لایب سان

he Problem: A Complex Case The first interview had barely ended, and the therapist was unable to dispel his sense of confusion with regard to the diagnosis. He began to look through his notes. Enrico is a 25-year-old university student, modest in appearance, and well spoken, who stopped taking exams over a year ago and does not attend courses. An only child, he lives with his parents and turned to the Third Center of Cognitive Psychotherapy for a rather unusual problem. Enrico faints or – he cannot say – sud- denly falls asleep while others are talking to him, slumping wherever he happens to be, on a chair or sofa. For sure, he loses consciousness, and this occurs frequently, three or four times a week. For this reason, he was admitted to a prestigious neurol- ogy department in Rome. After a thorough battery of examinations, tests, and assessments, epilepsy, narcolepsy, or other organic causes were ruled out. The doc- tors’ verdict was: “It’s a psychological problem!” and they advised him to turn to the Third Center. During his hospital stay, the doctors had witnessed an episode of his passing out, and they had no qualms about excluding any possibility of simula- tion. They kindly sent us a video along with the EEG tracing and the measurements of muscle tone. In the very moment the video showed the patient slump, the EEG trace showed cerebral activity continuing as in a state of wakefulness (which made it possible to rule out narcolepsy), while the EMG showed a total collapse of muscle tone. “Possibly a faint?” the therapist wondered, meaning a dissociative defense from a situation of overwhelming threat, characterized by loss of muscle tone.

ix Contents 1 The Problem of the Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Antonio Semerari, Fabio Moroni, Giuseppe Nicolò, and Antonino Carcione 2 Knowing the Mind . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Antonino Carcione, Livia Colle, and Antonio Semerari 3 Metacognition as a General Factor of Personality Pathology . . . . . . . 35 Ilaria Riccardi, Roberto Pedone, and Antonio Semerari 4 Treatment Integration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Giuseppe Nicolò, Antonino Carcione, Donatella Fiore, Stefania D’Angerio, Michele Procacci, and Antonio Semerari 5 The Pretreatment Phase: The Assessment Interview and Communication of the Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . 61 Giuseppe Nicolò, Laura Conti, and Donatella Fiore 6 The Therapeutic Relationship . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Antonio Semerari, Giovanni Pellecchia, and Antonino Carcione 7 General Treatment Goals and Session Management . . . . . . . . . . . . . . 103 Antonino Carcione, Giuseppe Nicolò, Michele Procacci, and Antonio Semerari 8 Monitoring and Integration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 Antonio Semerari, Ilaria Riccardi, and Antonino Carcione 9 Differentiation and Decentration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141 Antonio Semerari, Fabio Moroni, Elena Bilotta, and Michele Procacci 10 Almost Impossible Cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173 Giovanni Pellecchia and Antonio Semerari x 11 Group Interventions: Skills Training . . . . . . . . . . . . . . . . . . . . . . . . . . 189 Livia Colle and Donatella Fiore 12 Pharmacological Treatment of Patients with Personality Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209 Giuseppe Nicolò, Michele Procacci, and Antonino Carcione 13 A Synthesis: Metacognitive Interpersonal Therapy . . . . . . . . . . . . . . 221 Antonino Carcione, Teresa Fera, and Antonio Semerari References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231 Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245

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