Borderlines: problems of self and object separation

The borderline has deficiencies in the capacity to maintain stable self and object representations and in establishing 'emotional separateness' from others. In order to create and maintain a 'propitious treatment situation' and a 'therapeutic alliance' the therapist must work with unusual sensitivity and repetitiveness on the ground rules of the therapeutic environment. Explicit clarifications of the therapist's usual constructive attitudes, as a caring, responsive, neutral and real person must be continuously emphasized. The intense psychotic transference potential that leads to therapeutic complications and disruptions can be worked through, if recognized early, through countertransference clues, acceptance of positive aspects of the countertransference and technical moves that enhance the patient's capacity for individuation and separation, all this within the framework of a structured and consistent therapeutic situation. These assertions are illustrated by specific instances from treatment processes.