Click here to download

Trauma and attachment in borderline patients
Journal Title: PSICOTERAPIA PSICOANALITICA 
Author/s: Clara Mucci 
Year:  2019 Issue: Language: Italian 
Pages:  18 Pg. 91-108 FullText PDF:  199 KB
DOI:  10.3280/PSP2019-002005
(DOI is like a bar code for intellectual property: to have more infomation:  clicca qui   and here 


The author proposes an integration of some dynamics of relational psicoanalysis (with special reference to Ferenczi) and object relation theory (Green, Kernberg) with affective neuroscience (Schore, Panksepp) and attachment theory and dissociation (Schore, Liotti) in order to indicate and discuss clinically the effects of three levels of trauma of human agency as the eziopathological factor oat the basis of the functioning of severe personality disorders. The neurobiological consequences and the affective and psychological dynamics of three levels of trauma of human agency (early relational trauma, maltreat-ment and abuse, and massive social traumatizations) are described and cast in contrast with traumatizations of natural catastrophies or acci-dents which do not create dissociation (because they do not involve an affective realtion) and are not at the basis of what is called Complex PTSD (traumatization stemming from long term abuse in a relation-ship), still unrecognised by DSM-5 and acknowledged only by PDM-2. A brief description of a borderline patient follows, with a clear inter-nalization of the victim-persecutor dyad of traumatic origin, with the indication of the particular affective repartion and the steps to follow to restablish affect regulation in the therapy, a process the author calls "embodied witnessing", based on the usage of the various circuits of the mind-body-brain, through appropriate mirroring of the split parts, through enactments and constant affect regulation, at the borders of the window of affect dysregulation between the two subjects of the thera-peutic process.
Keywords: Trauma, affect regulation, victim-persecutor dyad, personali-ty disorders, borderline.

  1. Schore A.N. (2012). The science of the art of psychotherapy. New York: Norton.
  2. Schore A.N. (2019a). Right Brain Psychotherapy. New York: Norton.
  3. Schore A.N. (2019b). The Development of the Unconscious Mind. New York: Norton.
  4. Schore A.N. (2003a). Affect regulation and the repair of the self. New York: Norton.
  5. Schore A.N. (2003b). Affect dysregulation and disorders of the self. New York: Norton.
  6. Aparo A., Casonato M., Vigorelli M. (1989). Modelli genetico-evolutivi in psicoanalisi. Bologna: Il Mulino.
  7. Bowlby J. (1969). Attaccamento e perdita. Torino: Boringhieri, 1976.
  8. Correale A., Vigorelli M. (2009). Linee generali per una discussione su un approccio teorico-clinico al disturbo borderline di personalità. Intervento al congresso dell’associazione Mito e Realtà, Milano.
  9. Felitti V.J. et al. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the Adverse Childhood Experiences (ACE) study. American Journal of Preventive Medicine, 14(4): 245-258.
  10. Green A. (1993). The dead mother. Psyche, 47(3): 205-240., DOI: 10.4324/9780429478024-8
  11. Ferenczi S. (1932a). Diario clinico. Milano: Cortina, 1988.
  12. Ferenczi S. (1932b) Confusione delle lingue tra adulti e bambino (Il linguaggio della tenerezza e il linguaggio delle passioni). In: Masson J.M. (a cura di). Assalto alla verità. La rinuncia di Freud alla teoria della seduzione. Milano: Mondadori, 1984.
  13. Fonagy P., Target M. (2001). Attaccamento e funzione riflessiva. Milano: Cortina, 2001.
  14. Fonagy P., Moran G., Steele M., Steele H. (1992). L’integrazione della teoria psicoanalitica e del lavoro sull’attaccamento: la prospettiva intergenerazionale. In: Ammaniti M., Stern D., Attaccamento e psicoanalisi. Roma- Bari: Laterza, 61-85.
  15. Fraiberg S. (1982). Patological defenses in infancy. Psychoanalytic Quarterly, 51: 612-635.
  16. Gabbard G. (2000). Psichiatria psicodinamica. Milano: Cortina.
  17. Kernberg O. (1976). Teoria della relazione oggettuale e clinica psicoanalitica. Torino: Bollati Boringhieri, 1980.
  18. Kernberg O. (1995). Disturbi gravi di personalità. Torino: Bollati Boringhieri.
  19. Liotti G., Farina B. (2011). Sviluppi traumatici. Eziopatogenesi, clinica e terapia della dimensione dissociativa. Milano: Cortina.
  20. Main M. (1996). Introduction to the special section on attachment and psychopathology: Overview of the field of attachment. Journal of Consulting and Clinical Psychology, 64: 237-243., DOI: 10.1037/0022-006X.64.2.237
  21. Main M., Solomon J., Discovery of an insecure-disorganized/disoriented attachment pattern: procedures, findings and implications for the classification of behaviour. In: Brazelton T.B., Yogman M. (eds.), Affective development in infancy. Norwood, NJ: Ablex, 95-124.
  22. Mucci C. (2014). Trauma, healing and the reconstruction of truth. American Journal of Psychoanalysis, 74(1): 31-47.
  23. Mucci C. (2017). Implicit memory, unrepressed unconscious, and trauma theory: The turn of the screw between contemporary psychoanalysis and neuroscience. In: Craparo G., Mucci C. (eds.). Unrepressed unconscious, implicit memory, and clinical work. London: Karnac Books, 99-129.
  24. Mucci C. (in corso di pubblicazione). A right brain dissociative model for right-brain disorders: Dissociation vs repression in borderline and other severe psychopathologies of early traumatic origin. In: Tweedy R. (ed.). The divided therapist: Hemispheric difference and contemporary psychotherapy. London: Karnac Books.
  25. Mucci C. (2017b). Ferenczi’s revolutionary therapeutic approach. American Journal of Psychoanalysis, 77, 3: 239-254.
  26. Mucci C. (2018). Borderline Bodies. Affect Regulation Therapy for Personality Disorders. New York: W.W. Norton.
  27. Mucci C. (2019). Corpi Borderline. Regolazione affettiva e clinica dei disturbi di personalità. Milano: Cortina.
  28. Panksepp J., Biven E. (2012). Archeologia della mente. Milano: Cortina, 2014.
  29. Perry B.D., Pollard R. (1997). Altered brain development following global neglect in early childhood. In: “Proceedings from the Society for Neuroscience Annual Meeting”. New Orleans.
  30. Racamier P.C. (1996). Incesto e incestuale. Milano: Franco Angeli, 2003.
  31. Schore A.N. (1994). Affect Regulation and the Origin of the Self. NY: Lawrence Erlbaum.
  32. Schore A.N. (1996). The experience-dependent maturation of a regulatory in the orbital prefrontal cortex and the origin of developmental psychopathology, Development and Psychopathology, 59-87., DOI: 10.1017/S0954579400006970
  33. Schore A.N. (1997). Interdisciplinary developmental research as a source of clinical models. In: Moskowitz M., Monk C., Kaye C., Ellman S. (eds.). The Neurobiological and Developmental Basis for Psychotherapeutic Intervention. New York: Jason Aronson.
  34. Schore A.N. (2009). La disregolazione dell’emisfero destro. Attaccamento traumatico e psicopatogenesi del disturbo post-traumatico da stress. In: Williams R. (a cura di). Trauma e relazioni. Le prospettive scientifiche contemporanee. Milano: Cortina.
  35. Schuengel C., Bakersmans-Kranenburg M.J., Van Ijzendoorn M.H. (1999). Frightening maternal behavior linking unresolved loss and disorganized infant attachment. Journal of Consulting and Clinical Psychology, 67: 54-63., DOI: 10.1037/0022-006X.67.1.54
  36. Schwarz E.D., Perry B.D. (1994). The post-traumatic response in children and adolescents. Psychiatric Clinics of North America, 17(2): 311-326., DOI: 10.1016/S0193-953X(18)30117-5
  37. Tronick E.Z., Winberg M.K. (1997). Depressed mothers and infants: Failure to form dyadic states of consciousness. In: Murray L., Cooper P.J. (eds.). Post-Partum Depression in Child Development. New York: Guilford.
  38. Williams R. (a cura di) (2009). Trauma e relazioni. Le prospettive scientifiche contemporanee. Milano: Cortina.

Clara Mucci, Trauma and attachment in borderline patients in "PSICOTERAPIA PSICOANALITICA" 2/2019, pp. 91-108, DOI:10.3280/PSP2019-002005

   

FrancoAngeli is a member of Publishers International Linking Association a not for profit orgasnization wich runs the CrossRef service, enabing links to and from online scholarly content