Am J Psychiatry 1978; 135:1305-1315
Copyright © 1978 by American Psychiatric Association
The psychodynamics and developmental psychology of the borderline patient: a review of the literature
ER Shapiro
The author reviews the psychodynamics and developmental psychology of the
borderline patient as described in the literature on intensive therapy,
early mother-child interaction, and family interaction. Focusing on the
borderline patient's characteristic difficulties in intimate relationships,
he describes the patient's use of splitting and projective identification
as seen in the characteristic transference- countertransference interaction
in intensive therapy. These primitive defensive mechanisms, which are also
utilized by family members, appear to contribute to a failure of empathic
responses both during the child's early development and in the family
interactions during his adolescence. The author concludes that conceptual
attempts to relate adult and child phenomena, although highly speculative,
create new and useful perspectives for the treatment of the borderline
patient.
