Sample Essays: A Reaction Essay on Otto Kernberg Views of Bordeline Personality

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mental_healthThe concept of Borderline Personality Organisation (BPO) arose in the 1950’s to account for clients who could neither be classified as neurotic nor as psychotic. Though Knight (1953) introduced the term within this context, it was Stern (1938) who first coined the term, categorizing clients who had previously been described as ‘as-if personalities’, ‘latent schizophrenics’, ‘pseudopsychopathic schizophrenics’, ‘pseudoneurotic schizophrenics’, ‘sub-clinical schizophrenics’ and ‘occult schizophrenics’. [1]

Otto Kernberg’s formulation (1984, 1989) of BPO is psychodynamic and structural. He proposes three main features of BPO [2]:

  • Identity diffusion
  • Primitive defensive operations
  • Intact reality testing

Kernberg posits these features to result from pathological object relations. Which in this instance refer to the internal object world. This theory concerns itself with the internalisation of external relations and suggests that the difficulties experienced by individuals with BPO result from a failure to integrate intrapsychic representations of self and others. [2]

Furthermore, these aspects of self and other are defensively separated into “all good” and “all bad” representations. The individual presents with a chaotic, fragmented two-dimensional view of self and others. Emotional subtlety, sophisticated role-relatedness and psychological depth are all missing from the representational world of the borderline individual. [2]

In the psychotherapeutic relationship, self and object representations may be activated in the transference. The processes of projection and identification will be operating – thus a devalued depreciated self representation will be projected onto the therapist whilst the client identifies with a harsh critical object representation, hence the notion of ‘identification with the aggressor’. The affective link may be anger or fear. Typical self-object representations activated in the transference as shown below. [3]

Self

Destructive bad infant

Controlled enraged child

Unwanted child

Defective worthless child

Abused victim

Sexually assaulted prey

Deprived child

Out of control angry child

Naughty sexually exciting child

Dependent gratified child

Object

Punitive sadistic parent

Controlling parent

Uncaring, self involved parent

Contemptuous parent

Sadistic attacker

Rapist

Selfish parent

Impotent parent

Castrating parent

Doting admiring parent

In working with clients with borderline psychopathology the therapist must be able to tolerate intense, rapidly shifting affect within the relationship. Kernberg (1984, 1989) focuses on transference analysis within a supportive setting, i.e. working in the ‘here and now’ along the transference – counter-transference paradigm. His primary focus via clarification, confrontation and interpretation is the integration the split internal object as it becomes manifest transactionally in the psychotherapeutic relationship. [3]

Otto Kernberg has postulated a theory of BPD based on a phenomenon he describes as splitting. Splitting appears to be the main defense mechanism of the borderline. A borderline perceives people in terms of black and white or as either good or bad objects. The main problem in handling borderlines is to cope with their unrealistic views of other people – and in their attempts to create self-fulfilling prophecies to make the world fit with his or her perceptions. If a borderline perceives you as a good object, he or she will go to great lengths in providing situations or interpretations compatible with this view. [4]

References

  1. Kernberg, O.F.; Selzer, M.A.; Applebaum, A.H.; Carr, A.C. & Koenigsburg, U.W. (1989) Psychodynamic Psychotherapy of Borderline Patients.
  2. Nigg, J. T., Lohr, N. E., Westen, D., Gold, L. J., & Silk, K. R. (1992). Malevolent object representations in borderline personality disorder and major depression. Journal of Abnormal Psychology, 101, 61-67.
  3. Greene, L. R., Rosenkrantz, J., & Muth, D.Y. (1986). Borderline defenses and countertransference: Research findings and implications. Psychiatry, 49, 253-264.
  4. Westen, D. (1990). Towards a revised theory of borderline object relations: Contributions of empirical research. International Journal of Psychoanalysis, 71, 661-693.

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