Selzer M A, Koenigsberg H W, Kernberg O F
Am J Psychiatry. 1987 Jul;144(7):927-30. doi: 10.1176/ajp.144.7.927.
The initial treatment contract with a borderline patient recognizes the patient's potential for destructiveness and builds in safeguards. The therapist's effort to protect the treatment mobilizes the patient's primitive defenses. The therapist must be prepared to respond to resistance to the contract by clarification, confrontation, and occasionally interpretation. Although countertransference reactions evoked by the patient's use of primitive defenses complicate the therapist's task of defining the necessary treatment frame, the therapist's recognition of countertransference responses can enable him to establish and enforce an appropriate contract.
与边缘型人格障碍患者签订的初始治疗合同认识到患者具有破坏性的可能性，并设有防护措施。治疗师为保护治疗所做的努力会调动患者的原始防御机制。治疗师必须准备好通过澄清、对抗，偶尔进行解释来应对患者对合同的抵触情绪。尽管患者使用原始防御机制引发的反移情反应使治疗师界定必要治疗框架的任务变得复杂，但治疗师对反移情反应的认识能够使他制定并执行一份恰当的合同。
