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Four different models of Borderline Personality Disorder (BPD), each based on a different psychopathological theory, have produced manualised treatments with evidence of efficacy. It can be argued, on the grounds of the comparable results of the outcome studies, that these different treatments share a common mechanism of action related to the same psychopathological kernel of Borderline Personality Disorder, albeit the key role of this kernel in the pathogenesis of the disorder is not explicitly acknowledged in their psychopathological theories. This paper argues that such a psychopathological kernel can be described as dissociative and is caused by chronic psychological traumatisation in the developmental years and by disorganisation of infant attachment -- two common features of Borderline Personality Disorder developmental psychopathology. Following a review of the studies supporting this hypothesis, the paper dwells on the basic psychotherapy processes allegedly shared by the four different models of Borderline Personality Disorder treatment. [ABSTRACT FROM AUTHOR]

Pierre Janet expounded repeatedly, in his writings, the three main differences between his theory, that he had called psychological analysis, and Sigmund Freud's psychoanalytic theory. First, the concept of narrowing of consciousness as the direct effect of vehement emotions is quite different from the idea of an active defensive process displacing unacceptable mental contents outside consciousness. Second, Janet's concept of the sub-conscious (le subconscient) diverges significantly from Freud's view of the Unconscious. Third, Janet's rejected what he labeled Freud's pan-sexualism. This paper is a cursory examination of contemporary psychological and neuroscience contributions to psychotraumatology that may be matched with Janet's three contentions about the main differences between his ideas and Freud's. The aim of the paper is to foster in the reader a reflection on how contemporary psychotraumatology may provide a common background for examining what seems more vital nowadays of the two divergent roots, French and Austrian, of dynamic psychiatry. [ABSTRACT FROM AUTHOR]

The clinical case described in this article illustrates the value of taking into account the dynamics of disorganized attachment in the assessment of attachment-related phobias (phobia of attachment and phobia of attachment loss) during the psychotherapy of chronically traumatized patients. These seemingly opposite phobias typically coexist in the same patient, appear as phobias of both inner states (affect phobias) and relational experiences, and are linked to dissociated representations of self-with-other. Theory and research on attachment disorganization provide a clinician-friendly conceptual framework for capturing both the intrapsychic (e.g., intrusive and nonintegrated mental states) and the relational (e.g., dramatic unsolvable dilemmas in interpersonal exchanges) aspects of the attachment-related phobias. The therapeutic strategy and the key interventions that logically follow from a case formulation based on this conceptual framework are examined. [ABSTRACT FROM AUTHOR]

This paper reviews theoretical, clinical and research studies on the apperance, in a subgroup of obsessive compulsive disorders (OCD), of symptoms related to the disruption of the usually integrated functions of consciousness, memory, identity and perception (pathological dissociation). The coexistence of dissociative and obsessive-compulsive symptoms is a relatively frequent clinical occurrence, that seems to be responsible for unsatisfactory response to the cognitive-behavorial therapy (CBT) of OCD. The aim of the review is to clarify the different types of dissociative symptoms and processes that may appear in OCD, their relation to absorption in compulsive responses, and the role played by traumatic expreriences in the association between dissociative and obsessive-compulsive symptoms. Such a clarification is a necessary premise to the implementation of modified types of CBT interventions able to yield satisfactory outcomes in cases of OCD complicated by dissociative symptoms. [ABSTRACT FROM AUTHOR]

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The article offers an historical review of studies on the role played by attachment processes in dissociative psychopathology. The treatise proceeds from Bowlby's first insights, through Main and her collaborators' empirical studies on attachment disorganization, to the first formulation of the hypothesis linking disorganized early attachment to pathological dissociation. Recent research supporting the hypothesis is then reviewed. It is concluded that infant attachment disorganization is in itself a dissociative process, and predisposes the individual to respond with pathological dissociation to later traumas and life stressors. Four implications of this theory are interspersed in the re- view and are discussed in the final section: (I) pathological dissociation should be viewed as a primarily intersubjective reality hindering the integrative processes of consciousness, rather than as an intrapsychic defense against mental pain; (2) early defenses against attachment-related dissociation are based on interpersonal controlling strategies that inhibit the attachment system; (3) dissociative symptoms emerge as a consequence of the collapse of these defensive strategies in the face of events that powerfully activate the attachment system; (4) psychotherapy of pathological dissociation should be a phase-oriented process focused primarily on achieving attachment security, and only secondarily on [ABSTRACT FROM AUTHOR]