title: Omnipotence, helplessness, and control with the borderline patient.
abstract: Via transference, borderline patients attempt to actualize dyads that represent fixations at and regressions to the symbiotic phase and the differentiation subphase of separation/individuation. Early awareness of separateness leads to the idealization of the provider as omnipotent and devaluation of the separate self as helpless. Efforts are directed at re-fusion to restore the positive symbiotic self-object via controlling the omnipotent other. This primitive constellation becomes reenacted in the transference with the borderline patients. Clinical examples from long-term psychotherapy with three borderline patients illustrate this constellation and outline the following strategies by which they attempt to reestablish symbiosis manipulatively and maintain fantasies of omnipotence: (1) impulsivity; (2) selection of a dependent object; (3) seduction; (4) overt and covert manipulation (identification with the aggressor); and (5) compliance. These pathological transferences may illuminate reconstructions of early differentiation in borderline infantile development and the impact which this differentiation can have upon subsequent self-systems and object relationships.
mesh_terms: D000328:Adult; D001883:Borderline Personality Disorder / Q000523:psychology* / Q000628:therapy; D002668:Child Rearing; D003299:Cooperative Behavior; D003858:Dependency, Psychological; D005260:Female; D006801:Humans; D007175:Impulsive Behavior; D007207:Individuation; D009034:Mother-Child Relations; D009769:Object Attachment; D010554:Personality Disorders / Q000523:psychology*; D011369:Professional-Patient Relations; D012725:Sexual Behavior; D014167:Transference, Psychology