Partial Dissociation as Encountered in the Borderline Patient*

My aims in this paper are to present clinical data which exemplify processes of partial dissociation as they are encountered in borderline patients and to explore those processes in order to illuminate some of the difficult technical problems inherent to the treatment of borderline patients. The clinical data are derived mainly from two patients who fall into the lower, i.e., more damaged end of the borderline spectrum and who therefore most resemble the psychoses. While the first of these patients would have in the past been diagnosed as schizophrenic and the second, a schizoaffective disorder, they each conform to the borderline clinical criteria as defined by Kernberg. Psychotic episodes (two in the first patient, one in the second) have occurred either under the influence of excessive use of alcohol and drugs, or as the result of transference psychosis. The psychotic episodes were brief in duration and both patients demonstrated easy recoverability with or without psychopharmacologic intervention and hospitalization. When seen at other times, neither patient exhibited evidence of a thought disorder and reality testing was good. Other patients to whom I shall refer in the course of this paper have been under my care for varying and extended periods of time. This second group of patients falls into the upper level of the borderline spectrum and consists of individuals who function quite well in their professional worlds, whose social relationships are only partially impaired and whose inner lives and family relationships are seriously disturbed.

Within the overall aims of this paper, I plan to demonstrate the