Restricted accessResearch articleFirst published online 2000-12
Attachment and Contained Splitting: A Combined Approach of Group and Individual Therapy to the Treatment of Patients Suffering from Borderline Personality Disorder
In this article the authors describe the three-year combined group and individual therapy project for patients suffering from severe borderline personality disorder. The project attempted through careful supervision and regular whole-team meetings to integrate the research findings of attachment theory into the practice of both group and individual therapy. Material from the group sessions follows a description of the project's organization and the relevant attachment theory.
Ainsworth M.D.S.
, Blehar, M.C., Waters, E. and Wall, S. (1978) Patterns of Attachment. A Psychological Study of the Strange Situation. Hillsdale, NJ: Erlbaum.
2.
Bowlby, J.
(1969) Attachment and Loss, 2nd edn, vol. 1: Attachment. London: Hogarth Press.
3.
Bowlby, J.
(1973) Attachment and Loss, vol. 2: Separation, Anxiety and Anger. London: Hogarth Press.
4.
Bowlby, J.
(1980) Attachment and Loss, vol. 3: Loss, Sadness and Depression. London: Hogarth Press.
5.
Bremner, J.D.
, Randall, P., Scott, T.M., Bronen, R.A., Seibyl, J.B., Southwick, S.M., Delaney, R.C., McCarthy, G., Charney, D.S. and Innis, R.B. (1995) `MRI-based Measures of Hippocampal Volume in Vietnam Combat Veterans', American Journal of Psychiatry152: 973-981.
6.
Fairbairn, R.
(1952) Psychoanalytic Study of the Personality. London: Routledge and Kegan Paul.
7.
Fonagy, P.
(1999) `Transgenerational Consistencies of Attachment: A New Theory'http:/www.psychematters.com/papers/fonagy2.htm
8.
Fonagy, P.
, Steele, M. and Steele, H. (1991a) `Maternal Representation of Attachment during Pregnancy Predicts the Organisation of Infant-Mother Attachment at One Year of Age', Child Development62: 880-893.
9.
Fonagy, P.
, Moran, G., Steele, H. and Higgitt, A.C. (1991b) `The Capacity for Understanding Mental States: The Reflective Self in Parent and Child and its Significance for Security of Attachment', Infant Mental Health Journal13: 200-216.
10.
Fonagy, P.
, Steele, M., Steele, H., Leigh, T., Kennedy, R., Mattoon, G. and Target, M. (1995) `Attachment: The Reflective Self and Borderline States: The Predictive Specificity of the Adult Attachment Interview and Pathological Emotional Development', in S. Goldberg, R. Muir and J. Kerr (eds) Attachment Theory: Social, Developmental and Clinical Perspectives. Hillsdale, NJ and London: Analytic Press.
11.
George, C.
, Kaplan, N. and Main, M. (1985) `The Adult Attachment Interview', in M. Main and R. Roldwyn (eds) Assessing Attachment through Discourse, Drawings and Reunion Situations. New York: Cambridge University Press.
12.
Herman, J.
(1992) Trauma and Recovery: The Aftermath of Violence from Domestic Abuse to Political TerrorNew York: Basic Books.
13.
Lindemann, E.
(1944) `Symptomatology and Management of Acute Grief'. American Journal of Psychiatry, 101: 141-149.
14.
Main, M.
(1981) Avoidance in the Service of Attachment: A Working Paper', in K. Immelman, G. Barlow, M. Main and L. Petrinovitch (eds) Behavioural Development: The Bielefeld Interdisciplinary Project. New York: Cambridge University Press.
15.
Main, M.
and Hesse, E. (1992) `Disorganized/Disorientated Infant Behaviour in the Strange Situation: Lapses in Monitoring of Reasoning and Discourse During the Parent's Adult Attachment Interview and Dissociative States', in M. Ammanti and D. Stern (eds) Attachment and Psychoanalysis, pp. 1-56. Rome: Gius Laterza and Figli (trans. into Italian).
16.
Ogawa, J.R.
, Sroufe, A., Weinfeld, N., Carlson, E.A. and Egeland, B. (1997) Development and the Fragmented Self: Longitudinal Study of Dissociative Symptomatology in a Non-Clinical Sample', Development and Psychopathology9: 855-879.
17.
Panksepp, J.
, Siviy, S.M. & Normansell, I.A. (1985) `Brain opiods and social emotions', in M. Reik & T. Field (eds) The Psychobiology of Attachment and Separation, pp. 3-49. London: Academic Press.
18.
Patrick, M.
, Hobson, R.P., Castle, P., Howard, R. and Maughan, B. (1994) `Personality Disorder and the Early Representations of Early Social Experience', Developmental Psychopathology94: 375-388.
19.
Perry, B.D.
(1994) `Neurobiological Sequelae of Childhood Trauma: PTSD in Children', in M.M. Murburg (ed.) Catecholamine Function in Posttraumatic Stress Disorders: Emerging Concepts. Washington, DC: American Psychiatric Press.
20.
Perry, B.D.
and Pate, J.E. (1993) Neurodevelopment and the Psychobiological Roots of Post-Traumatic Stress Disorder', in L.F. Kosiol and C.E. Stout (eds) The Neuropsychology of Mental Disorders: A Practical Guide. Springfield, IL: Charles C. Thomas.
21.
Perry, B.D.
, Pollard, R., Blakeley, T., Baker, W. and Vigilante, D. (1995) `Childhood Trauma, the Neurobiology of Adaptation and "Use-Dependent" Development of the Brain: How "States" Become "Traits"', Infant Medical Health Journal16(4): 271-291.
22.
Pines, M.
(1990) `Group Analytic Psychotherapy and the Borderline Patient', in B.E. Roth, W.N. Stone and H.D. Kibel (eds) The Difficult Patient in Group: Group Psychotherapy with Borderline and Narcissistic Disorders, p. 42. American Group Psychotherapy Association, Monograph Series. Madison, CT: International Universities Press, Inc.
23.
Pines, M.
and Schermer, V.L. (1994) `An Editorial Introduction', in V.L. Schermer and M. Pines (eds) Ring of Fire. Primitive Affects and Object Relations in Group Therapy. London: Routledge.
24.
Rauch, S.L.
, van der Kolk, B.A., Fisler, R.E., Alpert, N.M., Orr, S.P., Savage, C.R., Fischman, A.J., Jenike, M.A. and Pitman, R.K. (1996) `A Symptom Provocation Study of Posttraumatic Stress Disorder Using Positron Emission Tomography and Script Driven Imagery', Archives of General Psychiatry53: 380-387.
25.
Sroufe, L.A.
(1983) `Infant-Caregiver Attachment and Patterns of Adaptation in Pre-School: The Roots of Maladaptation and Competence', in M. Perlmutter (ed.) Minnesota Symposium in Child Psychology, vol. 16, pp. 41-81. Hillsdale, NJ: Erlbaum.
26.
Stern D.
(1985) The Interpersonal World of the Infant: A View from Psychoanalysis and Developmental Psychology. New York: Basic Books.
27.
van der Kolk, B.
(1989) `The Body Keeps the Score: Memory and the Evolving Psychobiology of Posttraumatic Stress', Harvard Review of Psychiatry1: 253-265.
28.
van der Kolk, B.
(1996) `The body keeps the score: approaches to the psychobiology of Post Traumatic Stress Disorder', in B. van der Kolk, A.C. McFarlane & L. Weisaeth (eds) Traumatic Stress, the effects of overwhelming experience on Mind, Body and Society, pp. 214-241. New York: Guildford Press.
29.
Van Ijzendoorn, M.H.
and Bakermans-Kranenburg, M.J. (1997) `Intergenerational Transmission of Attachment: A Move to the Contextual Level', in L. Atkinson and K.J. Zucker (eds) Attachment and Psychopathology. New York/London: Guildford Press.
30.
Welldon, E.V.
(1988) Mother, Madonna, Whore. London: Free Association Books.
31.
Zulueta, F.de
(1993) From Pain to Violence, the Traumatic Roots of Destructiveness. London: Whurr.
