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Psychotherapy in Borderline and Narcissistic Personality Disorder

Published online by Cambridge University Press:  02 January 2018

Anna Higgitt  and
Peter Fonagy
Anna Higgitt*
Affiliation:
St Charles Hospital, Exmoor Street, London W10
Peter Fonagy
Affiliation:
Psychoanalysis Unit, University College London
*
∗Correspondence
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Abstract

Psychodynamic concepts about borderline personality disorder are reviewed and the literature concerning psychotherapeutic treatment of this group is examined. The treatment contexts considered include: psychoanalysis and intensive (expressive) psychoanalytic psychotherapy, supportive psychotherapy, group psychotherapy, family therapy, in-patient treatment, the therapeutic community, cognitive–behavioural approaches, and combinations of drugs and psychotherapy. The practical implications of recent follow-up studies for intervention strategies are considered.

Type
Review Articles
Information
The British Journal of Psychiatry , Volume 161 , Issue 1 , July 1992 , pp. 23 - 43
Copyright
Copyright © 1992 The Royal College of Psychiatrists 

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References

Abend, S. M., Porder, M. S. & Willick, M. S. (1983) Borderline Patients: Psychoanalytic Perspectives. Monograph 7 of the Kris Study Group. New York: International Universities Press Google Scholar
Adelman, A. (1985) Pills as transitional objects: a dynamic understanding of the use of medication in psychotherapy. Psychiatry, 48, 246–253.Google Scholar
Adler, G. (1977) Hospital management of borderline patients and its relation to psychotherapy. In Borderline Personality Disorders (ed. Hartocollis, P.), pp. 307–323. New York: International Universities Press.Google Scholar
Adler, G. (1986) Borderline Psychopathology and its Treatment. New York: Jason Aronson.Google Scholar
Akiskal, H. S. (1981) Subaffective disorders: dysthymic, cyclothymic, and bipolar II disorders in the “borderline” realm. Psychiatric Clinics of North America, 4, 25–36.CrossRefGoogle ScholarPubMed
Akiskal, H. S., Chen, S. E., Davis, G. C., et al (1985) Borderline: an adjective in search of a noun. Journal of Clinical Psychiatry, 46, 41–48.Google ScholarPubMed
Alexander, F. (1957) Psychoanalysis and Psychotherapy. London: George Allen.Google Scholar
Androlunis, P. A., Glueck, B. C., Stroebel, C. F., et al (1981) Organic brain dysfunction and borderline personality disorder. Psychiatric Clinics of North America, 4, 61–66.Google Scholar
Aronson, T. A. (1989) A critical review of psychotherapeutic treatments of the borderline personality: historical trends and future directions. Journal of Nervous and Mental Disease, 177, 511–527.Google Scholar
Bacal, H. (1981) Notes on some therapeutic challenges in the analysis of severely regressed patients. Psychoanalytical Inquiry, 1, 29–56.Google Scholar
Baron, J., Gruen, R., Asnis, L., et al (1985) Familial transmission of schizotypal and borderline personality disorders. American Journal of Psychiatry, 142, 927–934.Google Scholar
Baron-Cohen, S. (1987) Autism and symbolic play. British Journal of Developmental Psychology, 5, 139–148.CrossRefGoogle Scholar
Baron-Cohen, S. (1989) The autistic child's theory of mind: A case of specific developmental delay. Journal of Child Psychology and Psychiatry, 30, 285–298.CrossRefGoogle ScholarPubMed
Baron-Cohen, S., Leslie, A. M. & Frith, U. (1985) Does the autistic child have a “theory of mind”? Cognition, 21, 37–46.Google Scholar
Bion, W. R. (1957) Differentiation of the psychotic from the non-psychotic personalities. International Journal of Psychoanalysis, 38, 266–275.Google Scholar
Bion, W. R. (1959) Attacks on linking. International Journal of Psychoanalysis, 40, 308–315.Google Scholar
Bion, W. R. (1962) Learning from Experience. London: Heinemann.Google Scholar
Boyer, L. B. (1987) Regression and countertransference in the treatment of a borderline patient. In The Borderline Patient: Emerging Concepts in Diagnosis, Psychodynamics and Treatment (eds Grotstein, J. S., Solomon, M. F. & Lang, J. A.). Hillsdale, NJ: The Analytic Press.Google Scholar
Brandchaft, B. & Stolorow, R. D. (1987) The borderline concept: An intersubjective view. In The Borderline Patient: Emerging Concepts in Diagnosis, Psychodynamics and Treatment, Vol. 2 (eds Grotstein, J. S., Solomon, M. F. & Lang, J. A.), pp. 103–126. Hillsdale, NJ: The Analytic Press.Google Scholar
Brenman, E. (1980) The value of reconstruction in adult psychoanalysis. International Journal of Psychoanalysis, 61, 53–60.Google Scholar
Brown, L. J. (1981) A short-term hospital program preparing borderline and schizophrenic patients for intensive psychotherapy. Psychiatry, 44, 327–336.CrossRefGoogle ScholarPubMed
Brown, S. L. (1987) Family therapy and the borderline patient. In The Borderline Patient: Emerging Concepts in Diagnosis, Psychodynamics and Treatment, Vol. 2 (eds Grotstein, J. S., Solomon, M. F. & Lang, J. A.), pp. 201–210. Hillsdale, NJ: The Analytic Press.Google Scholar
Buie, D. H. & Adler, G. (1982) Definitive treatment of the borderline personality. International Journal of Psychoanalytic Psychotherapy, 9, 51–87.Google ScholarPubMed
Chatham, P. (1985) Treatment of the Borderline Personality. New York: Aronson.Google Scholar
Chessick, R. D. (1979) A practical approach to the psychotherapy of the borderline patient. American Journal of Psychiatry, 33, 531–546.Google Scholar
Ekstein, R. & Wallerstein, R. (1954) Observations of the psychology of borderline and psychotic children. Psychoanalytic Study of the Child, 9, 344–369.Google Scholar
Elkin, I., Pilkonis, P. A., Docherty, J. P., et al (1988) Conceptual and methodological issues in comparative studies of psychotherapy and pharmacotherapy, I: Active ingredients and mechanisms of change. American Journal of Psychiatry, 145, 909–917.Google Scholar
Elkin, I., Pilkonis, P. A., Docherty, J. P., et al (1988) Conceptual and methodological issues in comparative studies of psychotherapy and pharmacotherapy, II: Nature and timing of treatment effects. American Journal of Psychiatry, 145, 1070–1076.Google Scholar
Federn, P. (1947) Principles of psychotherapy in latent schizophrenia. American Journal of Psychotherapy, 1, 129–144.Google Scholar
Feldman, R. D. & Guttman, H. A. (1984) Families of borderline patients: literal-minded parents, borderline parents and parental protectiveness. American Journal of Psychiatry, 141, 1392–1396.Google ScholarPubMed
Fenton, W. S. & McGlashen, T. H. (1990) Longterm residential care: treatment of choice for refractory character disorders. Psychiatric Annals, 20, 44–49.CrossRefGoogle Scholar
Fonagy, P. (1982) Psychoanalysis and empirical science. International Review of Psychoanalysis, 9, 125–145.Google Scholar
Fonagy, P. (1989) On tolerating mental states. Bulletin of the Anna Freud Centre, 12, 91–115.Google Scholar
Fonagy, P. (1991) Thinking about thinking: some clinical and theoretical considerations concerning the treatment of a borderline patient. International Journal of Psychoanalysis, 72, 639–656.Google Scholar
Fonagy, P. & Higgitt, A. (1990) A developmental perspective on borderline personality disorder. Revue Internationale de Psychopathologie, 1, 125–159.Google Scholar
Fonagy, P. & Moran, G. M. (1991) Understanding psychic change in child psychoanalysis. International Journal of Psychoanalysis, 72, 15–22.Google Scholar
Fonagy, P., Steele, M., Steele, H., et al (1991) The capacity for understanding mental states: the reflective self in parent and child and its significance for security of attachment. Infant Mental Health Journal, 13, 200–216.Google Scholar
Frances, A. J. (1990) Foreword. In The Fate of Borderline Patients (ed. Stone, M. H.). New York: Guilford Press.Google Scholar
Frances, A. J. & Widiger, T. (1986) The classification of personality disorders: an overview of problems and solutions. In American Psychiatric Association Annual Review, Vol. 5 (eds Frances, A. J. & Hales, R. E.). Washington DC: American Psychiatric Press.Google Scholar
Frank, J. D. (1988) Specific and non-specific factors in psychotherapy. Current Opinion in Psychiatry, 1, 289–292.Google Scholar
Freud, A. (1970) The Writings of Anna Freud: Vol. 8. Psychoanalytic Psychology of Normal Development 1970–1980. London: Hogarth Press and the Institute of Psychoanalysis.Google Scholar
Friedman, H. J. (1975) Psychotherapy of borderline patients: the influence of theory on technique. American Journal of Psychiatry, 132, 1048–1052.Google Scholar
Frosch, J. (1988) Psychotic character versus borderline. International Journal of Psychoanalysis, 69, 445–456.Google ScholarPubMed
Fyer, M. R., Frances, A. J., Sullivan, T., et al (1988) Comorbidity of borderline personality disorder. Archives of General Psychiatry, 45, 348–352.Google Scholar
Gabbard, G. O. (1989) Splitting in hospital treatment. American Journal of Psychiatry, 146, 444–451.Google Scholar
Giovacchini, P. L. (1979) Treatment of Primitive Mental States. New York: Aronson.Google Scholar
Giovacchini, P. L. (1987) The ‘unreasonable’ patient and the psychotic transference. In The Borderline Patient: Emerging Concepts in Diagnosis, Psychodynamics and Treatment, Vol. 1 (eds Grotstein, J. S., Solomon, M. F. & Lang, J. A.), pp. 59–68. Hillsdale, NJ: The Analytic Press.Google Scholar
Gordon, C. & Beresin, E. (1983) Conflicting treatment models for the inpatient management of borderline patients. American Journal of Psychiatry, 140, 979–983.Google Scholar
Greben, S. E. (1983) The multi-dimensional inpatient treatment of severe character disorders. Canadian Journal of Psychiatry, 28, 97–101.Google Scholar
Grinker, R. R. (1975) Neurosis, psychosis and the borderline states. In Comprehensive Textbook of Psychiatry (eds Freedman, A. M., Kaplan, H. I. & Saddock, B. J.), pp. 845–850. Baltimore: Williams and Wilkins.Google Scholar
Grobman, J. (1980) The borderline patient in group psychotherapy: a case report. International Journal of Group Psychotherapy, 30, 299–318.Google Scholar
Grotstein, J. S., Lang, J. A. & Solomon, M. F. (1987) Convergence and controversy: II. Treatment of the borderline. In The Borderline Patient: Emerging Concepts in Diagnosis, Psychodynamics and Treatment, Vol. 1 (eds Grotstein, J. S., Solomon, M. F. & Lang, J. A.), pp. 261–310. Hillsdale, NJ: The Analytic Press.Google Scholar
Gunderson, J. G. (1984) Borderline Personality Disorder. Washington DC: American Psychiatric Press.Google Scholar
Gunderson, J. G. & Zanarini, M. C. (1987) Current overview of borderline diagnosis. Journal of Clinical Psychiatry, 48 (suppl.), 5–11.Google Scholar
Gunderson, J. G., Frank, A. F., Ronningstam, E. F., et al (1989) Early discontinuance of borderline patients from psychotherapy. Journal of Nervous and Mental Disease, 177, 38–42.CrossRefGoogle ScholarPubMed
Harris, P. L. (1989) Children and Emotion: The Development of Psychological Understanding. Oxford: Basil Blackwell.Google Scholar
Hartocollis, P. (1980) Long-term hospital treatment for adult patients with borderline and narcissistic personality disorders. Bulletin of the Menninger Clinic, 44, 212–226.Google Scholar
Haugsgjerd, S. (1987) Toward a theory for milieu treatment of hospitalized borderline patients. In The Borderline Patient: Emerging Concepts in Diagnosis, Psychodynamics and Treatment, Vol. 2 (eds Grotstein, J. S., Solomon, M. F. & Lang, J. A.), pp. 211–226. Hillsdale NJ: Analytic Press.Google Scholar
Herman, J. L., Perry, C. & van der Kolk, B. A. (1989) Childhood trauma in borderline personality disorder. American Journal of Psychiatry, 146, 490–495.Google Scholar
Horner, A. J. (1975) A characterological contraindication for group psychotherapy. Journal of American Academy of Psychoanalysis, 3, 301–305.Google Scholar
Horwitz, L. (1977) A group-centred approach to group psychotherapy. International Journal of Group Psychotherapy, 27, 423–439.Google Scholar
Horwitz, L. (1987) Indications for group psychotherapy with borderline and narcissistic patients. Bulletin of the Menninger Clinic, 51, 248–260.Google Scholar
Jackson, M. & Pines, M. (1986) In-patient treatment of borderline personality. Neurologia et Psychiatrica, 9, 54–87.Google Scholar
Jones, S. A. (1987) Family therapy with borderline and narcissistic patients. Bulletin of the Menninger Clinic, 51, 285–295.Google Scholar
Kennedy, R. (1989) The Family as In-patient. London: Free Association Books.Google Scholar
Kernberg, O. (1967) Borderline personality organisation. Journal of the American Psychoanalytic Association, 15, 641–685.Google Scholar
Kernberg, O. (1972) Final report of the Menninger Foundation's psychotherapy research project: summary and conclusions. Bulletin of the Menninger Clinic, 36, 181–195.Google Scholar
Kernberg, O. (1975) Borderline Conditions and Pathological Narcissism. New York: Jason Aronson.Google Scholar
Kernberg, O. (1976) Technical considerations in the treatment of borderline personality organisation. Journal of the American Psychoanalytic Association, 24, 795–829.Google Scholar
Kernberg, O. (1984) Severe Personality Disorders: Psychotherapeutic Strategies. New Haven, CT: Yale University Press.Google Scholar
Kernberg, O. (1987) Borderline personality disorder: A psychodynamic approach. Journal of Personality Disorders, 1, 344–346.Google Scholar
Kernberg, O. (1992) Measurements of change in the psychodynamic psychotherapy of the borderline patient. In New Approaches to Psychoanalytic Research (eds Fonagy, P. & Kernberg, O.). London: IPA (in press).Google Scholar
Kernberg, O., Selzer, M., Koenigsberg, H. W., et al (1989) Psychodynamic Psychotherapy of Borderline Patients. New York: Basic Books.Google Scholar
Kibel, H. D. (1988) Combined individual and group treatment with borderline and narcissistic patients. Borderline and Narcissistic Patients in Therapy (ed. Slavinska-Hory, N.), pp. 17–45. Madison, Connecticut: International Universities Press, Inc.Google Scholar
King, P. (1978) Affective response of the analyst to the patient's communications. International Journal of Psychoanalysis, 59, 329–334.Google Scholar
Klein, M. (1940) Mourning and its relation to manic-depressive states. In The Writings of Melanie Klein. London: Hogarth Press Google Scholar
Klein, M. (1950) Contributions to Psycho-Analysis, 1921–1945. London: Hogarth Press.Google Scholar
Klein, M. (1957) Envy and gratitude. In The Writings of Melanie Klein, Vol. 3, pp. 176–235. London: Hogarth Press Google Scholar
Knight, R. (1953) Borderline states. Bulletin of the Menninger Clinic, 17, 1–12.Google Scholar
Kohut, H. (1971) The Analysis of the Self. New York: International Universities Press.Google Scholar
Kohut, H. (1977) The Restoration of the Self. New York: International Universities Press.Google Scholar
Kohut, H. (1984) How Does Analysis Cure? Chicago: University of Chicago Press.Google Scholar
Kutter, P. (1982) Basic Aspects of Psychoanalytic Group Therapy. London: Routledge & Kegan Paul.Google Scholar
Lang, J. A., Grotstein, J. S. & Solomon, M. F. (1987) Convergence and controversy: 1. Theory of the borderline. In The Borderline Patient: Emerging Concepts in Diagnosis, Psychodynamics and Treatment, Vol. 1 (eds Grotstein, J. S., Solomon, M. F. & Lange, J. A.), pp. 385–422. Hillsdale, NJ: The Analytic Press.Google Scholar
Lansky, M. R. (1987) Shame in the family relationships of borderline patients. In The Borderline Patient: Emerging Concepts in Diagnosis, Psychodynamics and Treatment, Vol. 2 (eds Grotstein, J. S., Solomon, M. F. & Lang, J. A.), pp. 187–200. Hillsdale, NJ: The Analytic Press.Google Scholar
Lansky, M. R. (1989) The subacute hospital treatment of the borderline patient: Management of suicidal crisis by family intervention. Hillside Journal of Clinical Psychiatry, 11, 81–97.Google Scholar
Linehan, M. M. (1987) Dialectical behavioral therapy: a cognitive behavioral approach to parasuicidc. Journal of Personality Disorders, 1, 328–333.Google Scholar
Loranger, A., Oldham, J. & Tullis, E. (1982) Familial transmission of DSM–III borderline personality disorder. Archives of General Psychiatry, 39, 795–799.Google Scholar
Macaskill, N. D. (1980) The narcissistic core as a focus in the group therapy of the borderline patient. British Journal of Medical Psychology, 53, 137–143.Google Scholar
Macaskill, N. D. (1982) Therapeutic factors in group therapy with borderline patients. International Journal of Group Psychotherapy, 32, 61–74.Google Scholar
McGlashen, T. H. (1986) The Chestnut Lodge follow-up study: III. Long-term outcome of borderline personalities. Archives of General Psychiatry, 43, 20–30.Google Scholar
McGlashen, T. H. (1987) Borderline personality disorder and unipolar affective disorder: longterm effects of co-morbidity. Journal of Nervous and Mental Disease, 175, 467–473.Google Scholar
McGlashen, T. H. & Heinssen, R. K. (1988) Hospital discharge status and longterm outcome for patients with schizophrenia, schizoaffective disorder, borderline personality disorder and unipolar affective disorder. Archives of General Psychiatry, 45, 363–368.Google Scholar
McReynolds, P. (1989) Diagnosis and clinical assessment: current status and major issues. Annual Review of Psychology, 40, 83–108.CrossRefGoogle ScholarPubMed
Mahler, M. S., Pine, F. & Bergman, A. (1975) The Psychological Birth of the Human Infant. New York: Basic Books.Google Scholar
Mahler, M. S. & Kaplan, L. (1977) Developmental aspects in the assessment of narcissistic and so-called borderline personalities. In Borderline Personality Disorders (ed. Hartocollis, P.), pp. 71–85. New York: International Universities Press.Google Scholar
Main, T. (1957) The ailment. British Journal of Medical Psychology, 30, 129–145.Google Scholar
Mandelbaum, A. (1977) The family treatment of the borderline patient. In Borderline Personality Disorders (ed. Hartocollis, P.), pp. 423–438. New York: International Universities Press.Google Scholar
Masterson, J. (1976) Psychotherapy of the Borderline Adult. New York: Brunner/Mazel.Google Scholar
Masterson, J. (1981) The Narcissistic and Borderline Disorders. New York: Brunner/Mazel.Google Scholar
Masterson, J. & Costello, J. L. (1980) From Borderline Adolescent to Functioning Adult, the Test of Time. New York: Brunner/Mazel.Google Scholar
Meissner, W. W. (1987) A contribution to the issues of borderline diagnosis. In The Borderline Patient: Emerging Concepts in Diagnosis, Psychodynamics and Treatment, Vol. 1 (eds Grotstein, J. S., Solomon, M. F. & Lang, J. A.), pp. 73–82. Hillsdale, NJ: The Analytic Press.Google Scholar
Miller, L. J. (1989) Inpatient management of borderline personality disorder: a review and update. Journal of Personality Disorders, 3, 122–134.Google Scholar
Miller, L. J. (1990) The formal treatment contract in the inpatient management of borderline personality disorder. Hospital and Community Psychiatry, 41, 985–987.Google Scholar
Modell, A. (1963) Primitive object relationships and the predisposition to schizophrenia. International Journal of Psychoanalysis, 44, 282–291.Google Scholar
Modell, A. (1968) Object Love and Reality. New York: International Universities Press.Google Scholar
Mueser, K. T. & Berenbaum, H. (1990) Psychodynamic treatment of schizophrenia: Is there a future? Psychological Medicine, 20, 253–262.Google Scholar
Murray, L. (1988) Effects of post-natal depression on infant development: Direct studies of early mother-infant interactions. In Motherhood and Mental Illness (eds Kumar, R. & Brockington, I. F.). London: Wright.Google Scholar
Nurnberg, H. G. & Suh, R. (1980) Limits: Short-term treatment of hospitalized borderline patients. Comprehensive Psychiatry, 21, 70–80.Google Scholar
O'Shaughnessy, E. (1981) A clinical study of a defensive organization. International Journal of Psychoanalysis, 62, 359–369.Google Scholar
Ogata, S. N., Silk, K. R., Goodrich, S., et al (1990) Childhood sexual and physical abuse in adult patients with borderline personality disorder. American Journal of Psychiatry, 147, 1008–1013.Google Scholar
Palombo, J. (1987) Self object transference in the treatment of borderline neurocognitively impaired children. In The Borderline Patient: Emerging Concepts in Diagnosis, Psychodynamics and Treatment, Vol. 1 (eds Grotstein, J. S., Solomon, M. F. & Lang, J. A.), pp. 317–346. Hillsdale, NJ: The Analytic Press.Google Scholar
Paris, J., Brown, R. & Nowlis, D. (1987) Longterm follow-up of borderline patients in a general hospital. Comprehensive Psychiatry, 28, 530–535.Google Scholar
Perry, J. C. (1985) Depression in borderline personality disorder: lifetime prevalence at interview and longitudinal course of symptoms. American Journal of Psychiatry, 142, 15–21.Google Scholar
Perry, J. C. & Cooper, S. H. (1986) A preliminary report on defenses and conflicts associated with borderline personality disorder. Journal of the American Psychoanalytic Association, 34, 863–893.CrossRefGoogle ScholarPubMed
Perry, S. (1990) Combining antidepressants and psychotherapy: rationale and strategies. Journal of Clinical Psychiatry, 51, (suppl.), 16–20.Google Scholar
Pines, M. (1978) Group analytic psychotherapy of the borderline patient. Group Analysis, 11, 115–126.Google Scholar
Pines, M. (1990) Group analytic psychotherapy and the borderline patient. In The Difficult Patient In Group: Group Psychotherapy with Borderline and Narcissistic Disorders (eds Roth, B. E., Stone, W. N. & Kibel, H. D.), pp. 31–44. Madison, Connecticut: International Universities Press, Inc.Google Scholar
Pope, H. G., Frankenburg, F. R., Hudson, J. I., et al (1987) Is bulimia associated with borderline personality disorder? A controlled study. Journal of Clinical Psychiatry, 48, 181–184.Google Scholar
Racker, H. (1968) Transference and Countertransference. London: Hogarth Press.Google Scholar
Rey, J. H. (1979) Schizoid phenomena in the borderline. In Advances in the Psychotherapy of the Borderline Patient (eds le Boit, J. & Lapponi, A.), pp. 449–484. New York: Jason Aronson.Google Scholar
Rockland, L. H. (1967) A supportive approach: psychodynamically oriented supportive therapy – treatment of borderline patients who self-mutilate. Journal of Personality Disorders, 1, 350–353.Google Scholar
Rosenbluth, M. (1987) The inpatient treatment of the borderline personality disorder: a critical review and discussion of aftercare implications. Canadian Journal of Psychiatry, 32, 228–237.Google Scholar
Rosenfeld, H. (1978) Notes on the psychopathology and psychoanalytic treatment of some borderline patients. International Journal of Psychoanalysis, 59, 215–221.Google Scholar
Rosenfeld, H. (1987) Impasse and Interpretation. London: Tavistock Publications.Google Scholar
Rosser, R. M., Birch, S., Bond, H., et al (1987) Five year follow-up of patients treated with inpatient psychotherapy at the Cassel Hospital for Nervous Diseases. Journal of the Royal Society of Medicine, 80, 549–555.Google Scholar
Roth, B. E. (1980) Understanding the development of a homogenous identity impaired group through countertransference phenomena. International Journal of Group Psychotherapy, 30, 404–412.Google Scholar
Roth, B. E. (1990) The group that would not relate to itself. In The Difficult Patient In Group: Group Psychotherapy with Borderline and Narcissistic Disorders (eds Roth, B. E., Stone, W. N. & Kibel, H. D.), pp. 127–155. Madison, Connecticut: International Universities Press, Inc.Google Scholar
Rutter, M. (1987) Temperament, personality and personality disorder. British Journal of Psychiatry, 150, 443–458.Google Scholar
Sandler, J. (1976) Countertransference and role-responsiveness. International Review of Psychoanalysis, 3, 43–47.Google Scholar
Sandler, J. (1976) Actualisation and object relationships. Journal of the Philadelphia Association of Psychoanalysis, 3, 59–70.Google Scholar
Sandler, J. (1983) Reflections on some relations between psychoanalytic concepts and psychoanalytic practice. International Journal of Psychoanalysis, 64, 35–45.Google Scholar
Sandler, J. (1987) Projection, Identification, Projective Identification. London: Karnac Books.Google Scholar
Sansone, R. A. & Madokasira, S. (1990) Borderline personality disorder: guidelines for evaluation and brief inpatient management. Psychiatric Hospital, 21, 65–69.Google Scholar
Schane, M. & Kovel, V. (1988) Family therapy in severe personality disorders. International Journal of Family Psychiatry, 9, 241–258.Google Scholar
Schmideberg, M. (1947) The treatment of psychopathic and borderline patients. American Journal of Psychotherapy, 1, 45–71.Google Scholar
Searles, H. F. (1986) My Work with Borderline Patients. Northvale, NJ: Jacob Aronson.Google Scholar
Segal, H. (1964) Introduction to the Work of Melanie Klein. New York: Basic Books.Google Scholar
Segal, H. (1972) A delusional system as a defence against the emergence of a catastrophic situation. International Journal of Psychoanalysis, 53, 393–402.Google Scholar
Selzer, M. A., Koenigsberg, H. W. & Kernberg, O. F. (1987) The initial contract in the treatment of borderline patients. American Journal of Psychiatry, 144, 927–930.Google Scholar
Shapiro, T. (1983) The borderline syndrome in children: a critique. In The Borderline Child (ed. Robson, K.), pp. 11–30. New York: McGraw Hill.Google Scholar
Shapiro, T. (1989) Psychoanalytic classification and empiricism with borderline personality disorder as a model. Journal of Consulting and Clinical Psychology, 57, 187–194.Google Scholar
Shea, M. T., Pilkonis, P. A., Beckham, E., et al (1990) Personality disorders and treatment outcome in the NIMH treatment of depression collaborative research program. American Journal of Psychiatry, 147, 711–718.Google ScholarPubMed
Shearer, S. L., Peters, C. P., Quaytman, M. S., et al (1990) Frequency and correlates of childhood sexual and physical abuse histories in adult female borderline patients. American Journal of Psychiatry, 147, 214–216.Google Scholar
Siever, L. J. & Gunderson, J. G. (1979) Genetic determinants of borderline conditions. Schizophrenia Bulletin, 5, 59–86.Google Scholar
Silver, D. (1983) Psychotherapy of the characterologically difficult patient. Canadian Journal of Psychiatry, 28, 513–521.Google Scholar
Singer, M. (1987) Inpatient hospitalization for borderline patients: process and dynamics of change in long- and short-term Treatment. In The Borderline Patient: Emerging Concepts in Diagnosis, Psychodynamics and Treatment, Vol. 2 (eds Grotstein, J. S., Solomon, M. F. & Lang, J. A.), pp. 227–242. Hillsdale, NJ: The Analytic Press.Google Scholar
Sohn, L. (1985) Narcissistic organisation, projective identification and the formation of the identificate. International Journal of Psychoanalysis, 66, 201–213.Google Scholar
Soloff, P. H. & Millward, J. W. (1983) Psychiatric disorders in the families of borderline patients. Archives of General Psychiatry, 40, 37–44.CrossRefGoogle ScholarPubMed
Solomon, M. F. (1987) Therapeutic treatment of borderline patients by non-analytic practioners. In The Borderline Patient: Emerging Concepts in Diagnosis, Psychodynamics and Treatment, Vol. 2 (eds Grotstein, J. S., Solomon, M. F. & Lang, J. A.), pp. 243–260. Hillsdale, NJ: The Analytic Press.Google Scholar
Spillius, E. B. (1988) General introduction. In Melanie Klein Today: Developments in Theory and Practice. Vol. I: Mainly Theory (ed. Spillius, E. B.). London: Routledge.Google Scholar
Steiner, J. (1979) The border between the paranoid-schizoid and the depressive positions in the borderline patient. British Journal of Medical Psychology, 52, 385–391.Google Scholar
Steiner, J. (1987) The interplay between pathological organisations and the paranoid-schizoid and depressive positions. International Journal of Psychoanalysis, 68, 69–80.Google Scholar
Stern, D. (1985) The Interpersonal World of the Child. New York: Basic Books.Google Scholar
Stone, M. H. (1977) The borderline syndrome: evolution of the term, genetic aspects and prognosis. American Journal of Psychotherapy, 31, 345–365.Google Scholar
Stone, M. H. (ed.) (1986) Essential Papers on Borderline Disorders: One Hundred Years at the Border. New York: New York University Press.Google Scholar
Stone, M. H. (1987) Systems for defining a borderline case. In The Borderline Patient: Emerging Concepts in Diagnosis, Psychodynamics and Treatment (eds Grotstein, J. S., Solomon, M. F. & Lang, J. A.), pp. 13–35. Hillsdale, NJ: The Analytic Press.Google Scholar
Stone, M. H. (1987) Psychotherapy of borderline patients in light of longterm follow-up. Bulletin of the Menninger Clinic, 51, 231–247.Google Scholar
Stone, M. H. (1989) Long-term follow-up of narcissistic borderline patients. Psychiatric Clinics of North America, 12, 621–641.Google Scholar
Stone, M. H., Hurt, S. W. & Stone, D. K. (1987) The PI 500: Long-term follow-up of borderline inpatients meeting DSM–III criteria: I. Global outcome. Journal of Personality Disorders, 1, 291–298.Google Scholar
Stone, M. H. (1990) The Fate of Borderline Patients: Successful Outcome and Psychiatric Practice. New York: The Guilford Press.Google Scholar
Stone, W. N. & Gustafson, J. P. (1982) Technique in group psychotherapy of narcissistic and borderline patients. International Journal of Group Psychotherapy, 32, 29–47.Google Scholar
Swartz, M., Blazer, D., George, L., et al (1990) Estimating the prevalence of borderline personality disorder in the community. Journal of Personality Disorders, 4, 257–272.Google Scholar
Swett, C., Surrey, J. & Cohen, C. (1990) Sexual and physical abuse histories and psychiatric symptoms among male psychiatric outpatients. American Journal of Psychiatry, 147, 632–636.Google Scholar
Tarnopolsky, A. & Berelowitz, M. (1987) Borderline personality: a review of recent research. British Journal of Psychiatry, 151, 724–734.Google Scholar
Tausk, V. (1919) On the origin of the ‘influencing machine’ in schizophrenia. Reprinted (1933) in Psychoanalytic Quarterly, 2, 519–556.Google Scholar
Tolpin, M. (1987) Injured self-cohesion: Developmental, clinical and theoretical perspectives. In The Borderline Patient: Emerging Concepts in Diagnosis, Psychodynamics and Treatment, Vol. 1 (eds Grotstein, J. S., Solomon, M. F. & Lang, J. A.), pp. 233–249. Hillsdale, NJ: The Analytic Press.Google Scholar
Torgersen, S. (1984) Genetic and nosological aspects of schizotypal and borderline personality disorders. Archives of General Psychiatry, 41, 546–554.Google Scholar
Trevarthen, C. (1980) The foundations of intersubjectivity: development of interpersonal and cooperative understanding in infants. In The Social Foundations of Language and Thought (ed. Olson, D. R.). Toronto: Norton.Google Scholar
Tucker, L., Bauer, S. F., Wagner, S., et al (1987) Long-term hospital treatment of borderline patients: a descriptive outcome study. American Journal of Psychiatry, 144, 1443–1448.Google Scholar
Turner, R. M. (1989) Case study evaluations of a bio-cognitive-behavioral approach to the treatment of borderline personality disorder. Behavior Therapy, 20, 477–489.Google Scholar
Tuttman, S. (1990) Principles of psychoanalytic group therapy applied to the treatment of borderline and narcissistic disorders. In The Difficult Patient In Group: Group Psychotherapy with Borderline and Narcissistic Disorders (eds Roth, B. E., Stone, W. N. & Kibel, H. D.), pp. 7–29. Madison, Connecticut: International Universities Press, Inc.Google Scholar
Tyrer, P. (1989) Clinical importance of personality disorder. Current Opinion in Psychiatry, 2, 240–243.Google Scholar
Tyrer, P., Seivewrioht, N., Fbrguson, B., et al (1990) The Nottingham study of neurotic disorder: relationship between personality status and symptoms. Psychological Medicine, 20, 423–431.Google Scholar
Vaglum, P., Friis, S., Imon, T., et al (1990) Treatment response of severe and nonsevere personality disorders in a therapeutic community day unit. Journal of Personality Disorders, 4, 161–172.Google Scholar
Volkan, V. D. (1987) Six constellations of psychoanalytic psychotherapy of borderline patients. In The Borderline Patient: Emerging Concepts in Diagnosis, Psychodynamics and Treatment, Vol. 2 (eds Grotstein, J. S., Solomon, M. F. & Lang, J. A.), pp. 5–24. Hillsdale, NJ: The Analytic Press.Google Scholar
Waldinger, R. J. (1987) Intensive psychodynamic therapy with borderline patients: an overview. American Journal of Psychiatry, 144, 267–274.Google Scholar
Waldinger, R. J. & Frank, A. F. (1989) Clinicians' experiences in combining medication and psychotherapy in the treatment of borderline patients. Hospital and Community Psychiatry, 40, 712–718.Google Scholar
Wallerstein, R. (1986) Forty-two Lives in Treatment. New York: Guilford Press.Google Scholar
Wallerstein, R. (1988) One psychoanalysis or many? International Journal of Psychoanalysis, 69, 5–21.Google Scholar
Wallerstein, R. (1990) Psychoanalysis: the common ground. International Journal of Psychoanalysis, 71, 3–20.Google Scholar
Weiler, M. A., Val, E. R., Gaviria, M., et al (1988) Panic in borderline personality disorder. Psychiatric Journal of the University of Ottowa, 13, 140–143.Google Scholar
Westen, D. (1991) Cognitive-behavioural interventions in the psychoanalytic psychotherapy of borderline personality disorders. Clinical Psychology Review, 11, 211–230.Google Scholar
Westen, D., Lundolph, P., Misle, B., et al (1990) Physical and sexual abuse in adolescent girls with borderline personality disorder. American Journal of Orthopsychiatry, 60, 55–66.Google Scholar
Widiger, T. A., Frances, A., Spitzer, R. L., et al (1988) The DSM–III personality disorders: an overview. American Journal of Psychiatry, 145, 786–795.Google Scholar
Winnicott, D. W. (1949) Hate in the countertransference. International Journal of Psychoanalysis, 30, 69–75.Google Scholar
Winnicott, D. W. (1953) Transitional objects and transitional phenomena. International Journal of Psychoanalysis, 34, 89–97.Google Scholar
Winnicott, D. W. (1960) The theory of the parent-infant relationship. In The Maturational Process and the Facilitating Environment, pp. 37–55. New York: International Universities Press Google Scholar
Winnicott, D. W. (1965) The Maturational Process and the Facilitating Environment. London: Hogarth Press.Google Scholar
Wishnie, H. A. (1975) Inpatient therapy with borderline patients. In Borderline States in Psychiatry (ed. Mack, J. E.). New York: Grune and Stratton.Google Scholar
Wong, N. (1980) Combined group and individual treatment of borderline and narcissistic patients: heterogenous vs. homogenous groups. International Journal of Group Psychotherapy, 30, 389–404.Google Scholar
Wong, N. (1968) Combined individual and group treatment with borderline and narcissistic patients. In Borderline and Narcissistic Patients in Therapy (ed. Slavinska-Holy, N.). Madison: Connecticut: IUP.Google Scholar
World Health Organization (1986) Draft of Chapter V. Geneva: WHO.Google Scholar
Yalom, I. D. (1975) The Theory and Practice of Group Psychotherapy (2nd edn). New York: Basic Books.Google Scholar
Zanarini, M. C., Frankenberg, F. R. & Gunderson, J. G. (1988) Pharmacotherapy of borderline patients. Comprehensive Psychiatry, 29, 372–378.Google Scholar
Zanarini, M. C., Gunderson, J. G., Frankenburg, F. R., et al (1990) Discriminating borderline personality disorder from other Axis II disorders. American Journal of Psychiatry, 147, 161–167.Google Scholar
Zanarini, M. C., Gunderson, J. G. & Frankenburg, F. R. (1990) Cognitive features of borderline personality disorder. American Journal of Psychiatry, 147, 57–63.Google Scholar
Zetzel, E. R. (1971) A developmental approach to the borderline patient. American Journal of Psychiatry, 127, 867–871.Google Scholar
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