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Gender aspects in the planning of psychotherapy for borderline personality disorder

Gender-Aspekte in der Psychotherapieplanung mit Borderline-Persönlichkeitsstörungen

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Zusammenfassung

Untersuchungsziel war die Erfassung geschlechtsspezifischer Variablen für eine erfolgreiche Psychotherapieplanung und die Untersuchung von Gender-relevanten Einflussfaktoren auf den stationären Behandlungsverlauf bei Patienten mit Borderline-Persönlichkeitsstörung. An zwanzig Patienten wurden Angst, aggressive Verhaltensweisen, interpersonelle Probleme, Kontrollüberzeugungen und Selbstkonzept vor und nach 6-wöchiger psychoanalytisch orientierter stationär psychiatrischer Behandlung untersucht. Bei Frauen bestand soweit Einsicht in Zusammenhänge zwischen Angst, Aggression, Affizierbarkeit und interpersonelle Probleme, dass diese Problematik Ich-synton ihren Niederschlag im Selbstbild fand, dementsprechend reflektiert und in vor allem gleichgeschlechtlichen Patient-Therapeut-Dyaden weitergehend bearbeitet werden konnte, sodass eine ambulante Psychotherapie weiterführend in Anspruch genommen werden konnte. Männer verharrten stärker in regressiver Abwehrhaltung und in narzisstischer Betonung starker Selbstwirksamkeitsüberzeugungen, gleichzeitig persistierte die Aggression, und eine Ablehnung von weiterführender Psychotherapie herrschte vor. Die Ergebnisse legen eine geschlechtsadäquate Bearbeitung der Aggressionproblematik, Bindungs- und Reflexionsfähigkeit nahe und werden anhand psychoanalytischer Hypothesen diskutiert.

Summary

OBJECTIVE: The aim of the study was to generate hypotheses for examining gender-specific variables with predictive value for the planning of successful psychotherapy in patients with borderline personality disorder. METHODS: Anxiety, aggression, interpersonal problems, locus of control and self-concept were investigated in twenty psychiatric inpatients before and after psychoanalytically oriented psychotherapy lasting for six weeks. RESULTS: Women in gender-matched patient-therapist dyads gained insight into relationships between anxiety, aggression and interpersonal problems to the extent that they experienced them as ego-syntonic problems and as a concern of their own self-concept, and were therefore able to engage in further outpatient psychotherapy. Men more often remained in regressive resistance and in narcissistically boosted conviction of self-efficacy, with simultaneous persistence of aggression and non-engagement in further psychotherapy. CONCLUSION: The results underline the importance of considering gender role stereotypes and suggest the significance of gender-sensitive attitudes in dealing with aggression and exploring attachment styles and reflective functioning.

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Authors and Affiliations

  1. Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Austria

    Henriette Löffler-Stastka, Elisabeth Ponocny-Seliger & Marianne Springer-Kremser

  2. Department of Psychiatry, State Mental Health Hospital Gugging/Donauklinikum, Austria

    Theodor Meißel

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  1. Henriette Löffler-Stastka
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  2. Elisabeth Ponocny-Seliger
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  3. Theodor Meißel
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  4. Marianne Springer-Kremser
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Correspondence to Henriette Löffler-Stastka.

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Löffler-Stastka, H., Ponocny-Seliger, E., Meißel, T. et al. Gender aspects in the planning of psychotherapy for borderline personality disorder. Wien Klin Wochenschr 118, 160–169 (2006). https://doi.org/10.1007/s00508-006-0573-6

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  • DOI: https://doi.org/10.1007/s00508-006-0573-6

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