Am J Psychiatry 1985; 142:9-14
Copyright © 1985 by American Psychiatric Association
Medicolegal pitfalls in the treatment of borderline patients
TG Gutheil
Patients with the borderline syndrome, although not always the sickest
patients, often cause the most difficulty because of their intense and
contagious affects, their often impulsive behavior, and the strains they
place on the treaters' countertransference. The author explores the
hitherto ignored area of medicolegal problems that often arise in treatment
of borderline patients. Specifically, he addresses the issues of legal
ignorance of the syndrome, the effect of dynamic processes such as
splitting and psychotic transference, problems regarding limit setting and
related management approaches, and problems arising from
countertransference phenomena. He suggests approaches to these problems as
well.
