chapter  13
10 Pages

Comparing Psychoanalytic Psychotherapies

Assumption as to Basic Pathology and its Etiology The basic pathology of the borderline and narcissistic per-

sonality disorders is a developmental arrest or impairment of the self due to one or all of three factors: (1) genetic defects; (2) separation stress; and (3) the mother's difficulties in supporting the individuative, emerging aspect of the self. The final common clinical pathway is that real self-activation leads to separation anxiety and to abandonment depression, that leads to defense. The patient has the capacity for self-activation, but the need to defend against the depression keeps it from being activated. The therapeutic intervention removing these defenses enables the patient to work through the depression and overcome the developmental arrest.