Can a Shrink Really Help Patients Who Have Borderline Personality Disorder?

Psychoanalysis as a Clinical Treatment for BPD Freud’s observation that individuals are often unaware of their own causal factors affecting emotions and behavior led to his development of psychoanalysis. According to Freud’s psychodynamic perspective, the intrapsychic drives influencing human behavior are primarily unconscious. His theory of personality focuses on unconscious forces, psychic determinism, anxieties, and internal conflicts which coalesce to manifest as intellectual and emotional difficulties (Brenner, 2001; Friedman, 1975; Gabbard, 2004; Gaston, et al., 1998; Greenberg & Mitchell, 1983; Ogden, 1986). Seven features distinguish psychodynamic therapy from other therapies (Shedler, 2010). These features are (1) focus on affect and expression of emotion; (2) exploration of attempts to void distressing thoughts and feelings; (3) identification of recurring themes and patterns; (4) discussion of past experience (developmental focus); (5) focus on interpersonal relations; (6) focus on the therapeutic relationship; and, (7) exploration of fantasy life (Blagys & Hilsenroth, 2002; Burum & Goldfried, 2007; Shedler, 2010). The determination of these distinguishing features was made through empirical examination of session recordings and from transcripts of therapy sessions (Shedler, 2010). Psychodynamic therapists explore reoccurring themes and disruptive thought patterns that negatively affect concepts of self, interpersonal relationships, and the ability to enjoy life. Although aware of painful or self-defeating patterns, some patients are not able to manage these patterns (Gabbard, 2004). Often, patients are drawn to emotionally unavailable romantic partners and even abusive partners (Dutton, et al., 2006). For patients who are unaware of the ways they sabotage themselves, work with a psychodynamic psychotherapist can help them become more emotionally aware and thus, able to change (McWilliams, 2011; Sachse, et al., 2011; Shedler, 2010; Wampold, et al., 2002; Waters, et al., 2000 ).