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These clinical notes stem from my experiences and difficulties encountered in the treatment of borderline neurosis. In brief outline my experiences were as follows.
During the process of my analytic work, some of my patients in the borderline group experienced an intense difficulty in following the fundamental rule, i.e., free association. An important feature of this difficulty was that of the patients' awareness of the fact that they were not obeying the basic rule but were stubbornly and tenaciously refusing to coooperate with the task of analysis. The patient, either by implication or directly, says as follows: “I cannot tell you all the things that do come to my mind. I know I'm not helping the analysis by this refusal to express my thoughts, and in case you want to terminate the treatment, you can, but whatever you might decide to do, I just cannot express my thoughts.” Rene Laforgue (17) describes similar experiences thus: “But there are other cases—and here we come to the second category—in which the patient, consciously and voluntarily, on principle, so to speak, refuses to disclose certain thoughts and to obey the rule. You are then no longer confronted with the victim of a conflict, a prey to an inhibition or to an excess of anxiety. No, the patient simply says, ‘I am not going to tell you such and such a thing’, whether because he thinks that it does not concern you or for other reasons. Or else, without saying anything about it to you, he may refuse to submit to the rule. I confess that sometimes I have been in a great difficulty in these cases, and it was my experience of such situations which suggested the theme of this paper. Persuasion, argument, authority, the imposing of conditions, the dismissal of the patient—I have resorted to all these expedients, but without any satisfactory result.”
Attempts at describing to the patient his behavior and rebellion against the analytic procedure have often resulted in provoking extreme anger and bitterness. In t