An exploration of separation-individuation themes in the borderline personality disorder

In an attempt to test hypotheses derived from Mahler's theory of borderline development, Rorschach protocols of borderline and schizophrenic patients were studied for the presence of themes related to the separation-individuation process. A specially constructed Separation-Individuation Theme Scale was used with a 96% reliability of agreement between two raters. The borderline group attained more separation-individuation themes than the schizophrenic group, whereas the schizophrenics showed more preseparation-individuation themes. The results were interpreted as a validation of Mahler's theory. In addition, the results tended to confirm a developmental model for the understanding of psychopathology.     

The Present Status of Group Therapy in United States Correctional Institutions

A time-limited group treatment program focusing on mothers of toddlers with a borderline personality disorder is reported. The project involved two intersecting groups—the toddler group and the mother group. The focus of the work with the children was to promote their social interests and skills to an expanded world beyond the maternal dyad. The focus of the work with the mothers was on their difficulties with emotional separation-individuation and on strengthening their ego functioning, particularly in the area of mothering so that they could participate positively in their child's separation-individuation phase.

Representative group process is presented as it organized around three distinct phases. The initial phase was marked by intense resistance, and ambivalence. During the middle phase, group cohesion developed around shared feelings and issues. The termination phase focused insistently on issues of separation. Conclusions drawn from the project include the utility of a group approach in influencing maternal behavior.     

Affect in early memories of borderline patients

Psychoanalytically oriented observers using the framework of object relations theory noted that patients with borderline personality organization manifest serious pathology in their capacity to use internalized imagery to cope with the vicissitudes of separation-individuation. This study examined one source of such imagery, the affect associated with a specific sample of early memories, including the earliest recollections of parents. Patients with borderline personality disorder were compared with paranoid schizophrenics and patients with neurotic character pathology. Forty-five outpatients, 15 in each group, participated in the study. It was found that borderline patients had significantly fewer positively toned early memories than neurotics or paranoid schizophrenics. Only the neurotic group, had a majority of affectively positive memories. The results are generally consistent with object relations theories of borderline psychopathology.     

Qualitative and Quantitative Szondi Diagnosis

Psychoanalytically oriented observers using the framework of object relations theory noted that patients with borderline personality organization manifest serious pathology in their capacity to use internalized imagery to cope with the vicissitudes of separation-individuation. This study examined one source of such imagery, the affect associated with a specific sample of early memories, including the earliest recollections of parents. Patients with borderline personality disorder were compared with paranoid schizophrenics and patients with neurotic character pathology. Forty-five outpatients, 15 in each group, participated in the study. It was found that borderline patients had significantly fewer positively toned early memories than neurotics or paranoid schizophrenics. Only the neurotic group, had a majority of affectively positive memories. The results are generally consistent with object relations theories of borderline psychopathology.     

Chinese version of the separation-individuation inventory

The importance of the separation-individuation process in object relations theory is well known in disciplines of psychology, counseling, and human development. Based on the Separation-Individuation Inventory of Christenson and Wilson, which measures the manifestations of disturbances in this process, a Chinese version of the inventory was developed. For college students Cronbach coefficient alpha was .89, and test-retest reliability over 28 days was .77. The scores of the inventory had positive correlations with both the number of borderline personality characteristics and the Individualism-Collectivism Scale, respectively. Also, the mean score on the inventory of patients diagnosed with borderline personality disorder was significantly higher than that of the two normal control groups (ns = 564). Thus the inventory possessed satisfactory construct validity. Cultural differences regarding the separation-individuation process need to be investigated further.     

The Sense of Being Dead and of Dying: Some Perspectives

The present communication is made in response to a published study (Lester and Schumacher, 1969) which found no support for hypotheses that schizophrenic women might usefully be conceptualized as dying women, and that schizophrenics (men and women) would have more death themes in their TAT stories than non-schizophrenics. The present authors argue that there is no reason to expect schizophrenic women to feel like dying women, do present empirical data strongly supporting the notion of a relation between feelings of unreality and of deadness, and suggest reasons for Lester and Schumacher's failure to find schizophrenic-nonschizophrenic differences in TAT themes of death.     

Mentalisierungsbasierte Psychotherapie bei schizophrenen Psychosen

Recently, there has been growing interest in new methods of psychotherapeutic interventions for schizophrenic patients. Social cognition, social functioning and quality of life are central objectives. Mentalization-based therapy (MBT) is a specific psychodynamic method developed from the fundament of attachment theory and empirical psychotherapy research for the treatment of borderline personality disorder, particularly focusing on attachment relationships, mentalizing capacity and affect regulation. Studies have shown that MBT is able to ameliorate interpersonal experience and social life. The latest neuroscientific findings support this view and encourage the application of a modified form of MBT in the treatment of schizophrenic patients. The authors present a concept for disorder-specific interventions in schizophrenia, including psychoeducational aspects and mentalizing exercises which step-by-step lead to a more reflective work in mentalization-based group psychotherapy.     

An Empirical Study of Object Relations and Defensive Operations in Antisocial Personality Disorder

This study assessed the object relations, defensive operations, and level of psychopathy and narcissism in a group of antisocial personality disordered offenders. The Rorschach protocols of 33 subjects who met the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-111-R], American Psychiatric Association, 1987) criteria for antisocial personality disorder were analyzed utilizing Kwawer's (1980) criteria for borderline object relations categories (borderline phenomena), the Lerner and Lerner (1980) Defense Scale, and a number of experimental criteria including Cooper and Arnow's (1986) defense criteria. Level of narcissism was assessed utilizing Exner's (1973) Self-Focus Sentence Completion Test. Hare's Psychopathy Checklist was used as an independent variable to determine a subject's level of psychopathy. Those subjects scoring 30 or more on the psychopathy checklist were compared to subjects scoring less than 30. The level of narcissism or proportion of defenses did not differ significantly between the severe psychopaths (230) and the moderate psychopaths (< 30). The severe psychopaths produced a significantly greater number of borderline object relations. I conclude that antisocial individuals tend to be highly egocentric, and that narcissism is one component of psychopathy. Severe psychopaths, as a group, tend to be more borderline in their functioning than those exhibiting moderate levels of psychopathic disturbance. I also conclude that individuals who are incarcerated for felony offenses and also meet the DSM-111-R criteria for antisocial personality disorder exhibit degrees of borderline personality organization.     

A Music Projective Technique

Twenty college students and twenty hospitalized patients diagnosed as schizophrenic, equated for age, sex, and intelligence, were told to tell a story to sixteen successive pre-recorded excerpts of music. Tests of reliability indicated that the Ss' reaction times and rates of verbalization were stable from music excerpt to excerpt and from test to retest. Interrater reliabilities of judgments concerning verbal content of responses were acceptable. Analyses of variance indicated the hospitalized group had longer reaction times before verbalization to the music stimulus, spoke less during the music, but more during the interim period between music excerpts. The hospitalized group used significantly less human content and visual imagery, but significantly more animal content than the college group. In general, reaction time was quicker to fast tempo music than slow tempo music, and fast tempo music evoked happier more outgoing themes than slow tempo music. Stories told by the hospitalized group were often highly inappropriate vis-a-vis music demands. The instrument clearly differentiated groups.     

Directed forgetting of emotional stimuli in borderline personality disorder

On the basis of clinical literature, the authors hypothesized that individuals with borderline personality disorder (BPD) would show biased information processing when they were exposed to negative affective stimuli of a particular type. Individuals with BPD and controls were tested using a directed forgetting paradigm. Study participants were exposed to 3 types of words (borderline, neutral, positive) and were cued to either remember or forget each word as it was presented. There were no group differences on a free recall task for words in the remember condition. However, participants with BPD recalled significantly more of the borderline words from the forget condition than did controls. In other words, borderline participants remembered borderline words that they were instructed to forget. These results may be consistent with enhanced encoding of salient words and perhaps related themes in BPD individuals.     

Schizophrenia and paranoia as solutions to predictive failure

Abstract

Paranoia and schizophrenia represent two opposite ways of reacting to invalidation. In paranoia the system tends to become more and more monolithic. Whenever the paranoid individual's observations contradict his or her personal theory, the theory prevails, so that the system evolves toward an “exaggerated dogmatism.” In the schizophrenic syndrome, on the other hand, we find renunciation of a unitary organization of knowledge. In this form of an “exaggerated empiricism,” the system moves toward fragmentation, and predictions become variable and contradictory. The path that is followed depends on the premorbid structure of the individual's system and the particular kind of invalidation experienced.     

The psychotic personality: A psychoanalytic theory and its application in clinical practice

This paper presents and discusses aspects of Bion's theory of the psychotic personality. In particular, it focuses on the psychotic personality's attacks on the dependent and needy self. The paper considers how Bion's theory can be applied to understanding the schizophrenic patient. Examples are given to show its importance not only in analytic practice, but also within general psychiatry.     

Sex-role identity and separation-individuation pathology

The Mahlerian theory of childhood psychological development suggests that the same sex parenting of girls in the mother-child dyad predisposes women to experience specific difficulties in the separation-individuation (S-I) process (Mahler, Pine & Bergman, 1975). Pathological states in adulthood have been attributed to these S-I disturbances (Pine 1979; Kernberg 1980). However, this theory has never been empirically tested. In this study 53 subjects were assessed for adult manifestation of disturbance in the separation-individuation process using a self-report questionnaire (Separation-Individuation Inventory: Christenson & Wilson, 1985), In contrast to previous theoretical work, women showed significantly lower levels of disturbance in the separation-individuation process than did men. Assessment of sex-role identity (Bem Sex Role Inventory: Bem, 1981) showed no significant difference between overall sex-role identity of the male and female subjects. Individuals lacking any clear sex-role identity showed significantly higher levels of disturbance in the separation-individuation process than those with feminine, masculine or androgynous identity. These findings demonstrate the importance of considering sex-role identity as well as biological sex when describing some psychological characteristics and also demonstrate the importance of any sex-role acquisition, whether male or female, for psychological well-being.     

Impact of Card Rotation on the Frequency of Rorschach Reflection Responses

This study examines evidence for boundary disturbances in depressive, borderline, and schizophrenic hospitalized inpatients. Certain thought disorder signs on the Rorschach are reconceptualized as indices of boundary formation, which is defined as the capacity to create particular distinctions along women bipolar coordinate of experience where previously no distinction was possible, and which defines each cluster of experience through a maintenance of differential functioning. The borderline group scored significantly high on the indices of laxness and moderately severe inner-outer boundary formation. The schizophrenic group scored significantly higher on indices of self-other and somewhat higher on severe inner-outer boundary disturbance. Schizophrenics may be organized at a level of self-other boundary formation which subsumes inner-outer boundary formation, while the borderline group is organized at a level of inner-outer boundary formation.     

Boundary disturbance in borderline and psychotic states

This study examines evidence for boundary disturbances in depressive, borderline, and schizophrenic hospitalized inpatients. Certain thought disorder signs on the Rorschach are reconceptualized as indices of boundary formation, which is defined as the capacity to create particular distinctions along wome bipolar coordinate of experience where previously no distinction was possible, and which defines each cluster of experience through a maintenance of differential functioning. The borderline group scored significantly high on the indices of laxness and moderately severe inner-outer boundary formation. The schizophrenic group scored significantly higher on indices of self-other and somewhat higher on severe inner-outer boundary disturbance. Schizophrenics may be organized at a level of self-other boundary formation which subsumes inner-outer boundary formation, while the borderline group is organized at a level of inner-outer boundary formation.     

Separation-individuation phenomena in adulthood: general concepts and the fifth individuation

The elaboration of separation-individuation theory in the years beyond childhood has been a psychoanalytic focus for several decades. In this paper, the nature of separation-individuation phenomena in adulthood and the terminology and controversy surrounding the use of the terms third, fourth, and fifth individuation are considered first; a detailed elaboration of the concept of the fifth individuation in late adulthood follows.     

Suicide as a resolution of separation-individuation among adolescent girls

The purpose of this study was to discover if there is a relationship between suicidal adolescent girls and borderline phenomena, and to examine separation anxiety in suicidal girls. Hansburg's Separation Anxiety Test and Gunderson's Diagnostic Interview for Borderline Disorder were administered to 40 adolescent girls. Only those girls that had attempted suicide were included in this study. The findings of this research suggested that adolescent suicide is a borderline phenomena that has its roots in the early separation-individuation phase of development, resulting in separation anxiety. The adolescent girl gets relief from the abandonment depression and feelings of separateness by using suicide as a vehicle for regression to a symbiotic state where she earlier had experienced safety.