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Pubblicato dalla Casa editrice statunitense Routledge  è uscito il libro  di Antonella Ivaldi "Treating Dissociative and Personality Disorders, a Motivational Systems Approach to Theory and Treatment"  ( ).


Treating Dissociative and Personality Disorders draws on major theorists and the very latest research to help formulate and introduce the Relational/Multi-Motivational Therapeutic Approach (REMOTA), a new model for treating such patients within a clinical setting.
It forms the clinical reverberation of the common factors model, promoting a perspective of integration of different theories and approaches and introduces the question of the relationship between traumatic structure and personality disorders.
REMOTA constitutes an integrative and comparative new approach that will be indispensable for combining relational clinical knowing and Lichtenberg’s and Liotti’s motivational system theories, which identify the universal invariants that govern human relatedness, starting from evolutionism and infant research.
Supported by her contributors, Antonella Ivaldi provides an overview of existing theories and evidence for their effectiveness in practice, sets out her own theory in detail through rich and compelling case histories
The narratives in this book show how it is possible to integrate different contributions within a multidimensional aetiopathogenic treatment model, which considers the mind as a manifestation of the relationship between body and world.
From a conceptual perspective, according to which consciousness emerges and develops in the interpersonal dimension, this book proves how it becomes possible to understand, in the therapeutic space, what stands in the way of sound personal functioning, and how to create the conditions for improving this. at different levels of functional complexity.
Treating Dissociative and Personality Disorders will be highly useful in addressing the particular clusters of symptoms presented by patients, stimulating therapists of different backgrounds to explore the complexity of human nature.
It will appeal to psychoanalysts and psychotherapists, especially those in training, clinicians of different backgrounds interested in comparative psychotherapy, as well as social workers and graduate and postgraduate students.


This is an important and creative contribution to the psychotherapy integration movement. It brings together two different yet overlapping perspectives in the treatment of some of the most difficult – and painfully suffering – patients we work with.  It does not gloss over differences, yet creatively seeks commonalities and complementarities.  Moreover, by adding group work to the work with individuals it still further extends the reach of the integration and contributes valuably to the effort to relieve human suffering.
Paul L. Wachtel, Ph.D. Distinguished Professor, Doctoral program in clinical psychology, City College of NY and CUNY Graduate Center.  

Relationship, theory, and clinical acuity all come together in the wonderful synthesis that is central to Antonella’s presentation and personhood.  
Using rich clinical examples, she demonstrates how her use of motivational theory enables her to navigate the challenges of treating difficult patients.   
Joseph Lichtenberg Psychiatrist and Psychoanalyst. Founder and training analyst at the Washington Institute for Contemporary Psychotherapy and Psychoanalysis. Past President of the International Association for Psychoanalytic Self Psychology. Editor in chief of the journal Psychoanalytic Inquiry.

Antonella Ivaldi’s Relational/Multi-Motivational Therapeutic Approach (REMOTA) is an
important text for clinicians seeking to impact severely traumatized individuals whose
intersubjective possibilities have been severely compromised.
In bridging two major multi-motivational systems theorists, Lichtenberg and Liotti,  Ivaldi’s further extends the terrain to include data from multiple sources - infant and attachment research,
neuroscience, trauma theory, the treatment of dissociative disorders, individual and group therapies. With beautifully illustrated clinical sensitivity, with vibrancy and fluidity, and with a dialogic touch, Ivaldi continuously questions and postulates afresh the strengths and limitations always intrinsic to this complex field of mind and soul.  
Hazel Ipp, PhD.  Joint Editor-in-Chief, Psychoanalytic Dialogues: The International Journal of Relational Perspectives, Past – President of IARPP.  

Antonella Ivaldi’s book expresses all the determination, but also the creativity, of a passionate clinician. When the writing seems heavily theoretical, it melts in the clinical dimension; and when it is likely to become fervently clinical, it turns to the dialogue with the theoretical dimension. It is a useful and complete book, capable of holding together different approaches.
The relational breath of Ivaldi’s multidimensional model hosts a brilliant and critical exchange with Lichtenberg’s and Liotti’s motivational theories.
When we read the clinical histories written by Ivaldi we find ourselves not only thinking about clinical cases described by a sensitive colleague: It is as if the voices and behaviors of our “real” patients are coming to life.
Vittorio Lingiardi  Psychiatrist, Psychoanalyst. Full Professor of Dynamic Psychology at the Faculty of Medicine and Psychology of the Sapienza University of Rome. Director of the postgraduate school of clinical psychology.

To my knowledge Antonella Ivaldi’s is the first attempt at a comparison of two different theories focused mainly on the lived experience of a psychotherapist, which is dialoguing simultaneously with herself, her professional mentors and each of her difficult patients
Giovanni Liotti  Psychiatrist and Psychotherapist. Teaches “Clinical Applications of Attachment Theory” at the APC postgraduate School of Psychotherapy in Rome, Italy. Past President of the Italian Society of Behavioural and Cognitive Therapy (SITCC).

This book is an intriguing and very important attempt by Antonella Ivaldi to create a new approach to personality disorders. In a very sophisticate an yet clear and expressive way she uses motivational theories of different approaches to create a unique theory and a unique treatment. I frankly believe that every clinician, but also every person interested in psychotherapy, will greatly enjoy this book and find it extremely useful.
Gianni Nebbiosi  Psychoanalyst. Founding member and President of ISIPSé. Vice President of IARPP. Member of the IAPSP International Council.
Today there are so many psychotherapy books that it is really difficult to get oriented. This book by Antonella Ivaldi is surely worth reading: it goes right to the heart of crucial issues of contemporary psychotherapy. It deals with theory of motivation and with the possibility of integrating different therapeutic approaches. And what is most fascinating is that while it shows the importance of theory, it never loses sight of the nuances of clinical encounter. In this book the patient seems even more “real”, when seen through the lens of theory.
Paolo Migone, M.D., Editor, Psicoterapia e Scienze Umane

This fascinating and inspiring book edited by Antonella Ivaldi has many clinical and scientific merits, the main of which is its successful attempt to harmoniously integrate theories and methods originating from different perspectives in a new multidimensional aetiopathogenic treatment model for patients with personality and dissociative disorders. Thanks to a series of well-described and enlightening clinical cases, Antonella Ivaldi convincingly guides the reader thorough her innovative model in which individual and group psychotherapy are efficaciously combined. Using the therapeutic relationship in a complex way,  she builds a bridge between contemporary psychoanalysis and cognitive-evolutionary model.
This really is a brilliant book, which I strongly recommend.
Rita B. Ardito, Ph.D., President of the Italian Society of Behavioural and Cognitive Therapy

Tables Contents

Notes on Contributors Foreword by Giovanni Liotti
Foreword by Joseph D. Lichtenberg Acknowledgements

Introduction 1

1 Theorising about Theory 5

2 Theoretical foundations 11

Where this model fits among other theoretical perspectives in psychotherapy
Motivational systems theories
A comparison of the theories: a personal synthesis

3 The therapeutic relationship from the theoretical perspective of motivational systems 38

Introduction – Antonella Ivaldi
Motivational systems and the problems of patients with narcissistic, borderline, and dissociative disorders – Joseph D. Lichtenberg
The debate between Joseph Lichtenberg and Giovanni Liotti. From infant research to evolutionism: two motivational perspectives in dialogue – Giovanni Liotti and Joseph D. Lichtennerg

4 Complex trauma theories and psychopathology: the difficult patient 63

Who is the difficult patient?
Trauma and dissociation
Psycophysiology of trauma

5 Personality disorders: diagnosis and treatment 102

Empirically supported psychological approaches to the treatment of personality disorders
Why do different treatment models prove to be equally effective? A hypothesis based on motivational theories

6 The relational/multi motivational therapeutic approach (REMOTA) 115

The structure of the dual setting REMOTA: a simple structure for a complex process                                                        
           The therapeutic relationship and its complexity
           How the therapist trains for the complexity of the relationship
           The first phase of treatment: individual therapy
           Setting and relationship: negotiating the therapeutic alliance
The metacontext: therapy in the real context of the patient’s life
Working with emotions
Empathy: a complex process?
The body in therapy: the use of non-verbal communication in the relationship

The group: methodological considerations
Is affiliation an inborn motivation ?
Being in a relationship using two session rooms
The therapeutic relationship and the group
Why does the integration of the individual and the group setting improve working conditions? A biopsychosocial hypothesis based on the evolution theory

7 Some methodological considerations on outcome research in  psychotherapy and results of a naturalistic study in the treatment of patients with severe axis I/II comorbidity disorders 197

Some food for thought
The Gold Standard for research on outcomes in medicine and psychotherapy: is all that glitters gold?
Some problems with RCTs in psychotherapy
Results from a controlled naturalistic study in the treatment of severe comorbid axis I/II patients

8 Group psychotherapy: addressing impediments to engaging the affiliative motivational system 217

Functioning in groups
Affiliation and group membership
Aspects of affiliation in group therapy
Impediments to the activation of the affiliative motivational system
From individual to group: a case

References 239
Index 257

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