PubMed · 7558980
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R D Chessick. 1995. Poststructural psychoanalysis or wild analysis?. https://doi.org/10.1521/jaap.1.1995.23.1.47
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The first step in the management of borderline personality disorder is making the correct diagnosis. A clinical example illustrates symptoms of a patient with borderline personality disorder in a family practice setting. Major characteristics of borderline personality disorder include severe mood instability, fear of abandonment, chronic boredom, self-injury, unstable interpersonal relationships, "splitting," identity instability and borderline rage. Early diagnosis may help prevent potential management problems and possible doctor-patient conflicts.
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In this article it is shown that, in spite of the diagnostic heterogeneity and in spite of differing concepts for treatment, basic principles for treatment may be assessed that have proven effective in daily therapeutic routine. It is decisive to consider typical difficulties in which therapists of borderline patients may get involved. Treatment is primarily based on psychotherapy. After a short review of different therapeutic concepts for borderline derangements, fundamental psychotherapeutic principles are illustrated. According to target symptoms, psychotropic drugs may be indicated as an adjunct. The use of various drugs is discussed. Ambulatory and clinical options for treatment and their indications are summarized, and treatment of borderline patients by their family doctor is stressed in particular.