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Aggression in Personality Disorders and Perversions [Paperback]

Doctor (M.D.) Otto Kernberg M.D. (Author)
5.0 out of 5 stars  See all reviews (3 customer reviews)

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Book Description

September 27, 1995
In this important book, one of the world's foremost psychoanalysts explores the role of aggression in severe personality disorders and in normal and perverse sexuality, integrating new developments in psychoanalystic theory with findings from clinical work with severely regressed patients.

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Product Details

  • Paperback: 326 pages
  • Publisher: Yale University Press (September 27, 1995)
  • Language: English
  • ISBN-10: 0300065086
  • ISBN-13: 978-0300065084
  • Product Dimensions: 8.8 x 5.9 x 1 inches
  • Shipping Weight: 1.1 pounds (View shipping rates and policies)
  • Average Customer Review: 5.0 out of 5 stars  See all reviews (3 customer reviews)
  • Amazon Best Sellers Rank: #779,003 in Books (See Top 100 in Books)

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13 of 15 people found the following review helpful:
5.0 out of 5 stars a treasure trove of clinical wisdom, June 4, 2001
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This review is from: Aggression in Personality Disorders and Perversions (Paperback)
Kernberg brings his clinical acumen and unique blend of ego psychology and object relations to bear upon the problem of aggression, particularly rage and its cognitively higher-level manifestation as hatred, in severe personality disorders.

He begins by offering a sensible formulation of affect theory, a developmental model which the clinician can use as a checklist: when the patient approaches an area of emotional sensitivity, is his affect primitive and disorganized or evolved enough to appear as an emotion? Is the somatic component there? The cognitive? And, since affect involves an object, is the object relation there too? If not, how far from consciousness? What defenses protect it?

The book is organized into sections on the role of affects, developmental aspects of broad-spectrum personality disorders (not necessarily (thank God) in the DSM sense), clinical applications of object relations theory (discusses the transference, structural change, and other such considerations), technical approaches to severe regression, and the dynamics of sexual perversion.

In this last section, Kernberg mentions that per classic analytic thought, homosexuality = unresolved Oedipal conflict. The man who loves a man is actually submitting to dad and thereby failing to identify with him and grow up. Explaining that the biological and clinical evidence is not yet in, Kernberg states, honestly enough, that in his clinical experience few homosexual men fail to present significant character pathology. But would a psychologically mature homosexual want to do therapy to begin with, especially within a tradition known to see homosexuality as infantile? And if the "I've always been like this" explanation given by my clients is true--and I think it is--then how is one to entirely escape significant pathology while growing up gay in a homophobic society? Unfortunately, these questions are not addressed in this otherwise indispensable work.

An extra gift is the author's obvious willingness to see beyond even the most destructive behaviors to the sense and suffering at their core.

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6 of 6 people found the following review helpful:
5.0 out of 5 stars Excellent book on aggression, November 6, 2002
By 
Gregg Silk (Gaithersburg, MD) - See all my reviews
Excellent book, author is an expert in narcissistic defenses and agression, but other personality disorders are also well covered. Kernberg deserves credit because personality disorders are difficult to describe because they are so disorganized, dishonest, and chameleon-like. The analysis of aggression in relationships is valuable for people in many fields.

Kernberg provides wonderfully candid descriptions of his own negative or inappropriate feelings towards patients, cases where pateints refuse to cooperate with treatment, and cases where these patients manage to use hospital politics (!) to thwart treatment.

My initial impression was that there seemed to be a bit too much jargon and the subsequent hair-splitting. As I read it, time and again I summarized long paragraphs by jotting down 5 to 10 words in the margin. But he does so as part of thorough overview of difficult literature, and considering the amount of ground he covers, this book could have been much longer.

Odd he doesn't mention Facism, when the description of violent narcissistic sadists who embrace tyrants is so evocative of strutting Nazis. And his final chapters on perversion versus healthy sexual function is strikingly similar to Krafft-Ebing's "An Attempt to Explain Masochism," who reached their conslusions long before Freud and developed a clearer definition of healthy functioning than Freud.

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4 of 6 people found the following review helpful:
5.0 out of 5 stars The Infant and the Deviant, June 21, 2003
By 
Sam Vaknin (Skopje, Macedonia) - See all my reviews
(REAL NAME)   
Kernberg has arguably contributed more than anyone - even more than Kohut - to the understanding of borderline conditions and pathological narcissism.
He is both a formidable theoretician and an outstanding clinician. This - a small part of his prodigious and erudite output - is a detailed and scholarly study of the role played in the dynamics of relationships by narcissism, aggression - both self-directed (as in masochism) and other-directed (as in sadism) - and the resulting perversions. It is disturbing to learn how central the role of hatred, envy and other transformations of aggression is in relationships and in antisocial behavior. There is a direct path from regressive infantilism to psychosis and sexual deviance (and one may add to political oppression). This tome is one of the best anatomies of psychological defenses gone awry. Sam Vaknin, author of "Malignant Self Love - Narcissism Revisited".
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Inside This Book (learn more)
First Sentence:
Marjorie Brierley (1937) was the first to point to a strange paradox regarding the role of affects in psychoanalytic theory and practice. Read the first page
Key Phrases - Statistically Improbable Phrases (SIPs): (learn more)
patients with severe character pathology, neurotic personality organization, psychopathic transferences, depressive transferences, organized perversion, black mental health worker, other unit chiefs, sadistic superego precursors, preoedipal aggression, dominant object relation, pathological grandiose self, patients with borderline personality organization, infantile patients, psychotic nucleus, neurotic character pathology, preoedipal conflicts, erotic idealization, superego pathology, hysterical personality disorder, paranoid regression, malignant narcissism, masochistic pathology, internalized object relations, primitive transferences, unconscious object relations
Key Phrases - Capitalized Phrases (CAPs): (learn more)
San Francisco, Melanie Klein
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