Thematic stages of recovery in the treatment of borderline personality disorder

Abstract

Borderline personality disorder is characterized by stereotypical, repetitive, and maladaptive interpersonal interactions. Considerable controversy exists regarding preferred treatment and prognosis. Patient-therapist interactions often result in traumatic reenactments and therapist burnout. Employing a case illustration and object relations theory, the author postulates that borderline patients have specific thematic questions that they are trying to resolve at sequential stages of their recovery. Each of the four thematic stages entails characteristic patient-therapist interactions, underlying conflicts, associated behaviors, and unique challenges and pitfalls that must be overcome in order to avoid traumatic reenactment and move forward in recovery.