The "out of the ordinary" actions, such as "salt" in food, are essential components of the treatment of borderline patients

The author examines some specific aspects of the treatment of borderline patients followed by a community mental health centre. Three different case studies highlight "unusual actions" of the team, helpful with borderline patients that have experienced traumatic primary relationships. These patients, thanks to their tireless efforts, succeed in remaining "stable in their instability". The unusual actions of the team, like salt in food, represent critical moments of the therapeutic relationship. These actions meet the basic need of a borderline personality to experiment, in ambivalent and contradictory ways, the solidity and trustworthiness of the therapeutic relationship. These specific episodes, described by Stern as "now moments", help to build the next step of a co-constructed treatment plan. The patient’s experience of "trust" and "empathy" opens new therapeutic horizons. This treatment approach requires the support of a multidisciplinary team that shares a common understanding of patient and therapy.

Keywords: Treatment, borderline, therapeutic relationship, setting

Renzo Muraccini, Come il sale, le azioni "fuori dall’ordinario" sono ingredienti indispensabili nel trattamento dei pazienti borderline in "RIVISTA SPERIMENTALE DI FRENIATRIA" 1/2011, pp 103-121, DOI: 10.3280/RSF2011-001008