The author suggests, in the case of Mr. S., to evaluate the functioning of the patient also through the personality organization lens, as the data provided does not exclude a diagnosis of Axis II disorder, in the area of borderline personality disorders. From the data collected it seems that the patient makes a massive use of old defense mechanisms typical of patients diagnosed with Axis II (splitting, projection, projective identification) which activate a reaction that denotes an enormous difficulty in containing internal states, although being capable of having an intact reality testing. A diagnosis in this direction would provide a useful suggestion for any future therapeutic work centered on the patient’s ability to mentalize and contain their moods.
Keywords: Attachment; Depression; DSM Diagnosis; Borderline Personality Disorder; Mentalization; Defense Mechanisms.