Nadelson T
Am J Psychiatry. 1977 Jul;134(7):748-51. doi: 10.1176/ajp.134.7.748.
Borderline patients often engender feelings ranging from apathy to rage in therapists. The author views the borderline patient's rage as defensive against fear of total negation resulting from projective identification with hostile part objects. The therapist's withdrawal or anger parallels the patient's projection of affect. Countertransference offers the potential for understanding a patient's terror, but therapists may become fixed in identifications that distort their understanding. Clarity often comes slowly as the therapist directs attention to his/her own affective state in order to understand the patient's vulnerability.
边缘型人格障碍患者常常会在治疗师身上引发从冷漠到愤怒等一系列情绪。作者认为,边缘型人格障碍患者的愤怒是一种防御机制,用以对抗因与充满敌意的部分客体进行投射性认同而产生的对完全被否定的恐惧。治疗师的退缩或愤怒与患者的情感投射相呼应。反移情为理解患者的恐惧提供了可能,但治疗师可能会陷入一些认同中,从而扭曲他们的理解。当治疗师将注意力转向自身的情感状态以理解患者的脆弱性时,清晰的认识往往会慢慢浮现。