Abstract
Analytically oriented psychotherapy (AOP) has been considered the treatment of choice for borderline patients and a useful technique in the treatment of schizotypal patients. There are many exceptions, however, in addition to a number of borderline and schizotypal patients who are just barely amenable to this modality: they are at the border of treatability by AOP. Limitations relating to time, cost, and the availability of therapists trained in this discipline render it important to delineate the factors which conduce either to the success or failure of AOP. From the author's clinical impressions about borderline and schizotypal patients at the border of treatability by AOP, a number of such factors emerge. On the positive side: likeableness, autoplastic defenses, high motivation, psychological-mindedness, genuine concern, good moral sense, self-discipline, and low impulsivity. Negative factors include, beside the opposites to the aforementioned, vengefulness and parental abusiveness or exploitation. A scale for measuring the balance between these positive and negative factors is proposed. Its use may, it is hoped, improve forecast, during initial consultation, as to which borderline and schizotypal patients will respond favorably to AOP.
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Selected References
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- Gunderson J. G., Singer M. T. Defining borderline patients: an overview. Am J Psychiatry. 1975 Jan;132(1):1–10. doi: 10.1176/ajp.132.1.1. [DOI] [PubMed] [Google Scholar]
- Kernberg O. Borderline personality organization. J Am Psychoanal Assoc. 1967 Jul;15(3):641–685. doi: 10.1177/000306516701500309. [DOI] [PubMed] [Google Scholar]
- McGlashan T. H. The Chestnut Lodge follow-up study. II. Long-term outcome of schizophrenia and the affective disorders. Arch Gen Psychiatry. 1984 Jun;41(6):586–601. doi: 10.1001/archpsyc.1984.01790170060007. [DOI] [PubMed] [Google Scholar]
- RACAMIER P. C. Sur les psychothérapies d'orientation psychanalytique; indications, objectifs et méthodes. Evol Psychiatr (Paris) 1953 Oct-Dec;4:623–653. [PubMed] [Google Scholar]
- STONE L. The widening scope of indications for psychoanalysis. J Am Psychoanal Assoc. 1954 Oct;2(4):567–594. doi: 10.1177/000306515400200402. [DOI] [PubMed] [Google Scholar]
- Stone M. H. Assessing vulnerability to schizophrenia or manic-depression in borderline states. Schizophr Bull. 1979;5(1):105–110. doi: 10.1093/schbul/5.1.105. [DOI] [PubMed] [Google Scholar]
- Stone M. H. Borderline syndromes: a consideration of subtypes and an overview, directions for research. Psychiatr Clin North Am. 1981 Apr;4(1):3–24. [PubMed] [Google Scholar]
- Stone M. H. Psychotherapy with schizotypal borderline patients. J Am Acad Psychoanal. 1983 Jan;11(1):87–111. doi: 10.1521/jaap.1.1983.11.1.87. [DOI] [PubMed] [Google Scholar]
- Stone M. H. Therapists' personalities and unexpected success with schizophrenic patients. Am J Psychother. 1971 Oct;25(4):543–552. doi: 10.1176/appi.psychotherapy.1971.25.4.543. [DOI] [PubMed] [Google Scholar]
- Woollcott P., Jr Prognostic indicators in the psychotherapy of borderline patients. Am J Psychother. 1985 Jan;39(1):17–29. doi: 10.1176/appi.psychotherapy.1985.39.1.17. [DOI] [PubMed] [Google Scholar]