Past Issues

Psychodynamic Implications of Self-mutilation in a Patient with Borderline Personality Disorder

Ping-Suen Yang

Objective:Borderline patients frequently have self-mutilation behavior to allay anxiety and to gratify certain wishes related to threats involving the breakdown of interpersonal relationships. In this case report, I present the psychodynamic implications of self-mutilation in a patient with borderline personality disorder who received psychodynamic psychotherapy. Case Report:A 30-year-old married female patient would hurt herself by cutting her wrists whenever she felt that she was going to be abandoned by her husband, and she experienced an immediate sense of relief after her self-mutilating behavior. After a two-year course of psychodynamic psychotherapy, the patient became more aware of the fact that self-mutilation was her way of trying to ward off terrifying fantasies of losing her beloved husband and was an attempt to restore her impaired relationship with him. But the actual results of her actions were contrary to the patient’s wishes. Conclusion: This case report illustrates that the understanding of patients’unconscious motives and fantasies of self-mutilation can facilitate borderline patients’ ability to effectively deal with their interpersonal diffi culties.
Key Word self-mutilation, borderline personality disorder, interpersonal relationships, psychodynamic psychotherapy
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