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Boundary issues and personality disorders.

Thomas G Gutheil1

  • 1Harvard Medical School and Massachusetts Mental Health Center, Brookline, MA 02446, USA.

Journal of Psychiatric Practice
|April 2, 2005
PubMed
Summary
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This article clarifies boundary theory in therapy, differentiating crossings from violations. It details consequences, patient personality disorders, and offers risk management strategies for therapeutic relationships.

Area of Science:

  • Psychology
  • Therapeutic Relationship Studies

Background:

  • Boundary theory is crucial in therapeutic relationships.
  • Understanding boundary crossings versus violations is key.
  • Context, power dynamics, and fiduciary duty influence boundary issues.

Purpose of the Study:

  • To provide a comprehensive overview of boundary theory.
  • To discuss the consequences of boundary problems.
  • To explore boundary issues in specific personality disorders and offer risk management strategies.

Main Methods:

  • Literature review of boundary theory.
  • Analysis of intrinsic and extrinsic consequences.
  • Examination of boundary issues related to personality disorders.
  • Discussion of countertransference and cultural factors.

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Main Results:

  • Distinction between boundary crossings and violations is clarified.
  • Extrinsic consequences include lawsuits, board complaints, and professional society complaints.
  • Specific boundary challenges arise with histrionic, dependent, antisocial, and borderline personality disorders.

Conclusions:

  • Awareness of context, power, and duty is essential for managing boundaries.
  • Cultural differences impact boundary perception.
  • Implementing risk management principles can prevent boundary problems.