Treating the Borderline Patient in Psychotherapy

An attempt has been made to describe the contribution of maternal libidinal availability and withdrawal to the etiology of the borderline syndrome. The mother's vital contribution to normal ego development has been emphasized, and the effects of deficiencies in that contribution to the development of the intrapsychic structure of the borderline — the split ego and the split object relations unit. The latter develops from the internalization of the two major themes of interaction with the mother, produces the lietmotif of the borderline's intrapsychic structure — the rewarding and withdrawing object relations part units. The rewarding part unit becomes allied with the pathological ego to defend against the withdrawing unit, but at the cost of failure to cope with reality. The relationship of these borderline intrapsychic structures to each other and to the therapist's intrapsychic structures, as developed in the therapeutic transference and resistance, is described and illustrated in a clinical example.