Transferencefocused

Transference-focused psychotherapy (TFP) is a manualized psychodynamic treatment for personality disorders, most notably borderline personality disorder (BPD). Developed by Otto Kernberg and colleagues in the 1980s, it uses the patient–therapist relationship as a window into the patient’s internal world. Grounded in object relations theory, TFP emphasizes mental representations of self and others, including splits, idealization, and devaluation, that shape behavior and affect.

TFP centers on analyzing the transference—the patient’s recurrent feelings, expectations, and defenses projected onto the analyst. Sessions are structured to reveal and interpret these patterns, with the aim of reducing rigid defenses, integrating fragmented self-representations, and improving affect regulation and reality testing. Therapists maintain a stance that is both empathic and interpretive, remaining vigilant for countertransference and focusing on the therapeutic alliance as a diagnostic and therapeutic instrument. The approach is typically time-limited, commonly 1 to 2 years, with intensive scheduling in the initial phase.

Indications and goals: TFP is primarily used for adults with BPD and may be applied to other severe personality disorders. Goals include reducing symptom severity, improving interpersonal functioning, increasing affect tolerance, and promoting greater unity of self-organization.

Evidence and context: Research indicates that TFP can reduce borderline symptoms, improve personality functioning, and lessen self-harm, though evidence is more limited in scope compared with dialectical behavior therapy in some domains. TFP requires substantial clinician training in psychodynamic technique and is resource-intensive, making it a demanding option within the spectrum of structured psychodynamic therapies.