[Borderline patients--management of self- and outwardly destructive behavior in inpatient pediatric and adolescent psychotherapy].

Destructive and self-injurious behavior among children and juveniles with borderline disturbances has brought institutions and staff members involved in child psychotherapy up against the limits of personal and institutional ability to deal with the situation. In order to be able to conduct productive therapy with these "borderline" cases, there is a need for critical examination of inpatient psychotherapy. The present study examines the background and effects of destructive behavior by means of two central types of psychological breakdown, "division" and "working off reactions". In different cases requiring therapy, such as the acting out of processes of division (expulsion, therapeutic isolation), the perpetuation of early behavior patterns, and malign regression, the study shows how important a clear organization of therapy and certain therapeutic attitudes are, particularly where these disturbances are concerned.