The Fragmented Personality

This book pioneers a new model of personality disorder primarily intended to serve mental health professionals, those already in practice and equally those in training. In contrast to the static concepts of mental normalcy and pathology, the presented nosology is dynamic (accounts for the reversibility of mental functioning) and personalized, context- and time sensitive. In a 3D diagnostic cylinder, the coordinates cross match the person’s common level of mental functioning (vertical diagnosis) with his or her behavior style (horizontal diagnosis) at a point in space and a unit of time, giving the clinician precise milestones to monitor changes in diagnosis and progress in therapy. The central problem with persons suffering from personality disorder does not rest in their extreme behaviors but rather underneath the surface, in the fragmented substrate of personality (a core deficit sine qua non shared by all individual variants), while extreme behaviors merely represent variable compensatory strategies. Based on this model, mechanism-based treatments are outlined: reconstructive interpersonal psychotherapy (a novel, integrative, transtheoretical approach which relies on psychoanalytic and humanist traditions) and mechanism-based pharmacotherapy of neurobiological vulnerabilities associated with excessive temperament traits.