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By most accounts, people with a borderline personality disorder
prove exceptionally difficult to treat. Divergent opinions abound
about what, if anything, contributes to a positive outcome. Is it
the quality of the relationship with the psychotherapist that is
curative, in that the careful attunement of therapist to patient
enables the development of a more secure attachment experience? Or
is it the technical and structural parameters of the therapy i.e.,
therapist neutrality, frame issues, and defensive operations
combined with skillfully formulated and timely interventions? Taken
together, the findings of attachment research and object relations
theory offer an integrated understanding of borderline personality
disorder as an attachment disorder that relies on a pervasive false
self for adaptation and personal connections. A particular
corrective relationship experience, therefore, is necessary if
positive personality changes and improved adaptive capacities are
to result. In Another Chance to Be Real, Donald and Deanda Roberts
propose a treatment approach, specific to those suffering from
borderline personality disorder, that emphasizes both relational
and technical variables as necessary in eliciting a positive
treatment outcome."
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