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Howell, E.F. (2002). Back to the “States” Victim and Abuser States in Borderline Personality Disorder. Psychoanal. Dial., 12(6):921-957.

(2002). Psychoanalytic Dialogues, 12(6):921-957

Back to the “States” Victim and Abuser States in Borderline Personality Disorder Related Papers

Elizabeth F. Howell, Ph.D.

Chronic and complex posttraumatic stress involving terrorization and betrayal by a caretaker can result in a particular kind of psychic organization that is structured largely by underlying, alternating victim/masochistic and abuser/rageful states. When we move our view of experience “back” to its underpinning in states, we can see how the oscillation between these states is a continual reenactment of the traumatic violation of the relational boundary. While “borderline” persons are capable of conscious awareness of their dramatically differing behaviors, the meaning of the behavior is disavowed. These unlinked, but switching states are decontextualized. Inasmuch as context provides meaning, the acted-out parts remain encapsulated as unowned experience.

Diagnostic formulation in terms of these dissociated states supplies a needed cohesiveness for the criteria given in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and adds specificity to the “borderline” defenses as spelled out by Kernberg. These shifting victim/masochistic and abuser/rageful self-states can be observed and talked about and are accessible to experience. Themes of behaviors that are typically enacted have to do with boundary violations, destructive

entitlement, betrayal, and mirroring the earlier experience, particularly of traumatic betrayals of attachment, of these survivors.

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