Techniques to develop object constancy with borderline clients.

Abstract

The relative failure to achieve object constancy is one of the hallmarks of borderline pathology. Clients manifesting this developmental failure remain chronically overdependent on others to provide them with the holding!soothing internal security operations which they cannot perform for themselves. This article delineates techniques that therapists can employ to help these clients through a threestep developmental process which culminates in the achievement of object constancy.

An ego/object relations approach to treating childhood sexual abuse survivors.

“…Ego regression, splitting, and intense negative affect often propel the borderline client into: (1) destructive acting out through intensified self-injurious behaviors (often, perhaps, representing a re-enactment of the original abuse against them); (2) premature termination of treatment; or (3) becoming suicidal. Even when traumatic memories are intrusive and hypermnesic (Terr, 1994), focusing on these memories often needs to take second priority to self and ego building and, in particular, to a focus on developing containment strategies and object constancy (i.e., Mcmann & Pearlman, 1990; Wells & Glickauf-Hughes, 1986). As a result of these problems, authors such as Hammond (1990) have cautioned therapists against the use of abreactive techniques with borderline clients in outpatient settings, noting, ’The ego strength capacity of the patient to uncover trauma and to handle the intensity of the abreaction should be taken into account.…”

“…The literature provides therapists with many practical approaches to working with different aspects of survivorship. For example, Wells and Glickauf-Hughes (1986) have discussed treatment strategies designed to facilitate the development of object constancy. In addition, Kernberg et al (1989) have presented step-by-step strategies designed to address projective identifications while Jordan (1993) has helped to elaborate the connection between shame and empathic knowing in the therapist’s alliance-building efforts.…”

The underside of psychotherapy: Confronting hateful feelings toward clients.

“…Borderline personality disorders are often thought of as difficult clients because of their excessive dependency upon others for soothing and/or bolstering their fragile sense of self (Adler, 1985). Because these clients believe that they are inherently "bad" (and thus undeserving of help), they frequently sabotage treatment (Wells & Glickauf-Hughes, 1986). This behavior, in turn, may evoke strong negative reactions in the people whose help they desperately seek.…”

The meaning and treatment implications of client-initiated scheduling changes in psychotherapy.

“…Clients manifesting this developmental failure remain chronically overdependent on others to provide them with the holding, soothing internal security operations which they can’t perform for themselves." (Wells & Glickauf-Hughes, 1986, p. 460)…”