Separation-individuation roller coaster in the therapy of a borderline patient

Many borderline patients experience gains, not setbacks, as negative and worthy of punishment. Thus, after taking a positive step toward being assertive and self-directing, the patient feels depressed, anxious, bad, and afraid. The progress of therapy experiences many ups and downs, not unlike a roller coaster. This article explains the psychodynamics of this phenomenon in terms of Masterson's theory. A clinical example is used to demonstrate how to identify this process and to help the patient work through it.