Otto F. Kernberg

Otto Friedmann Kernberg (Template:IPA; born 10 September 1928) is an Austrian-born American psychoanalyst and professor of psychiatry at Weill Cornell Medicine, known for developing transference-focused psychotherapy (TFP). He is recognized internationally for his contributions to the psychoanalytic theories on borderline personality organization and narcissistic pathology.<ref name="MitchellBlack1995">Mitchell, S. A., & Black, M. J. (1995). Freud and Beyond: A History of Modern Psychoanalytic Thought. New York: Basic Books, pp. 199–212.</ref><ref name="Lunbeck2014">Lunbeck, E. (2014). The Americanization of Narcissism. Cambridge, MA: Harvard University Press, pp. 64–70.</ref><ref>Doering, S., Hörz, S., Rentrop, M., Fischer-Kern, M., Schuster, P., Benecke, C., ... & Buchheim, P. (2010). "Transference-focused psychotherapy vs treatment by community psychotherapists for borderline personality disorder: randomised controlled trial". The British Journal of Psychiatry, 196(5), 389–395.</ref>

Early life and education

Kernberg was born in Vienna to Jewish parents, Leo and Sonia Paula (Friedmann) Kernberg.<ref>Koch, B. J., Bendicsen, H. K., & Palombo, J. (2009). Guide to Psychoanalytic Developmental Theories. New York: Springer, pp. 45–47.</ref> His family emigrated to Chile in 1939 to escape Nazi persecution. He studied biology and medicine at the University of Chile, where he also trained in psychiatry and psychoanalysis at the Chilean Psychoanalytic Society.<ref>Lopez-Corvo, R. (2003). The Dictionary of the Work of W. R. Bion. London: Karnac, p. 198.</ref>

Career

In 1959, Kernberg moved to the United States on a Rockefeller Foundation fellowship to study psychotherapy research with Jerome Frank at Johns Hopkins Hospital.<ref>Clarkin, J. F., Yeomans, F. E., & Kernberg, O. F. (2006). Psychotherapy for Borderline Personality: Focusing on Object Relations. Washington, DC: American Psychiatric Publishing, p. 12.</ref> He then joined the Menninger Clinic in Topeka, Kansas, where he directed the Psychotherapy Research Project and served as Supervising and Training Analyst at the Topeka Institute for Psychoanalysis.<ref name="Menninger">Template:Cite web</ref>

In 1973 he became Director of the General Clinical Service at the New York State Psychiatric Institute. The following year he was appointed Professor of Clinical Psychiatry at Columbia University and Training and Supervising Analyst at the Columbia University Center for Psychoanalytic Training and Research. In 1976 he joined Cornell University as Professor of Psychiatry and Director of the Institute for Personality Disorders at the New York Hospital–Cornell Medical Center.<ref>Clarkin, J. F., Levy, K. N., Lenzenweger, M. F., & Kernberg, O. F. (2004). "The Personality Disorders Institute/Borderline Personality Disorder Research Foundation randomized control trial for borderline personality disorder: rationale, methods, and patient characteristics". Journal of Personality Disorders, 18(1), 52–72.</ref> From 1997 to 2001 he served as President of the International Psychoanalytical Association (IPA). On his 97th birthday, September 10, 2025, he was named Honorary President of the IPA.

Transference-Focused Psychotherapy

Kernberg developed transference-focused psychotherapy (TFP), a structured form of psychodynamic treatment for borderline personality organization (BPO) and related conditions.<ref>Yeomans, F. E., Clarkin, J. F., & Kernberg, O. F. (2015). Transference-Focused Psychotherapy for Borderline Personality Disorder: A Clinical Guide. Washington, DC: American Psychiatric Publishing.</ref> TFP is based on object relations theory and emphasizes the interpretation of split and contradictory self- and object-representations as they emerge in the therapeutic relationship.

TFP typically involves two to three sessions per week, each lasting 45–50 minutes.<ref name="auto">Template:Cite journal</ref> Treatment begins with a contract defining patient and therapist responsibilities, including safety measures for suicidal and self-destructive behaviors.<ref name="auto"/> The therapeutic process centers on identifying object relations in the transference, interpreting associated affects and defenses (e.g., splitting, idealization, devaluation), and fostering integration of polarized self- and object-representations.<ref>Levy, K. N., Clarkin, J. F., Yeomans, F. E., Scott, L. N., Wasserman, R. H., & Kernberg, O. F. (2006). "The mechanisms of change in the treatment of borderline personality disorder with transference-focused psychotherapy". Journal of Clinical Psychology, 62(4), 481–501.</ref>

Randomized controlled trials have found TFP effective in reducing suicidality, anger, and impulsivity, and in improving reflective functioning and interpersonal capacity.<ref>Doering, S., Hörz, S., Rentrop, M., Fischer-Kern, M., Schuster, P., Benecke, C., ... & Buchheim, P. (2010). The British Journal of Psychiatry, 196(5), 389–395.</ref>

Theory on narcissism and relationship to Kohut

Kernberg distinguished between normal and pathological forms of narcissism. Pathological narcissism, in his view, involves libidinal investment in a pathological self-structure and manifests in conditions such as narcissistic personality disorder.<ref>Kernberg, O. F. (1975). Borderline Conditions and Pathological Narcissism. New York: Jason Aronson.</ref><ref name="Lunbeck2014"/>

His views have often been contrasted with those of Heinz Kohut, founder of self psychology. Kernberg emphasized aggression, primitive defenses, and pathological object relations in narcissistic pathology,<ref name="auto1">Kernberg, O. F. (1992). Aggression in Personality Disorders and Perversions. New Haven: Yale University Press.</ref> while Kohut emphasized developmental arrest and unmet empathic needs.<ref>Strozier, C. B. (2001). Heinz Kohut: The Making of a Psychoanalyst. New York: Farrar, Straus and Giroux, pp. 227–233.</ref>

In clinical technique, Kernberg recommended confronting and interpreting narcissistic defenses, whereas Kohut advocated sustaining empathic responsiveness to narcissistic transferences.<ref name="MitchellBlack1995"/> Their divergent approaches shaped one of the central debates in late 20th-century psychoanalysis.<ref>Mitchell, S. A. (1988). Relational Concepts in Psychoanalysis: An Integration. Cambridge, MA: Harvard University Press, pp. 80–85.</ref>

Developmental model

Kernberg proposed a developmental model of personality organization that integrates Freud's drive theory with Klein's positions.<ref>Kernberg, O. F. (1984). Severe Personality Disorders: Psychotherapeutic Strategies. New Haven: Yale University Press.</ref> Two critical early tasks are:

• Differentiation of self and other – failure predisposes to psychotic pathology.
• Integration of positive and negative representations – failure underlies borderline personality organization.<ref>Caligor, E., Kernberg, O. F., Clarkin, J. F., & Yeomans, F. E. (2007). Handbook of Dynamic Psychotherapy for Higher Level Personality Pathology. Washington, DC: American Psychiatric Publishing, pp. 12–20.</ref>

He outlined sequential stages: normal autism (0–1 month), symbiosis (2–6 months), differentiation (6–36 months), integration (from ~3 years), and consolidation of ego, superego, and id during the Oedipal period.<ref>Kernberg, O. F. (1976). Object Relations Theory and Clinical Psychoanalysis. New York: Jason Aronson, pp. 34–50.</ref>

Unlike Freud, Kernberg views libidinal and aggressive drives as consolidated from early relational experiences rather than innate.<ref name="auto1"/>

Honors and recognition

Kernberg has received multiple awards for his contributions to psychiatry and psychoanalysis, including:

• Heinz Hartmann Award, New York Psychoanalytic Society and Institute (1972)<ref>Template:Cite web</ref>
• Edward A. Strecker Award, Institute of the Pennsylvania Hospital (1975)<ref>Institute of the Pennsylvania Hospital. Edward A. Strecker Award in Psychiatry, award history.</ref>
• George E. Daniels Merit Award, Association for Psychoanalytic Medicine (1981)<ref>Association for Psychoanalytic Medicine. George E. Daniels Merit Award, award announcements.</ref>

He served as President of the International Psychoanalytical Association (IPA) from 1997 to 2001.<ref>International Psychoanalytical Association: Past Presidents</ref> Kernberg is a current Honorary President of IPA since September 10, 2025.

Personal life

Otto Kernberg was married to child psychiatrist Paulina Kernberg until her death in 2006.<ref>Template:Cite web</ref> In 2008 he married psychologist Catherine Haran.<ref>Template:Cite web</ref>

See also

• Object relations theory
• Borderline personality disorder
• Identity disturbance
• Self psychology
• International Psychoanalytical Association