Sublimation lays the groundwork for creativity - the process of translation sublimated activated into patterns and flow. It is no longer about just writing or painting as an activity but more about the flow of what is written and painted. It is no longer about just watching your breath to relax but more to be at onement with the flow of the breath.

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9781638485278

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Lobsang Rapgay is a clinical psychologist, Research Scientist and Adjunct Assistant Professor in the Department of Psychiatry, UCLA and Adjunct Associate Professor in Psychology, Department of Psychology, UNCW. He started his career as a clinical instructor in the Department of Behavioral Medicine, Beth Israel Hospital, Harvard Medical School and then as a staff psychologist, and then Assistant Clinical Professor and Director of the UCLA Behavioral Medicine Clinic - training center for psychiatric residents, and psychology externs. He then shifted to research in studying the neural and behavioral correlates of working memory in anxiety.He was a Tibetan Buddhist monk for 18 years and versed in Tibetan Buddhist theory and practice. He maintains a clinical practice in West Los Angeles.

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