Some clinical manifestations of structural defects in a borderline personality

A case is presented that illustrates specific clinical manifestations of structural deficits and psychopathological complexes characteristic of borderline patients. Following an overview of the patient's presenting problems and history, the patient's personality organization is conceptualized metapsychologically. Then the clinical manifestations of three core problem areas in the patient are explored: (1) deficits in narcissistic cathexis leading to clinically apparent, primitive, self-confirming character traits, (2) fear of helplessness and pathological attempts to establish a sense of control, and (3) arrest of drive development coupled with limited ego capacity for sublimation.