Abstract
The problems of residents working intensively with borderline inpatients in a general hospital psychiatric unit are described. The resident feels pressure because of inexperience with intensive psychotherapy, and the high visibility of working in a closely supervised team setting. The borderline patient baffles the resident with his defensive activity characterized by splitting, erotization, idealization, and negative therapeutic response. These difficulties complicate supervision, necessitating the supervisor's alertness to being caught in team splits or collusion with the resident's unrealistic hopefulness or nihilism. Supervision must actively address the resident's countertransference and the supervisor's counter-responses. Clinical vignettes illustrate the various problems.