Borderline Personality Disorder: Understanding the Unconscious Function of Deliberate Self Harm and Managing the Transference Relationship

Amanda Commons Treloar, PhD
Alumni of Monash University, School of Psychology, Psychiatry & Psychological Medicine, Victoria, Australia

Series: Psychology of Emotions, Motivations and Actions
BISAC: PSY018000

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Ideally a resource for clinicians and therapists, this book describes the value of using a psychoanalytic theoretical framework to explore and understand behavioural disturbance in patients diagnosed with borderline personality disorder (BPD). It blends both theoretical and practical treatment considerations in working with BPD, using detailed case study presentations to demonstrate this material. It also provides a description of diagnostic procedures and the importance of recognising the transference relationship with patients diagnosed with this disorder.

The psychoanalytic framework of moral masochism by Freud (1924/1961) is used to explore the unconscious function of deliberate self harm behaviours. Case illustrations are offered to highlight the process by which to understand the patient’s unconscious responses throughout treatment, and to appreciate the patient’s experience of clinical care when a consideration of these unconscious processes is disregarded or not adequately acknowledged. Specific discussion is then offered on appreciating the role of the clinician in the therapeutic alliance in terms of the patient’s prognosis. The role of the transference in the repetition of the patient’s trauma, and therefore the occurrence of recurrent deliberate self harm episodes during treatment, is then considered in detail.

Recommendations are also provided as to more robust diagnostic practices and more effective clinical responses to BPD patients, particularly in relation to the recognition of the significance of the transference relationship and the importance of managing the countertransference in the therapeutic contact with such patients. The theoretical content of this book has been empirically tested (within education programs offered to emergency medicine and mental health clinicians in Australia and New Zealand) to demonstrate its effectiveness in improving clinician attitudes toward working in this clinical area, and in improving clinician consideration of the diagnostic criteria required for application of the diagnosis. (Imprint: Nova)

Preface

Acknowledgements

PART 1: A Consideration of Borderline Personality Disorder

Chapter 1. Issues of Diagnostic Practice

Chapter 2. Deliberate Self Harm and Borderline Personality Disorder

Chapter 3. The Professional Response to Borderline Personality Disorder

PART 2: Interpretation of the Function of Deliberate Self Harm

Chapter 4. Understanding Self Harm with the Use of Conceptual Frameworks

Chapter 5. A Psychoanalytic Framework for Considering Self Harm

PART 3: The Clinical Illustration of the Moral Masochism Framework

Chapter 6. The Use of Clinical Interviews

Chapter 7. The Case Formulation of ‘Lisa’

Chapter 8. The Case Formulation of ‘Helen’

Chapter 9. The Case Formulation of ‘Eve’

Chapter 10. The Patient's Feedback on the Professional Response

PART 4: Clinical Practice and Treatment Recommendations

Chapter 11. Important Considerations in Working with Borderline Patients

Chapter 12. Issues to Consider Outside of the Therapeutic Session

Chapter 13. Strategies to Consider in the Therapy Room

Chapter 14. General Guidelines of Good Practice

Chapter 15. Final Comments on Working with Borderline Patients

References

Appendices

Index

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