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Tijdschrift voor Psychiatrie 23 (1981) 3, 151 - 162

Short report

From neurosis to borderline pathology.

F. Kortmann

The interest in 'the Ego' and 'the Self' increased tremendously in the past years. Narcissism is in fashion in laypress and in professional psychological literature. Supposedly parallel to this phenomenon its seems that in the psychiatric clinic and therapeutic community we have to deal with an increasing number of patients with narcissistic and borderline state disturbances. Originally the philosophy of the therapeutic community was tuned into neurotic disturbances. The narcissistic disturbances essentially differ from neurotic disturbances. That's the reason that it is necessary to adjust some of the original concepts of the therapeutic community. This adjustment is partly built on the theory of 0. Kernberg, concerning the formation of the self- and object-relations and epresentations. Very important is the task of the staff. They have to determine the optimal level of structuralisation in the community. It depends on that how far regression goes and from there how fruitful the primary task of examination of everybody's role in the community life can be performed in order to come to 'social learning'.