Am J Psychiatry 1978; 135:229-231
Copyright © 1978 by American Psychiatric Association
Splitting and identification with the aggressor in assaultive borderline patients
K MacVicar
The author describes two borderline inpatients with assaultive behavior
that was not controllable by medication. These patients use splitting to
separate all-good and all-bad part representations, which hinders tolerance
of ambivalence and control of aggression. Drive breakthroughs may reinforce
their feelings of omnipotence. Interpreting episodes to the patient in this
psychodynamic framework can aid their integration of self-representations
and their ability to control aggression. Therapists and staff should resist
the temptation to "give in" to such patients in order to forestall
explosions.
