The Execution Boundary and Borderline Hatred

by Kathi Stringer

July 19, 2002
[Revision N/A]

Special Thanks to Nicole for Inspiring Me to Write this Paper

The idea of writing this paper came up because after examining my own feelings and talking to individuals with borderline personality disorder, the issue seemed to come up frequently that their treater would threaten to ban them from the practice because of their primitive rage acted out in transference. 

Topographical Model

Abandonment and Rejection

�Borderline patients talk vividly about their longings to be held and contained, and their panic about being dropped, abandoned and rejected (p.221).� 

Searles echoes Adler, �borderline personality-organization itself renders ever-present, for him, the danger of separation and loss (p.288)�

This basic intrinsic borderline pathology and its destructive power will be the theme for this paper. 

Using Transference in the Analytic Space

�Transference is usually conceptualized as the transfer of love or hatred from the original object onto the therapist (p.156).�

For example a client may direct rage to the treater seen as the parental object since this rage is, in reality, rightfully at parents. Through this transference a client is able to work out this anger in the analytic space.

The analytic space is the realm where assigned roles are played out and examined to identify defenses and developmental organization of regressed individuals. 

Reassignment of Ego Strength

Lets talk about the Countertransference Hook

Projective Identification via the Hot Button

�These patients are expert in perceiving aspects of the therapist�s personality that are problem areas for the therapist. Primitive patients probably develop this skill from their style of existence, in which every encounter with any person is so threatening that they must perceive his weaknesses in order to be prepared for the final battle for survival (p.180)�

Most borderlines seem to have a honing device that directs them to the therapist�s ego weakness. Once this weakness is identified, a borderline may push the treater�s hot buttons defined previously as a countertransference hook. Once the treater is hooked through projective identification, the client has now gained a sense of control, if and only if, the treater identifies with the projection. If the borderline is successful and the treater identifies with the projection, (anger in this case) then what we call projective counteridentification has taken place (Ogden 1982). In other words the treater now behaves characteristically similar to the internal drama of the borderline (Adler), as if an alien force has taken the treater over (Gabbard). Sometimes the projective counteridentification is so miserable for the treater that he may take this dilemma under consultation. Kernberg reminds us that,

�Under conditions of projective counteridentification the therapist may unreasonably feel unfit to treat the patient (p. 86).� 

Since the treater may feel unreasonably unfit to treat the patient, the treater may threaten the client with the execution boundary. However

In cases under supervision or by consultation, it is here where the opportunity of magic begins. The treater is now in a position to respond in a kinder way providing a new experience for the borderline to internalize. This is what we call an introject. The treater is now offering a positive introject to the borderline, and if accepted, it may be taken in and assimilated. This is referred to as introjective identification. Meaning the client has identified and accepted the new experience from the treater and is willing to take it in to be assimilated. The client is now able to see the world as a modified and newer place in which to live. 

Advantage of Acting out Anger in Transference

�The therapist�s consistent, tactful, non-retaliatory handling of the patient�s rage allows the pathological defenses to be given up slowly and permits the patient to experience the therapist as the truly good object who can safely be intorjected (p176).� 

Gunderson also advocates the tolerance of negative transference as a basic tenet; �The therapist must be able to withstand the borderline�s verbal assaults without either retaliating or withdrawing. By this process, the patient�s hostility can be examined and understood as part of a more general pattern of relating to important others.�

The Holding Environment and Modified

�it is only when a sense of safety and trust finds solid footing in a secure clinical holding environment and ego relatedness with the clinician is established that clients can begin to risk testing the clinician�s durability.�

Once testing begins, consciously or unconsciously a treater can modify the projected hostilely and rage into a softer, soother objects and offer it back to the borderline as a modified positive introject. Apparently, since it took years to form the borderline personality, it will also take collaborative work, bit-by-bit, for the borderline to re-trust, relearn, and re-identify with something better then their terrifying internal objects. Some borderlines have burning determination to go back into the past via transference to the treater and resolve the anger that was emotionally fixated from an earlier period.

With most borderline personalities, trust is a funny thing. It reminds me of a tid-bit I remember that goes like this, �If the employee gets 1000 at-a-boys, then he shall receive the promotion as company president, but one ah-shit along the way, and the process starts all over again.� It is frustrating to a treater to start over because of a countertransference reaction caught by a receptive hypersensitive borderline. Perhaps the treater may reduce the at-a-boys toward a successful conclusion of treatment if the execution boundary did not constantly raise it�s ugly head and start the trusting process all over again.

Further exploration in some cases may reveal an unconscious narcissist longing in the treater, rooted in countertransference, to encourage dependency from the borderline. Since setting the execution boundary with regular reminders may cause a borderline to become clingier, more frantic, desperate, anxious, and distressed, then this would seem to satisfy the treaters unconscious wish for dependency. The problem is, this may hinder trust in the therapeutic alliance and of particular discern, treatment may be extended over a longer duration rising out of what a primitive personality may perceive as exclusion from the family relationship. �I am still bad and I can be cast out, and you have been lying to me all along that you really care about me. See, I knew this would happen.�

Harmful Introjects

�Much �self�-destructive behavior on the patient�s part consists in his having introjected some of this most primitive, �sickest� components of the analyst�s ego-functioning and, in the acting out, venting aggression upon this introject (p.323).� 

This describes the effect a negative introject can have on a client in the form of self-destruction. The execution boundary tossed into the therapeutic arena may certainly be a countertransference reaction from the treater to punish the client. The problem is, words are powerful and especially powerful when assimilated by the client from an idealized treater. The execution boundary is so powerful, so devastating, and so frightening, that the mere suggestion of it�s essence can set back treatment for months.

A Paradox

Conclusion

References: