Another Chance to be Real: Attachment and Object Relations Treatment of Borderline Personality Disorder

186 Pages·2007·0.62 MB·English

by  Donald D. Roberts

Another Chance
to Be Real

Another Chance
to Be Real
Attachment and Object Relations
Treatment of
Borderline Personality Disorder
Donald D. Roberts and Deanda S. Roberts
JASON ARONSON
Lanham • Boulder • New York • Toronto • Plymouth, UK
Published in the United States of America
by Jason Aronson
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Copyright © 2007 by Jason Aronson
All rights reserved. No part of this publication may be reproduced, stored
in a retrieval system, or transmitted in any form or by any means, electronic,
mechanical, photocopying, recording, or otherwise, without the prior permission
of the publisher.
British Library Cataloguing in Publication Information Available
Library of Congress Cataloging-in-Publication Data
Roberts, Donald D., 1939–
Another chance to be real : attachment and object relations treatment of
borderline personality disorder / Donald D. Roberts and Deanda S. Roberts.
p. ; cm.
ISBN-13: 978-0-7657-0553-2 (cloth : alk. paper)
ISBN-10: 0-7657-0553-2 (cloth : alk. paper)
ISBN-13: 978-0-7657-0554-9 (pbk. : alk. paper)
ISBN-10: 0-7657-0554-0 (pbk. : alk. paper)
1. Borderline personality disorder—Treatment. 2. Attachment behavior.
3. Object relations (Psychoanalysis) I. Roberts, Deanda S., 1942– II. Title.
[DNLM: 1. Borderline Personality Disorder—therapy. 2. Object Attachment.
3. Psychotherapy—methods. WM 190 R643a 2007]
RC569.5.B67R62 2007
616.85’852—dc22 2007022381
Printed in the United States of America
∞ ™ The paper used in this publication meets the minimum requirements of
American National Standard for Information Sciences—Permanence of Paper for
Printed Library Materials, ANSI/NISO Z39.48-1992.
Contents
Introduction: Attachment 1
1 Normal Development and the Real Self 9
2 Borderline Personality Disorder Development and the False Self 31
3 Compassionate Attunement: Igniting the Self 51
4 Stance, Neutrality, and Frame With the Borderline Patient 65
5 Listening and Speaking to the Borderline Patient:
An Invitation to a Secure Separation 77
6 Psychotherapy: Another Chance to be Real 97
7 Terri: Destitute and Desperate for Help 117
8 Susan: Immobilized, Helpless, and Hopeless 125
9 Laura: Tormented and in Trouble 145
10 Practical Considerations 153
11 Now and Then, Here and There, Change Happens 163
References 167
Index 175
About the Authors 179
v

Introduction
Attachment
Seven or eight years ago, we came upon an article in a mental health
journal.1 It was written by an ethologist, Helga Fischer-Mamblona
(2000), and it was the story, the developmental journey, of a goose. Feli was
one of the flock whose social behavior was being investigated by Konrad
Lorenz’s team of researchers; the geese lived in a seminatural environment
at the Max Planck Institute, Seewiesen, Germany. Feli was separated from
the flock at birth and lived the first 10 days of her life sequestered away
from visual and auditory stimulation. She then spent 8 weeks in a pen con-
structed so that she could see through the top but not make visual contact
with the other geese. Stimulation during this period was limited to the heat-
ing lamps in her pen and by the replacement of her food and water bowls.
As we understand it, goslings from birth onward vocally “greet” their
mothers, fathers, and siblings and repeatedly seek proximity and contact
with them. According to Fischer-Mamblona’s article (2000), this process
of initiating contact and becoming attached in the first days of life is the
most critical stage in a goose’s social development. Even in isolation, Feli
engaged in a gosling’s normal greeting and complaining behaviors. But
unlike her peers, she had no social context. There were no other geese
within her visual field at all, no mother goose to interact with. As the
author describes it, Feli seemed confused by this situation. She began
to scurry around in a disorganized and directionless way, making weak
and pathetic sounds into the vacant space of her pen. At first, she was
unresponsive to any changes in her environment. But in time, she came
to “greet” any changes that she observed, like the replacement of her food
dish or the ons and offs of the warming lights.
1
2 Introduction
At the end of 8 weeks, when she had acquired her feathers, Feli was
allowed to leave her pen and explore her environs. She was frightened
when she first saw the other geese, and if one approached her, she hur-
riedly returned to the safety of her pen. The researchers began to move
her feed bowls progressively closer to the other geese; with this help, she
gradually became desensitized to them. Eventually, she became able to
eat in the presence of the others, although if one approached her, she still
took refuge in her pen.
According to the article, goslings during the second spring of their lives
typically leave their families and are attracted to their peers, seemingly
looking for company and making social contacts. Feli observed this be-
havior and was fascinated by it. In fact, she sometimes shed her anxiety
and ran to join in. But the other geese didn’t recognize her as a member
of the flock. They considered her behavior a violation of good goose man-
ners and, as the observers expected, promptly chased her away. As this re-
peatedly happened, Feli’s fear and anxiety intensified, and her tendency
to flee the other geese increased.
Feli was faced with a knotty dilemma. If she approached another
goose, she was aggressively rejected; but if she withdrew to her pen,
she lived in complete isolation. Both her attachment and separation
behaviors had negative consequences. Apparently in response to this
quandary, when a goose approached, Feli began to groom her feathers,
an expression of her desire to engage socially. But, simultaneously, she
vigorously shook her head, a manifestation of her dread of being close to
another goose. Her observers thought that these incongruous behaviors
served to regulate the anxiety stimulated by her predicament. At first,
she preened and shook every time that a goose approached her, because
this elicited her conflict between approaching and fleeing. But over time,
the dilemma resolved itself after a fashion; the urge to flee, stimulated
by her fear of attachment, overpowered her desire to attach, and Feli
seemed to resign herself to being alone. She became increasingly with-
drawn and apathetic.
In their second year of life, geese become sexually mature, and this
intensifies attachment urges. But in Feli’s case, advances by other geese
merely caused her to withdraw. On occasion, a shy male would court
her from a distance, but instead of reciprocally approaching him, her re-
sponse was only to shake and preen. Her odd behavior discouraged the
other goose from coming nearer. This pattern persisted for 2 years.
But in Feli’s fourth year, something curious happened. A particularly
shy and cautious male approached her. This time, she did not retreat or
resist, and she mated for the first time and produced a nestful of eggs.
Observers noted that although she appeared to provide all of the usual
maternal ministrations, she still tended to flee when another goose came
Introduction 3
near, and she would (if necessary) vacate her nest. But she did manage to
tolerate the 4-week incubation period, and one gosling hatched.
Feli’s gosling immediately attempted to seek proximity to her mother.
But Feli did not respond to the gosling’s approach behavior. She with-
drew physically, preening and shaking and ignoring the gosling’s cries of
distress. The next day, the gosling was found dead.
Feli laid eggs again the next year. This time, the eggs were sterile.
The observers replaced them with fertilized duck eggs, which are less
sensitive than goose eggs and require a shorter incubation period. The
ducklings hatched, but once again, Feli did not respond to their approach
behavior, preening and shaking instead. Again, she abandoned the nest
in response to their pestering. Even after she returned, she was unrespon-
sive to the distressed appeals of the cold and hungry ducklings. A few
days later they, too, died.
In her sixth year, Feli once more laid sterile eggs; again, these were
replaced with ducks’ eggs. When the ducklings hatched, she again re-
sumed her preening and shaking and—a familiar sight by now—seemed
altogether apathetic to her “offspring.” But this time, the outcome was
quite different. These ducklings were relentless in their efforts to be close
to their “mother.” Several times a day, they would greet her and snuggle
up to her. Feli responded with her preening and shaking ritual, but these
ducklings could not be deterred, and they persisted in nibbling her feath-
ers and making efforts to get close. Feli tried to bite them—unanticipated
behavior in a mother goose, according to the author. For a while, even
these persistent ducklings resigned themselves to the situation and got
through the nights by keeping each other warm. Inexplicably, though,
during this time, Feli’s ritualized preening waned. One rainy night, the
ducklings returned to their mother for warmth—and this time, she gave
it to them.
This was a pivotal event. From then on, Feli responded, albeit hesitantly
at first, to her ducklings’ greetings. In fact, she began to demonstrate most
of the typical maternal behaviors of geese: She accompanied the ducklings
down to the water to feed; she bathed them; she tended to their feathers.
In response, the ducklings pursued her when she left them to graze, and
they approached her for warmth and protection. In short, an attachment
was realized—for the first time in Feli’s life.
This account has a bittersweet conclusion. An older gander approached
Feli, who this time did not retreat into ritual or distance. She actually
obliged, and the two remained a pair long after the ducklings had become
independent. During the 4 years that Feli and her gander were together,
they had their own goslings and reared them successfully. When the flock
moved to Konrad Lorenz’s lab in Austria, the pair lived together there for
2 more years. But one day, Feli mysteriously disappeared. Shortly after