title: Some interpersonal aspects of self-mutilation in a borderline patient.
abstract: Some interpersonal aspects of self-mutilation and vampiristic blood rituals in borderline states are discussed, as these were clarified in the therapeutic relationship established with a hospitalized young woman. The therapeutic stance during the period of inpatient treatment discussed emphasized consistent reinforcement of boundaries and limits in order to facilitate a mutual exploration of the interpersonal context in which her symptoms emerged. Blood rituals repeatedly expressed primitive identifications with intrusive, controlling, and sadistic aspects of a psychotic mothering figure. These were reflected in the treatment in her crazed, angry demands--through her symptoms--for a "caring" response from the therapist, whom she deliberately and vengefully assaulted through the medium of her own blood. Her manipulative and controlling efforts to maintain a human attachment highlighted her anxieties about separation and abandonment. In subsequent phases of the psychotherapeutic work, her relation to her own blood reflected struggles with womanhood and sexuality.
mesh_terms: D000328:Adult; D005260:Female; D005783:Gender Identity; D006801:Humans; D007398:Interpersonal Relations; D010287:Parent-Child Relations; D011575:Psychoanalytic Therapy; D012569:Schizotypal Personality Disorder / Q000523:psychology*; D012652:Self Mutilation / Q000523:psychology*