Object Relations Treatment of a Woman With Borderline Personality Disorder From a Mahlerian Perspective

Abstract

This article presents the treatment of a female patient with borderline personality disorder which draws on the principles of Margret Mahler’s object relations theory. Common characteristics of this disorder include fear of abandonment, unstable relationships, lack of identity, impulsiveness, pervasive emptiness, excessive anger, and the inability to regulate emotions. These symptoms are rooted in the dynamic, ambivalent, and prevailing struggle between the merger and individualization during the rapprochement subphase. Psychotherapy that utilizes transference within the treatment helps the patient to increase awareness of how she participates in a dyadic relationship based on early internalizations. The unconscious reenactment of early object relations is understood by uncovering defenses (splitting, projection, and projective identification) that play out in the therapist/patient relationship. This offers the patient the opportunity to integrate parts of the self and other, and hold ambivalent feelings without splitting or distorting. Consequently the therapeutic relationship is the vehicle for change.