Psychoanalysis for Borderline Personality Disorder and Psychotic Patients

Over the past decades, the number of studies in psychoanalysis has increased significantly. It is interesting to investigate how the psychoanalytic view on the typology of the levels of personality organization has changed over time, what is being paid attention to now, and what methods the analyst uses while working with patients of the neurotic, borderline, and psychotic levels of functioning. Within the framework of the chosen topic, we consider working with patients at the borderline and psychotic levels of personality functioning in the psychoanalytic approach and in psychoanalytic psychotherapy. The most important is the role of the primary diagnostic interview, the setting of the frame, the analysis of dreams, the interpretation of defenses. This work is carried out with the purpose to consider the theoretical foundations of personality organization, to determine the central intrapsychic conflicts of borderline patients and patients with a psychotic level of personality organization, to consider the countertransference feelings of the analyst during the analytical session, to study the factors that hinder analysis when working with borderline patients and psychotics, as well as to analyze practical examples. As a result of the work, the protective mechanisms used by patients of the borderline and psychotic level of functioning were studied, and the difference between higher-order defenses and primitive defenses was described. We also studied the degree of identity integration and the ability of borderline patients to test reality. An important part is the consideration of the intrapsychic conflicts that patients usually come across with. Due to the fact that it is the borderline patients and patients with severe mental disorders (psychoses) that represent the most complex category of analysands in the work, we aimed to summarize the available material, study psychoanalytic works and draw conclusions about working with the most difficult cases of patients. In general, the research within the framework of this final qualifying work opens up many areas for further study. However, the main tasks that were set for us in order to understand the basics of interaction with patients within the analytical frame have been achieved.