Anatomy of a Splitting Borderline: Description and Analysis of a Case History

Anatomy of a Splitting Borderline: Description and Analysis of a Case History

Anatomy of a Splitting Borderline: Description and Analysis of a Case History

Anatomy of a Splitting Borderline: Description and Analysis of a Case History

Synopsis

Borderline personality disorder is a diagnosis often given to those who have serious problems with self-image and mood, as well as with interpersonal relations. This text presents a journal of a 15-month course of therapy with a classic splitting borderline patient, followed by an in-depth analysis of the case from three very different, but ultimately converging, perspectives. While there is a large and growing literature on borderline personality disorder, Anatomy of a Splitting Borderline is the first book-length study of a borderline patient, expressly revealing facets of this mental illness and its therapeutic challenge that could only be summarized in previous, briefer case histories. Psychiatrists, psychoanalysts, psychologists, social workers, and those in training in these professions are the audience for this ground-breaking book.

Excerpt

This is a story -- whatever else it may be called, it is a story -- about someone who is mentally ill. It is a description and analysis of that illness, of the person who lives it, and of the world he creates.

The illness described here fits the clinical picture of borderline personality disorder as characterized by James F. Masterson, Otto F. Kernberg, and others and by DSM-III-R. Most of what has been written on this pathology is presented either from a psychoanalytic perspective, in psychoanalytic language, or strictly from the perspective of behavior. I have tried to understand and write about this illness mainly from the existential- phenomenological point of view, a perspective that owes its start and ground to Husserl and its development and further existentialization to Heidegger, Sartre, Merleau-Ponty, Jaspers, Binswanger, Boss, and Laing, among others. the technique is description and reflection. a fundamental assumption is that if the surface of a phenomenon, in this case a mental illness, is described well enough, the structure -- the anatomy -- will show itself, and the phenomenon will reveal its meaning. This text has the feel of the surface, in contrast to the subterranean feel of so much psychoanalytic writing.

The book has three parts. Part I is a journal of the therapy sessions between David Helbros (not his real name) and myself that took place over a period of fifteen months; the journal is primarily descriptive. in Part ii, the description is focused more sharply into analysis. in Part iii, David's illness is interrogated from the existential-phenomenological perspective, as an instance of what Karen Horney in her descriptive-analytic classification of . . .

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