BORDERLINE PERSONALITY-DISORDERS, PSYCHODYNAMICS AND PSYCHOTHERAPY INAN OUTPATIENT SETTING

Whereas Otto F. Kernberg (1975) and other authors primilary spoke of a borderline organization or a borderline syndrome, in DSM-III-R (1987) and DSM-IV (1994) there is registered a borderline personality disord er. In contrary to the narcissistic personality disorder only showing a self-pathology the borderline patients are characterized by a fragme ntation prone ego, i.e. an ego-pathology. Furthermore, they are also d isturbed in the realm of narcissism, since they were not able to exper ience their mother's love in their childhood or since out of anxieties always having to adapt to her demands they developed defense mechanis ms against the affects they were given. Borderline patients, therefore , not only tend to narcissistic compensations as grandiose selves, fus ion with a (self-) object and mirror-relationships or (in psychotherap y) transference, but especially also narcissistic injuries, rages and feelings or revenge. Because of their projective identifications, thei r corresponding transferences and their rigid defenses, they need on t he one hand early interpretations and realitiy testing, and on the oth er hand an indestructible human presence and a consistent structure of the therapeutic situation.