What is the role of shared values in a couple’s relationship?

How important is the therapist’s personal experience in the field of sexuality? Should a therapist have personal experience in the topics they work with?

What is the primary cause of narcissistic personality disorder, and is there a specific trauma underlying it?

These questions often arise in clinical practice, as they are connected with fundamental processes of affect regulation, relationship building, and the development of sexuality. It is not surprising that these — along with many others — became the subject of in-depth discussion with the trainer - Otto Kernberg, MD, during the First Workshop of Module I of the one-year training program “Love and Aggression: From Normality to Pathology.”

To convey the context and content of these discussions more fully, we would like to share with you the key impressions; thus:

On 15 November 2025, the First Workshop of Module I took place, dedicated to the biological determinants of aggressive and erotic behavior.

The workshop was divided into lectures, a practical component, and a Q&A session.

The lectures outlined historical and contemporary approaches to conceptualizing aggression and eroticism, establishing a theoretical basis for deeper clinical discussions.

Within the lectures, participants explored the following topics:

• Freud’s theory of libido and aggression as two basic drives;
• contemporary debates surrounding the concept of the death drive;
• neurobiological approaches to understanding aggressive behavior;
• aggression as a biological function and its place in the structure of the psyche;
• three affective systems of negative experience: aggression, flight, separation panic;
• affective manifestations of aggression — rage, envy, aggressive moods, irritation;
• three affective systems of positive experience: attachment, eroticism, and social bonds;
• development of the experience of the Self and perception of others;
• the role of affects in early childhood and their integration;
• antisocial personality structure as the most extreme expression of aggression;
• mature sexuality: its structure and integrative components;
• difficulties in the sexual lives of men and women;
• the importance of the therapist’s maturity when working with a patient’s sexuality.

The entire lecture block covered a wide range of theories—combining psychoanalytic theory with neurobiological research—allowing participants to view aggressive and erotic impulses as multidimensional phenomena that simultaneously encompass biological, emotional, and interpersonal dimensions.

This workshop demonstrated how complex and multilayered the interplay of aggressive and erotic impulses is in personality development and psychopathological conflicts, and how early biological and affective processes shape the later capacity for love, affect regulation, and the formation of stable relationships.

The practical part of the workshop was a public supervision dedicated to work with a patient with a dissociative disorder.

The case turned out to be illustrative for understanding how:

• to work with a patient with a dissociative disorder in general:

• it is crucial to maintain the therapeutic frame even in situations where the patient demonstrates sharply fragmented experiences of their own identity;
  
  
• dissociative mechanisms may intertwine with aggressive impulses.

In the final part of the First Workshop, a Q&A session took place in which Otto Kernberg answered participants’ questions, covering a wide spectrum of theoretical and clinical topics, including:

• Why does Otto Kernberg divide Panksepp’s seven affective systems into positive, negative, and neutral, if the affective experience of each drive can be either pleasant or unpleasant — depending on whether it involves tension due to deviation from homeostasis or satisfaction of a need and return to equilibrium?
  
  
• How, within the understanding of the inseparable connection between affect and object relations, is the primary anxiety described by Klein explained — the one experienced by the infant?
  
  
• Can polyamory and polygamy be considered mature forms of love if a person is aware of their orientation toward polyamory or polygamous tendencies and speaks about it openly?
  
  
• How to increase the potential for affect regulation?
  
  
• What is Otto Kernberg’s view on the fact that in some countries the state regulates “proper” sexuality through legal prohibitions or informational campaigns?
  
  
• How does Otto Kernberg conceptualize the dissociation between sex and love system? How does one go about treating it?
  
  
• Is it normal that children in Ukraine during wartime (ages 8–10) want to sleep with their parents? Can this negatively affect their future lives, and how should this be regulated?
  
  
• Is it true that TFP is not used with patients who have a psychotic level of personality organization? If so, how should one understand situations where the therapist assesses the patient’s condition from session to session, considering that symptoms may change while personality structure is generally stable?
• and other questions.

We sincerely hope that this brief selection of key points from the First Workshop inspires you to continue exploring new ideas. Perhaps this comprehensive and contemporary program will support you in doing so—helping you deepen your professional understanding of aggression, love, sexuality, and personality development, while also offering answers to questions that often arise in your patients and, at times, in your own relationships and personal life.

Registration for the Module I of the program is still open. The second workshop of Module I is coming very soon.

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TFP-Group Ukraine

Ukrainian Institute for Personality Disorders Studies

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