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Dive into the research topics where Diana Diamond is active.

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Featured researches published by Diana Diamond.


Journal of the American Psychoanalytic Association | 2009

The Interpretive Process in the Psychoanalytic Psychotherapy of Borderline Personality Pathology

Eve Caligor; Diana Diamond; Frank E. Yeomans; Otto F. Kernberg

While all patients become more concrete in their psychological functioning in areas of conflict, especially in the setting of transference regression, in the treatment of patients with severe personality pathology this process poses a particular clinical challenge. In the psychoanalytic psychotherapy of patients with severe personality pathology in general, and borderline personality disorder in particular, the interpretive process serves multiple functions. This process comprises a series of steps or phases that can be viewed as moving the patient further away from a single, poorly elaborated, and concrete experience in the transference, which dominates and floods subjectivity, and toward more fully elaborated, complex, stable, and integrated representations of the analyst and of what he or she evokes in the patients internal world.


Personality Disorders: Theory, Research, and Treatment | 2014

Attachment and Mentalization in Female Patients With Comorbid Narcissistic and Borderline Personality Disorder

Diana Diamond; Kenneth N. Levy; John F. Clarkin; Melitta Fischer-Kern; Nicole M. Cain; Stephan Doering; Susanne Hörz; Anna Buchheim

We investigated attachment representations and the capacity for mentalization in a sample of adult female borderline patients with and without comorbid narcissistic personality disorder (NPD). Participants were 22 borderline patients diagnosed with comorbid NPD (NPD/BPD) and 129 BPD patients without NPD (BPD) from 2 randomized clinical trials. Attachment and mentalization were assessed on the Adult Attachment Interview (AAI; George, Kaplan, & Main, 1996). Results showed that as expected, compared with the BPD group, the NPD/BPD group was significantly more likely to be categorized as either dismissing or cannot classify on the AAI, whereas the BPD group was more likely to be classified as either preoccupied or unresolved for loss and abuse than was the NPD/BPD group. Both groups of patients scored low on mentalizing, and there were no significant differences between the groups, indicating that both NPD/BPD and BPD individuals showed deficits in this capacity. The clinical implications of the group differences in AAI classification are discussed with a focus on how understanding the attachment representations of NPD/BPD patients helps to illuminate their complex, contradictory mental states.


Psychoanalytic Psychology | 2004

Attachment Disorganization: The Reunion of Attachment Theory and Psychoanalysis.

Diana Diamond

City College and The Graduate School and University Center of the City University ofNew York, New York Presbyterian Hospital—Weill Medical College of CornellUniversity, and New York UniversityThe author investigates the psychoanalytic implications of recent attachmentresearch on the disorganized attachment categoryin infants and theunresolvedfor trauma and loss adult attachment classification with which it has beenassociated. The author first reviews empirical findings on attachment disorga-nization and then explores the ways in which they are consistent with andilluminated by psychoanalytic concepts. The focus is on linkages between dis-organized attachment and Freud’s theoryof strain trauma and traumatic anxiety,Klein’s theoryof projective identification and the interplaybetween paranoid–schizoid and depressive anxieties in development, and Blatt’s theoryof psy-chological development as resulting from the interplayof anaclitic and intro-jective developmental lines. In so doing, this article contributes to the reunionbetween attachment theory and psychoanalysis.Manyof the ideas in this article have their roots in a series of dialogues that SidneyBlattand I had with attachment researchers while we were editing two issues of PsychoanalyticInquiry on the implications of recent attachment research for psychoanalysis. Much to our


Psychoanalytic Inquiry | 2013

Transference Focused Psychotherapy for Patients with Comorbid Narcissistic and Borderline Personality Disorder

Diana Diamond; Frank E. Yeomans; Barry L. Stern; Kenneth N. Levy; Susanne Hörz; Stephan Doering; Melitta Fischer-Kern; Jill Delaney M.S.W.; John F. Clarkin

Clinical experience involving the treatment of patients with comorbid borderline and narcissistic personality disorders suggests that this patient population is among the more difficult to treat within the personality disorder spectrum. In this article, we present refinements of Transference Focused Psychotherapy (TFP) based on our clinical experience with and research data on patients with comorbid narcissistic personality disorder/borderline personality disorder (NPD/BPD). We briefly review object relations formulations of severe narcissistic pathology, as well as recent research in attachment and the allied concept of mentalization, which have provided a new lens through which to view narcissistic disorders. The research findings from two randomized clinical trials demonstrating the efficacy and effectiveness of TFP are presented. The data from the two Randomized Clinical Trials (RCT) allowed for the study of the characteristics of the subgroup of borderline personality disorder patients who have comorbid NPD/BPD. Findings on comorbidity, attachment status, capacity for mentalization, and level of personality organization of borderline patients with comorbid NPD/BPD, compared with borderline patients without comorbid narcissistic pathology (BPD), are presented. Clinical implications of the observed group differences are discussed, with a focus on refinements in the technique of TFP. Clinical case material is presented to illustrate the specific challenges posed by narcissistic patients to carrying out TFP in each phase of treatment.


Psychoanalytic Psychology | 1989

Father-daughter incest: Unconscious fantasy and social fact.

Diana Diamond

This article examines the etiological role of incest as unconscious fantasy and incest as social fact in producing psychopathology


Contemporary Psychoanalysis | 2014

Change in Attachment and Reflective Function in Borderline Patients with and without Comorbid Narcissistic Personality Disorder in Transference Focused Psychotherapy

Diana Diamond; John F. Clarkin; Kenneth N. Levy; Kevin B. Meehan; Nicole M. Cain; Frank E. Yeomans; Otto F. Kernberg

Abstract Research has consistently found high rates of comorbidity between narcissistic personality disorder (NPD) and borderline personality disorder (BPD). Patients with this complex clinical presentation often present formidable challenges for clinicians, such as intense devaluation, entitlement, and exploitation. However, there is a significant gap in the literature in identifying the clinical characteristics of these NPD/BPD patients. In this article, we present recent research describing patients with comorbid NPD/BPD, as compared with patients with BPD without NPD (BPD), from two randomized clinical trials for the treatment of borderline personality disorder, with a particular emphasis on attachment status and mentalization. We anchor our discussion of these patients in object relations and attachment theory, and we describe our treatment approach, transference focused psychotherapy (TFP). We conclude by using case material to illustrate our research findings, highlighting the significant differences between patients with NPD/BPD and BPD/non-NPD in terms of their attachment classification.


Journal of Clinical Psychology | 2013

Attachment and Object Relations in Patients With Narcissistic Personality Disorder: Implications for Therapeutic Process and Outcome

Diana Diamond; Kevin B. Meehan

This article presents a therapeutic approach for patients with severe personality disorders, transference-focused psychotherapy (TFP), a manualized evidence-based treatment, which integrates contemporary object relations theory with attachment theory and research. Case material is presented from a narcissistic personality disorder (NPD) patient in TFP whose primary presenting problems were in the arena of sexuality and love relations, and whose attachment state of mind showed evidence of oscillation between dismissing and preoccupied mechanisms. Clinical process material is presented to illustrate the tactics and techniques of TFP and how they have been refined for treatment of individuals with NPD. The ways in which conflicts around sexuality and love relations were lived out in the transference is delineated with a focus on the interpretation of devalued and idealized representations of self and others, both of which are key components of the compensatory grandiose self that defensively protects the individual from an underlying sense of vulnerability and imperfection.


Journal of the American Psychoanalytic Association | 2008

EMPATHY AND IDENTIFICATION IN VON DONNERSMARCK'S THE LIVES OF OTHERS

Diana Diamond

Florian Henckel von Donnersmarcks The Lives of Others, set in the German Democratic Republic in 1984, five years before the fall of the Berlin Wall, has been called the first accurate depiction of the psychological terror wielded by the Stasi, the East German secret police, who safeguarded the dictatorship of the proletariat. The film is about the psychological and political transformation of a Stasi officer, Wiesler, who undertakes the surveillance of a prominent playwright and his actress lover. The mechanisms through which Wiesler comes to empathize and identify with the subjects of his investigation, as he observes and listens in on the rich blend of passion, poetry, and politics that characterizes their lives, are explored in depth. Wieslers transformation is based in part on the capacity to form implicit models of the behavior and experiences of others, based on the mirror neuron system, that Gallese and his colleagues call “embodied simulation.” Underpinning the processes of empathy and identification so central to this film, embodied simulation is an unconscious and prereflexive mechanism through which the actions, emotions, and sensations we observe activate internal representations of the bodily and mental states of the other. Embodied simulation also expands our understanding of the power of the primal scene, which has long been identified as a major organizer of unconscious fantasies and conflicts throughout life, and which forms the central metaphor of the film. Embodied simulation scaffolds our aesthetic response to art, music, and literature, underlies the dynamics of spectatorship, and potentially catalyzes resistance to totalitarian mass movements.


Archive | 2013

Transference-focused psychotherapy for narcissistic personality.

Barry L. Stern; Frank E. Yeomans; Diana Diamond; Otto F. Kernberg

The authors outline the application of Transference-Focused Psychotherapy (TFP), a structured, twiceweekly psychoanalytic psychotherapy, to patients with narcissistic pathology. The operation of splittingbased defenses in the maintenance of the pathological grandiose self that is characteristic of individuals with narcissistic personality disorders is described, as are the obstacles posed by this structure to therapists attempting to establish a viable treatment frame and engage patients in the early treatment process. The narcissistic patient’s difficulty tolerating the interpretive process in psychoanalytic psychotherapy is formulated based on the ideas of several writers in the modern Kleinian tradition as well as contemporary object relations theory. An extended case discussion illuminates the foregoing, and several modifications related to tact and timing, drawn from various analytic sources, are outlined to enhance the interpretive process in TFP.


Studies in Gender and Sexuality | 2009

The Fourth Wave of Feminism: Psychoanalytic Perspectives

Diana Diamond

The discussion focuses on the ways in which the 3 panelists in their lives and work embody fourth wave feminism, which combines politics, psychology, and spirituality in an overarching vision of change. Jane Fondas emphasis on the importance of making narratives of gender a central organizer for personal and societal transformation, Hedda Bolgars insistence that psychoanalysts recognize the complex dialectic between unconscious dynamics and sociocultural realities in order not to conflate conflicts rooted in social inequalities with individual issues, and Sue Shapiros understanding of the ambiguous role of individual therapy in situations of historical and social trauma such as the tsunami in Indonesia are all examples of fourth wave feminism in practice. The unfinished business of the first 3 waves of feminism—that is, the inequalities that persist in the political and personal spheres—are discussed with the idea that these unfinished agendas will contribute to the fourth wave, in which social action and spiritual/psychological practice converge.

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Kenneth N. Levy

City University of New York

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Jeri A. Doane

University of California

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