Summary
The class of patients who are descriptively neurotic but dynamically psychotic makes up a large proportion nowadays of those seeking psychiatric treatment, particularly in private practice. These patients present not only the challenge of differential diagnosis, but the resultant problem of differential treatment which avoids the danger of precipitating frank psychosis.
This paper considers the special therapeutic problems of the borderline group; illustrates differences in the technical handling of given material in these as against true neurotics on the one hand and frank schizophrenics on the other; and outlines the rationale for a comprehensive plan of differential treatment. The premises on which the outline of psychotherapy is based are discussed in relation to the nature of the therapist's relationship, the kind of interpretations given and the goal of treatment.
Attention is called to selective measures required in regard to (1) fantasy, (2) hostility, (3) homosexual material, (4) acting out, and (5) suicidal impulsions. Specific auxiliary measures are presented in relation to work with families of such patients.
The differential therapeutic procedures outlined in this plan can be utilized, to a large extent, by therapists of diverse theoretical orientations.
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The Consultation Center, Jewish Family Service, New York, N. Y., and the Family Consultation Service, Eastchester Neighborhood Association, Tuckahoe, N. Y.
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Eisenstein, V.W. Differential psychotherapy of borderline states. Psych Quar 25, 379–401 (1951). https://doi.org/10.1007/BF01584286
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DOI: https://doi.org/10.1007/BF01584286