Borderline personality disorder is a prevalent psychopathology; thus, most graduate students in psychology, residents in psychiatry, and early career clinicians will encounter patients with this disorder in the course of their training or initial professional practice. This paper provides clear and concise guidelines for conducting treatment geared toward the clinician's developmental level. It builds upon the knowledge and skills that are typically acquired during graduate education and training to provide an accessible framework for undertaking psychotherapy with patients who have borderline personality disorder. This paper draws upon common psychotherapeutic factors and existing evidence-based treatments for the disorder to identify principals and interventions that are likely to contribute to therapeutic action. It uses behavioral, cognitive, and psychodynamic interventions to address the patient's multidimensional psychopathology. This approach offers a coherent and integrated treatment framework for the beginning psychotherapy practitioner.

To many observers, reactive violence can present as a puzzling phenomenon. Offenders often report experiencing cognitive distortions during the event. Offenders may have no history of violence, yet crime scenes are often described as "horrific." When violence manifests, the motive often seems vastly disproportionate to any precipitating factor. Reactive violence is fueled by intense emotions, although they may not be evident before or during the event. How best to reconcile these findings and provide a parsimonious and coherent explanation? Psychoanalytic theory can illuminate the psychological processes that may underlie reactive violence. In particular, how narcissistic injury can generate impulsive aggression in vulnerable individuals. I draw upon Stanley Kubrick's film The Shining to study the phenomenon. While The Shining is a fictional horror film in which a family is tormented by supernatural forces, I argue that the horror does not emanate from paranormal sources; rather, it is found within human psychology.

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Stanley Kubrick's The Shining still generates intense interest nearly four decades after its release. There are numerous books, documentary films, websites, blogs, and YouTube videos dedicated to analyzing the film's content. Many of these analyses are wildly speculative. For example, the film is a coded confession by Kubrick that he faked the Apollo 11 moon landing footage. What about The Shining's content may contribute to some viewers generating such unusual interpretations? The present article applies psychoanalytic theory, supported by findings from cognitive science, to answer this question. It is argued that The Shining's ambiguity generates an “intolerance of uncertainty” for some viewers, which leads them to project their own beliefs and experiences onto the film's scenes and narrative. Additionally, the film's oedipally themed content evokes archaic associations that some viewers may struggle to integrate, which promotes cognitive regression to a less demanding mode of thought. Although this article focuses on a fictional film, its method and findings are potentially generalizable to other phenomena in which idiosyncratic interpretations are expressed.

Individuals sometimes do not achieve at the level that would be expected given their knowledge and/or skills when there is pressure to perform. When suboptimal performance is significant, and it occurs during a high stakes moment or event, the phenomenon is referred to metaphorically as "choking" under pressure. While the phenomenon is well-studied, the literature is dominated by cognitive-behavioral and neurological explanations. These findings are necessary components of any comprehensive understanding of choking (and its subsequent treatment); they are also insufficient. Increasingly, contemporary psychological science researchers and theorists are studying how implicit (i.e., unconscious) processes bypass conscious awareness and influence perceptions, thoughts, feelings, and behaviors. Using psychoanalytic theory, two psychodynamic conflicts that may contribute to choking under pressure are identified: conflict over autonomy, and conflict over aggression/competition. A more comprehensive explanation for choking advances our understanding of why performance may falter in high-stakes situations. These insights may lead to more effective treatments. Clinical Impact StatementUnconscious psychological conflicts may contribute to choking under pressure. Incorporating the conflict concept into clinical practice may lead to more effective treatments.