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This study\u00a0illustrates how IRT formulation and treatment proceed, and how it may also fail when there is not close adherence to underlying principles. Don is a music professor in his 40's with a significant trauma history and complex diagnostic profile that includes many hospitalizations and suicide attempts. He qualified for several diagnostic and statistical manual of\u00a0mental disorders personality disorders via formal diagnostic interviews (obsessive\u2010compulsive, avoidant, passive\u2010aggressive, narcissistic), as well as major depression, generalized anxiety, and substance abuse. Don's formulation demonstrates how self\u2010destruction can function as a \u201cgift of love\u201d to internalized representations of important caregivers. Data from work with patients like Don confirm the usefulness of Benjamin's IRT lens for navigating comorbidity, as well as the importance of underlying principles of change.<\/jats:p>","DOI":"10.1002\/jclp.23292","type":"journal-article","created":{"date-parts":[[2021,12,16]],"date-time":"2021-12-16T19:53:22Z","timestamp":1639684402000},"page":"396-408","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Using interpersonal reconstructive therapy to address comorbid problems organized by attachment\u2010based learning: The case of Don"],"prefix":"10.1002","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6797-1763","authenticated-orcid":false,"given":"Kenneth L.","family":"Critchfield","sequence":"first","affiliation":[{"name":"Ferkauf Graduate School of Psychology Yeshiva University New York City New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8754-6126","authenticated-orcid":false,"given":"Priyata","family":"Thapa","sequence":"additional","affiliation":[{"name":"Department of Graduate Psychology James Madison University Harrisonburg Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariaf\u00e9 T.","family":"Panizo","sequence":"additional","affiliation":[{"name":"Student Health and Counseling Services California State University Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8038-5841","authenticated-orcid":false,"given":"Nuno","family":"Concei\u00e7\u00e3o","sequence":"additional","affiliation":[{"name":"Research Center for Psychological Science (CICPSI), Faculdade de Psicologia Universidade de Lisboa Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,12,16]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Psychoanalytic therapy: Principles and applications","author":"Alexander F.","year":"1946"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1037\/h0037024"},{"key":"e_1_2_10_4_1","volume-title":"Interpersonal diagnosis and treatment of personality disorders","author":"Benjamin L. 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