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Treatment issues with borderline patients and the psychosomatic focus
1Dept. of Psychiatry, University of Illinois, College of Medicine, Winnetka 60093.
American Journal of Psychotherapy
|January 1, 1993
Summary
Borderline patients exhibit psychic discontinuity, leading to psychosomatic symptoms. Therapeutic regression can facilitate integration and improve treatment outcomes.
Area of Science:
- Psychology and Psychiatry
- Psychoanalytic Theory
- Psychosomatic Medicine
Background:
- Explores character structure defects in borderline patients.
- Challenges the notion of a smooth psychic continuum from id to ego.
- Introduces the concept of psychic discontinuity and lacunae.
Observation:
- Borderline patients experience psychic lacunae—empty psychological spaces.
- These lacunae often become focal points for somatic disruptions.
- Psychosomatic symptoms arise from these localized deficits.
Findings:
- Psychic discontinuity is a key feature of borderline character structure.
- Lacunae serve as psychosomatic foci, manifesting as physical symptoms.
- Treatment can be challenging but offers potential for integration.
Implications:
- A therapeutic setting allowing regression can help patients access split-off self-parts.
- This approach can lead to more manageable therapeutic interactions.
- In some cases, this therapeutic strategy may be life-saving.