Treatment issues with borderline patients and the psychosomatic focus.
I have discussed a group of borderline patients who can be conceptualized as having defects in character structure. There is no smooth, hierarchically arranged continuum from lower id-oriented to higher ego, secondary-process organized psychic levels. They suffer from psychic discontinuity, characterized by psychic lacunae, empty spaces devoid of psychological content. These lacunae are often the locus of somatic disruptions, a psychosomatic focus, which are manifested as psychosomatic symptoms. Though the treatment of these patients can be stormy, and, in some instances impossible, providing a setting in which these patients can comfortably regress and eventually get in touch with split-off parts of the self can lead to a manageable therapeutic interaction. On occasion, this might be life-saving.
Dept. of Psychiatry, University of Illinois, College of Medicine, Winnetka 60093.
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Giovacchini
D000328:Adult; D001883:Borderline Personality Disorder / Q000523:psychology / Q000628:therapy*; D003674:Defense Mechanisms; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011573:Psychoanalytic Interpretation; D011575:Psychoanalytic Therapy / Q000379:methods*; D011602:Psychophysiologic Disorders / Q000523:psychology / Q000628:therapy*; D012803:Sick Role