UE 601: History and Clinical Characteristics of Borderline States

These flashcards provide a comprehensive review of the historical development, psychoanalytic theories (Anglo-Saxon, American, and French), diagnostic criteria, and defense mechanisms associated with borderline states and narcissistic-identity suffering.

Borderline (A. Stern, 1938)

Patients who are neither neurotic nor psychotic, expressing an agonizing experience of affective insecurity, degraded self-esteem, and a rigid, non-adaptive defensive arrangement.

As-if Personality (H. Deutsch, 1942)

Subjects who appear adapted to their environment but give an impression of inauthenticity, with poor or non-existent affective reactions suggesting object disinvestment.

True Self (Winnicott)

The living, intimate, unique, creative, and spontaneous part of the subject linked to subjectivity and a sense of authenticity.

Pathological False-self (Winnicott)

A defensive process based on splitting that dissociates the true from the false and blocks access to the true self, giving the patient the impression of not really existing.

A-structural path (J. Bergeret)

A categorization for borderline states characterized by an absence of structure resulting from early, real, and disorganizing affective trauma that prevents the Oedipal crisis.

Pseudo-latency (J. Bergeret)

An arrangement of the Ego aimed at limiting trauma effects, stopping psycho-affective development before the integration of sexual differences.

Anaclitic Object Relation

A mode of relationship based on dependence and 'propping up' (étayage) where the subject expects narcissistic repair from a 'crutch object.'

States of Analyzability (A. Green)

A term for borderline cases where representation and symbolization processes fail, leaving the thought process empty of fantasies and creativity.

Pole of Narcissistic-Identity Suffering (R. Roussillon)

A conceptualization of borderline states focused on the lack of a subjectivizing function of the ego and the lack of 'being,' resulting from primary traumatic states.

Diagnostic and Statistical Manual (DSM) Borderline Criteria

A diagnosis requiring at least 5 manifestations, including frantic efforts to avoid abandonment, impulsivity, identity disturbance, and chronic feelings of emptiness.

Narcissistic Personality (DSM)

Characterized by a grandiose sense of importance, a lack of empathy, a need for admiration, and oscillations between idealization and devaluation.

Transfer Psychosis (Kernberg)

Severe distress or delusional episodes that develop specifically within the psychotherapeutic transfer and remain limited to the therapeutic space.

Narcissistic Conflict

A conflict rooted in the differentiation between Self and Others, centered on shame and the feeling of non-existence rather than guilt.

Oedipal Conflict

A conflict linked to the differentiation of sexes and generations, characterized by castration anxiety and guilt.

Splitting (Clivage)

A primary defense mechanism that separates good experiences from bad to prevent contamination, leading to identity fragility and a lack of access to ambivalence.

Projective Identification (M. Klein)

A form of projection where internal persecutory objects are imagined to penetrate an external object to take possession and control it from within.

Ego-skin passoire (Anzieu)

A concept describing the lack of containment and porous boundaries between the internal and external worlds in narcissistic-identity suffering.

Clinical of Emptiness (Clinique du vide)

Experiences of extreme non-being where the subject transforms unbearable object loss into a void or 'psychic desertification.'

Mentalization

The therapeutic goal of making verbal or visual thought possible in relation to one's psychic functioning, which is often bypassed by 'acting out' in borderline patients.