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Psychopathology II: Borderline
April 29, 2022 @ 3:30 pm - 5:00 pm, Wyman Classroom
Fourth Year Adult Psychoanalytic Training (APT)
2021-22, 3rd Trimester — Fridays, 3:30-5:00pm
Michael Pauly, MD
Charlotte Malkmus, MA LMHC
View Whole Syllabus
April 29, 2022 — Reflective Collapse, Disintegration, Emptiness and Suicide
[27 pages]
John Maltsberger, in The Decent Into Suicide, discusses the factors leading to suicidal collapse (affective flooding, desperate maneuvers to counter the emerging mental emergency, loss of control as the self begins to disintegrate, and grandiose mental scheming for mental survival) and connects these with the difficulties in the realm of affect regulation, ego helplessness, narcissistic surrender, breakdown of the representational world, and loss of reality testing.
In The Subjective Experience of Emptiness, Otto Kernberg writes about the chronic emptiness analysts often encounter when working with patients suffering from character pathology. He provides readers with important distinctions between depressive, narcissistic, and schizoid emptiness as experienced in the patients’ emotional worlds and in the countertransference.
Maltsberger, J.T. (2004). The descent into suicide. Int. J. Psycho-Anal., 85(3):653-667.
Kernberg, O. (1985) “The Subjective Experience of Emptiness” Borderline Conditions and Pathological Narcissism. Jason Aronson (213-224).