Editor’s Introduction

For JAPA 67/6 we are privileged to publish Otto Kernberg’s “Therapeutic Implications of Transference Structures in Various Personality Pathologies.” This paper, a tour de force of conceptual rigor and stylistic clarity, is in large part a summary statement of Kernberg’s multi-decade research program on the nature of personality structure and organization, especially their pathological formations, and the psychotherapeutic treatment implications that follow from that work. The history of psychoanalysis in the United States, as many are well aware, in large measure developed in tandem with academic medicine and psychiatry. In the 1950s through the 1970s, some eminent departments of psychiatry were led by academically minded psychoanalysts, and major research projects of significance flourished in that context. The Menninger Psychotherapy Research Project (Wallerstein 1986), to which, early in his career, Kernberg was a major contributor, is perhaps the best known example of empirical work combining a psychoanalytic orientation and painstaking methodology in an institutional setting. While the professional landscape has changed rather dramatically over the ensuing decades—signaled by the advent of DSM-III (see Wilson 1993)—and professional divisions between psychoanalysts and academic psychiatry have widened appreciably, Kernberg has continued his pursuit of a detailed examination of personality pathologies and their treatment from a psychoanalytic point of view. His influence has been vast, and certainly not only on the various research groups that continue to explore the details of personality disorders. His creatively bringing together American ego psychology and British object relations traditions has had a lasting impact on the psychoanalytic education of candidates and the training of psychiatric residents.

While it is impossible to fully capture the breadth and significance of Otto Kernberg’s contributions to mental health research and treatment, we hope that in this issue of JAPA the reader will get more than a sense of what he has meant to the field. Kevin Meehan, in his commentary, highlights some of the key research findings from Kernberg’s group, as well as efforts by others, influenced by this work, to study personality and transference. Salman Akhtar approaches his commentary as an experienced analyst and author and so offers an enriched clinical perspective on some of the issues raised in Kernberg’s paper. Susan Vaughan, in her generous and thoughtful commentary, gives us a window into what it was like to be impacted by Kernberg’s writings and teaching as a young psychiatrist at Columbia, and now as a leading teacher and administrator there. Finally, the papers by Adam Natoli and James Sexton and colleagues are fully within the research tradition Kernberg helped establish and has maintained throughout his career. We hope you find this set of papers and commentaries enriching, as they both mark the history of Kernberg’s research career and point toward a future in which more empirical work can be done within the domain of psychoanalysis.