The unreachable object? Difficulties and paradoxes in the analytical relationship with borderline patients.
The author investigates the main difficulties the analyst encounters in borderline patient analysis, focusing on the specific way in which such patients put the analyst's mental functioning to the test and highlighting the most salient elements of the transference-countertransference dynamic. The author picks out several of the paradoxes that characterize the analytical relationship with these patients, who are constantly seeking contact with the object, which is inevitably traumatic for them. On the basis of highly detailed clinical material, the author demonstrates how - no matter which theoretical-clinical model is adopted - a specific technical problem with these patients is how to manage their intense destructiveness. With these patients, countertransferential difficulties are inevitably predominant because of the looming threat of the destruction of the analytical relationship. Maintaining a balance between the recognition-legitimization of primary narcissistic mirroring needs and the recognition-control of narcissistic demands and attacks on the analytical link is as crucial as it is complex. The paper examines the most important therapeutic and anti-therapeutic factors, highlighting the importance of countertransference analysis and self-analysis as ways of accessing as yet unrepresented elements of the patient and analyst respectively. Particular attention is given to the role played by the analyst's subjectivity and to the enactment.
Via Dagnini 32, 40137, Bologna, Italia. irenerug@libero.it
Irene
I
Ruggiero
D000184:Acting Out; D000328:Adult; D000374:Aggression / Q000523:psychology; D001883:Borderline Personality Disorder / Q000523:psychology* / Q000628:therapy*; D003220:Conflict, Psychological; D003379:Countertransference; D003674:Defense Mechanisms; D003717:Denial, Psychological; D007172:Erectile Dysfunction / Q000523:psychology; D006801:Humans; D008297:Male; D009289:Narcissism; D009769:Object Attachment; D010817:Physician-Patient Relations; D011385:Projection; D011573:Psychoanalytic Interpretation; D011575:Psychoanalytic Therapy; D012059:Rejection, Psychology; D014167:Transference, Psychology; D014473:Unconscious, Psychology