ABSTRACT
This chapter describes an in-patient setting that endeavours to bring about a psychoanalytic process in patients and to achieve a permanent change in the way that they deal with their inner world and relationships. The objective of the treatment is to facilitate a psychoanalytic process in the patients. This psychoanalytic process is not only the classic one with the focus on resistance, and working-through. The expressive therapist refrains from psychoanalytic interpretations; he only uses his own medium. But his attitude fosters the opening of an intrapsychic space, which is essential for most of the so-called lower borderlines. Therapy with borderline and narcissistic personalities in a hospital setting means that one tries to work in the presence of a restricted level of symbolization and with difficulties in accepting the “as-if” quality of certain experiences. Patients with severe personality disorders do not lend themselves very well to classic psychoanalytic psychotherapy, in which the focus is on interpreting transference and relieving repression.
