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Japanese

A Psychotherapy of a Borderline Patient Naoki Hayashi 1 1Tokyo Metropolitan Matsuzawa Hospital Keyword: Borderline personality disorder , Psychotherapy , Supportive psychotherapy , Individuation , Symbiotic relationship pp.939-947
Published Date 1990/9/15
DOI https://doi.org/10.11477/mf.1405902903
  • Abstract
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 A case report of the first 6 year-psychotherapy of a borderline patient (15 years old at the first interview, male, unmarried), illustrates three phases of the therapy relationship; autism, symbiotic relation, and individuation. In the autistic phase which characterized the first year of therapy, the patient didn't recognize “not-me”; external objects and even his feelings and actions. He was quite passive and silent, and seemed to refuse to relate with the therapist in the interviews. The therapist accepted his silence only explaining the aim of the therapy and the role of the therapist. He then started relating with the therapist by asking his personal background, and gradually developed a symbiotic relationship with the therapist. In the symbiotic phase he showed intense intimacy, salvation desires, and at the same time extreme agression including homicidal ideas towards the therapist. The therapist was involved in the turbulent affects as a person, and suffered from the ambiguity of individuality and self boundary, a pathology shared with the patient, In this impasse of the psychotherapy it was the effort of the therapist to deliniate the boundary between the two participants and to reestablish his own individuality while keeping the therapeutic attitude, that enabled the patient to grasp his own feelings, actions, and intentions as inseparable parts of himself. In other words, it was this mutual involvement of the therapist and the patient that advanced the individuation process of the patient.


Copyright © 1990, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-126X 印刷版ISSN 0488-1281 医学書院

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