Disorganized attachment and borderline personality disorder: a clinical perspective.
The aim of this paper is to explore the links between the attachment-theory derived concept of disorganized attachment, and the psychiatric diagnosis of Borderline Personality Disorder (BPD). Disorganized attachment can be understood in terms of an approach-avoidance dilemma for infants for whom stressed or traumatized/traumatizing caregivers are simultaneously a source of threat and a secure base. Interpersonal relationships in BPD including those with care givers is similarly seen in terms of approach-avoidance dilemmas, which manifests themselves in disturbed transference/countertransference interactions between therapists and BPD sufferers. Possible ways of handling these phenomena are suggested, based on notion of 'meta-cognitive monitoring', in the hope of re-instating meaning and more stable self-structures, in these patients' lives.
Holmes
Jeremy
J
North Devon District Hospital, Barnstaple, Devon, UK. j.a.holmes@btinternet.com
D001883:Borderline Personality Disorder / Q000523:psychology / Q000628:therapy*; D006801:Humans; D009769:Object Attachment; D011575:Psychoanalytic Therapy / Q000379:methods*