Identification of Dynamic Patterns of Personal Positions in a Patient Diagnosed With Borderline Personality Disorder and the Therapist During Change Episodes of the Psychotherapy

Abstract

Personal positions and voices of a patient diagnosed with borderline personality disorder (BPD) and the therapist during long-term psychotherapy were studied aiming to find differences in the patterns formed in these aspects of subjectivity according to the level of elaboration of the change episodes achieved by the patient. This case study considered a stage of qualitative analysis where change episodes of the patient were traced through the Change Episodes Model. Later, through the Model of Analysis of Discursive Positioning in Psychotherapy (MAPP), the voices and personal positions of the patient and her therapist were identified in each of the change episodes. In the stage of quantitative analysis, dynamic patterns in the voices and personal positions were established, accounting for hypothetical attractors using the Space State Grid (SSG) technique in each of the three different levels of subjective elaboration that constitute the change episodes. The results established differentiated dynamic patterns in the change episodes, coherent with the patient’s change process, and formation of propositive/reflective specific patterns as the patient evolved in the three different levels of subjective elaboration. The above suggests that a subjective transformation process is displayed, and this is manifested in the different voices and personal positions that emerged as the change episodes evolve. The identified dynamic patterns can be considered nonlinear and emergent subjective exchanges between the patient and the therapist throughout the psychotherapy.

Una aproximación dialógica a la supervisión de la psicoterapia de personalidades disfuncionales

“…Un desarrollo reciente de esta línea teórica sugiere que abordar clínicamente tanto las voces internas de los pacientes como las de los terapeutas, así como sus influencias mutuas, contribuye significativamente al resultado del tratamiento (Hacohen et al, 2019). Dentro de las investigaciones en psicoterapias dialógicas, son especialmente reseñables las del grupo chileno (Mellado et al, 2022a(Mellado et al, , 2022b(Mellado et al, , 2023. Resulta especialmente reseñable un artículo sobre la utilización conjunta del análisis de secuencias dialógicas y el modelo de asimilación (Stiles et al, 2006), sin duda de gran interés pero que excede los propósitos del presente artículo.…”