ABSTRACT
This chapter presents the case of “Mary,” a psychotic and personality-disordered inpatient female adolescent with admitting diagnoses of schizoaffective disorder and bulimia (Axis I, Diagnostic and Statistical Manual of Mental Disorders [4th ed.; American Psychiatric Association, 1994]) and a comorbid low level borderline and psychotic personality organization. Although bulimia is included among the Axis I disorders (APA, 1994), in psychoanalytic studies eating disorders are widely subsumed under and presumed to share many aspects of borderline personality disorder. Rorschach interpretation will be discussed from an integrated perspective utilizing Comprehensive System analysis (Exner, 1991; Exner & Weiner, 1995), psychodynamic content (Cooper & Arnow, 1985; Kwawer, Lerner, Lerner, & Sugarman, 1980), and sequential analysis. The relation between Mary’s psychotic Axis I disorder and Axis II personality disorder is discussed with particular attention to symptomatology, interactional effects, and probable early developmental factors.
