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Rosenfeld, S.K. Sprince, M.P. (1965). Some Thoughts on the Technical Handling of Borderline Children. Psychoanal. St. Child, 20:495-517.

(1965). Psychoanalytic Study of the Child, 20:495-517

Some Thoughts on the Technical Handling of Borderline Children

Sara Kut Rosenfeld and Marjorie P. Sprince

SUMMARY

The body of this paper has been concerned with techniques used in the initial stages of treatment, which can extend over years and which aim at making the child more analyzable. We have not dealt with the later period of therapy when the borderline picture gradually changes and internalized conflict can become the center of treatment. We hope that at some future date other members of the group will describe just this process.

We have discussed the technique within the treatment situation, as it is in reality and not as we would like it to be. We would ask the reader to bear in mind that treatment in a clinic involves special problems such as consideration for other patients, for the building, and not least the question of transport.

We have described some of the problems peculiar to the treatment

of borderline children and particularly how each child's level of ego and object relationship is at a different stage of development so that there are a variety of different psychopathologies.

We have spoken of the need to make meaningful contact with the borderline child and the difficulties of following him into his psychic world. We have described how we may be forced into a more active role than we are accustomed to and we have stressed that the treatment relationship with these children is governed by their fragmentary ego, their proneness to acute anxiety, and their low level of object relationship.

Different methods of dealing with acute anxiety at the beginning of treatment have been considered; we have discussed the use of ego-supportive techniques and the timing of interpretations. We have also tried to give a picture of the impact of the child's material on ourselves, emphasizing how each therapist reacts differently to the material and defends herself against it in a different way. We think that this must influence our handling of the cases and that it may explain why we have evolved no single technique.

It may be that work with borderline children involves some specific anxiety since we so often feel personally responsible for the slow therapeutic gains seen in our patients. Working with colleagues in a group has a special value for us since it not only offers opportunities for exchange of views but also provides us with the support and reassurance which enable us to look at the material objectively and to attempt formulations such as we have undertaken in this paper.

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