The Unanswered Self: The Masterson Approach to the Healing of Personality Disorders
Dr. Candace Orcutt, Ph.D.
It is an honor and a privilege to write this blog on the book, The Unanswered Self: The Masterson Approach to the Healing of Personality Disorders, written by Dr. Candace Orcutt, Ph.D.
Psychiatrist and psychoanalyst, Dr. James F. Masterson, M.D., pioneered the Masterson Approach, a developmental, object relations approach to treating personality disorder. Through his clinical work and research, Dr. Masterson came to believe that the basis and treatment of personality disorder starts with understanding the formation of self and relationship that begins in the first three years of life.
I was first introduced to understanding “Self” during my 7-year training at the Masterson Institute in the 1980s with Dr. James Masterson. At that time my supervisor, trainer, mentor and now close friend, was Dr. Candace Orcutt, Ph.D.
In this book, Dr. Orcutt does a remarkable job detailing the theory and clinical practice of the Masterson Approach to the healing of the troubled self. In the process, she presents in-depth integrative concepts of “Self” of world renown theorists — Freud, Winnicott, Mahler, Kohut and Kernberg – showing how these views inform the structure and foundation of Masterson’s work. The “three major personality disorders” considered here include the schizoid, narcissistic and borderline disorders, which, Masterson holds, find their origin in failure to adequately manage stages of childhood development crucial to the psychic attainment of separation and individuation. Dr. Orcutt devotes an entire chapter to each of these topics, illustrated by detailed and lively case studies. A closing chapter offers an overview of Masterson’s work and beyond, with attention to trauma, dissociation, self-states, and multiple personality disorder (now called dissociative identity disorder). From a historical perspective and a developmental approach to the cause and treatment of personality disorder, Dr. Orcutt guides the reader’s understanding of why problematic behaviors are displayed, and explains specific techniques for helping. Currently, there isn’t a book of this depth or knowledge of the subject.
Who Should Read this Book?
- Every member of NAMI (National Association of Mental Illness)
- Anyone planning to be a clinician
- Law Enforcement
- Parents/Loved ones of those with personality disorders
Why Read this Book?
Understanding the cause of personality disorder, and what you, a parent and/or professional could possibly do to change the outcome is highly beneficial. It is extremely important to know what steps and actions you should take when encountering a person with a schizoid, borderline or narcissistic personality disorder.
From my own extensive training, I have been able to guide and consult on how to manage and cope with the enormous turmoil often encountered in dealing with a person with a personality disorder. In the past I have presented in-depth lectures on this subject to doctors to help them manage their medical office patients and waiting rooms, to local police on managing criminals, along with encouraging patients, colleagues, clergy, and members of NAMI on behavioral management.
Several of my patients have struggled with children, spouses or relatives with personality disorders and dissociative disorders, having no idea how to relate to them in their day-to-day life. I have referred them to several books on the subject, however, Dr. Orcutt’s book goes beyond any other. It fills the void and provides much deeper insight and guidance on the subject.
Where to Find this Book?
There are several endorsements of this book from distinguished experts in the field, including two that I have been honored to have studied with: Dr. Dan Brown, Ph.D., and Dr. Judith Pearson, Ph.D.
“Dr. Orcutt’s brilliant, creative and theory-bent mind is more than evident in her new book, The Unanswered Self. As with her last book, Trauma in Personality Disorder: A Clinician’s Handbook: The Masterson Approach, Dr. Orcutt’s current work grapples with the relationships existing amongst different theoretical perspectives including psychodynamic theory, object relations theory, and theories surrounding the nature of trauma and dissociation. Her profound level of training in and understanding of the works of Freud, Masterson, Winnicott and other psychodynamic and developmental theorists, and her experienced and deeply-felt knowledge of the impact of trauma on the developing self stand at the heart of this book, but ultimately, Dr. Orcutt’s synthesis of these varied approaches to the psychodynamics
and psychotherapy of Oedipal and pre-oedipal disorders culminates in her own original answers to some very old and very deep clinical and theoretical questions.”
– Judith Pearson, Ph.D., Director, The International Masterson Institute.
“In this remarkable blend of academic scholarship and clinical wisdom, Candace Orcutt compellingly describes the pioneering and seminal work of James Masterson on a spectrum of personality disorders. As the highly informative text and rich case material demonstrate, his writings were clearly ahead of their time, and thus his psychotherapeutic contributions are perhaps even more relevant today. On a personal level, having the good fortune of working closely with Jim and sharing our numerous common therapeutic and scientific interests was one of the highlights of my professional life.”
– Allan Schore, author of Right Brain Psychotherapy and The Development of the Unconscious Mind.
“This remarkable book could only be written by a close associate of James Masterson over the years, who was also a thoroughly competent clinician, and who was well-read enough to create her own overview of the field. Dr. Candace Orcutt clearly meets this three-fold requirement. In this book she reviews the “Masterson Approach” in considerable detail. Her main point is that the Masterson Approach has a deeper structure to it, a part of which has remained under-emphasized in the field. The deep structure in the Masterson Approach is that the subphases of Margaret Mahler’s separation/individuation phase include the developmental tasks typically failed by patients with developmental arrests and personality disorders. The three sub-phases of separation/individuation are: the hatching or differentiation sub-phase, the practicing sub-phase, and the rapprochement sub-phase. In the Masterson Approach, as detailed by Dr. Orcutt, these sub-phases correspond to the developmental stages of the schizoid, narcissistic, and borderline personalities, respectively. Each sub-phase description is followed by richly illustrated case examples that clearly explain the developmental task and best how to repair the developmental deficit. Dr. Orcutt concludes her book by arguing that Masterson only came to appreciate later in his professional life the role of the schizoid personality with its potential correspondence to Mahler’s developmental studies. That omission curtailed the inclusion of the concepts of dissociated parts and shifting self-states when their integration would have both benefited the Masterson Approach and helped to remedy their under-recognition in the field. The last chapters on dissociated parts and unacknowledged trauma are brilliant. Dr. Orcutt has created a masterful synthesis of the past fifty years of the clinical field, especially relevant to the treatment of personality and major dissociative disorders.”
– Daniel P. Brown, author of Memory, Trauma-Treatment, and the Law, and Attachment Disturbances in Adults Daniel P. Brown, Ph.D., Harvard Medical School
This book is a Must-read for anyone looking to understand personality disorders, or for anyone interacting with a person with a personality disorder.