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McCarthy, J.B. (1996). Paranoia and Omnipotent Symbiosis in Borderline Adolescents. J. Amer. Acad. Psychoanal., 24(1):45-59.

(1996). Journal of American Academy of Psychoanalysis, 24(1):45-59

Paranoia and Omnipotent Symbiosis in Borderline Adolescents

James B. McCarthy, Ph.D*

Borderline adolescents' interactions express regressed, labile forms of relatedness. Primitive anxiety disrupts their relatedness in ways that signal not only the failure of defensive operations, but also impairments in the maturational process. Borderline adolescents' transference reactions present defensive elements of omnipotent grandiosity and paranoia that derive from their lack of ego integration. The intermittently symbiotic quality of such transference responses concretizes the extent of their psychopathology.

My primary aim in this article is to describe how omnipotent symbiosis and paranoia characterize borderline adolescents' transference reliving of early object relationships. By tracing borderline adolescents' clinical features and transference issues, I hope to illuminate the jarring effects of their annihilation anxiety, as well as their relative lack of differentiation from internalized objects. A secondary objective will be to use clinical material in order to elaborate Freudian, interpersonal, and object relations views of borderline adolescents' character patterns. The brief clinical examples I have chosen will demonstrate that undifferentiated states of primitive anxiety about annihilation of the self and the object are frequent aspects of borderline adolescents' subjective experience. Enormous clinical benefit can be derived from allowing borderline adolescents' regressed transference reactions to develop, and analyzing the nuances of mutual interaction that stimulate their unfolding.

Many borderline adolescents retain paranoid anxiety and a magical, omnipotent symbiotic relatedness in their interactions, as well as their transference configurations. My use of the term symbiotic transference refers to states of psychic fusion in which there is a lack of psychological boundaries, and not to processes of identification and internalization of aspects of the analyst.

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