Anger, Anhedonia, and the Borderline Syndrome

Of the numerous defensive operations available to the borderline personality, two have been singled out for systematic study in this paper. They are anger and anhedonia. Anger and anhedonia are complex affect states around which many borderline patients organize their relatively stable and highly individual personalities. The theory of multiple function is the concept upon which this investigation into the role of anger and anhedonia in the borderline syndrome is predicated. The following vignette is an all too typical and frequent expression of the vicissitudes of anger.

Miss C is a twenty-nine-year-old white woman who is in intensive psychotherapy. She came to psychiatric attention following a serious suicide attempt. Miss C was seen in consultation the morning after her suicide attempt and related the following material:

I had been depressed all week and I had been smoking pot almost every night for the past month. My boyfriend walked out on me over some silly argument and I had called my brother and asked him to take me out to dinner. He did, but he took me to a place where a lot of his friends hang out. He ignored me just when I needed him the most. I got angry and I danced with this black guy from the band. When I came back to the table my brother asked me what I thought I was doing and wanted to know if I was ever going to grow up. He said that I had embarrassed him in front of his friends. While driving me home he kept it up and made fun of me and humiliated me and when I got home I felt sick inside. I felt alone and that no one cared. I had a couple of drinks and daydreamed of smashing him in the head with a hammer or something. Then I took a razor and cut my wrist. I was surprised how easy it was. It hurt plenty and I wouldn't have been able to go through with it if I hadn't been drinking. The booze made it easier. I watched it bleed a long time and then I got dizzy and sick to my stomach. I got scared and went next door and asked the lady there to take me t