Buie And Adler :
Buie and Adler propose that the pathology displayed by sufferers of borderline personality disorder (BPD) such as instability, uncontrolled rage and anger, can be attributed, primarily, to early dysfunction in the relationship between the individual as a young child and his/her mother.
More specifically, Buie and Adler hypothesize that, as a young child, the BPD sufferer was insufficiently ‘held’ by the mother, particularly during the rapprochement phase of interactions.
What Is Meant, In Psychotherapy, By ‘Holding’?
In psychotherapeutic terms, the word ‘holding’ does not necessarily entail literal, physical holding (although, ideally, of course, a mother would physically hold her young child when s/he was distressed and in need of comfort), but can also involve its emotional equivalent (verbally comforting and soothing the child, for example).
However, because of the mother’s failure to sufficiently ‘hold’ (physically, emotionally or both) the BPD sufferer when s/he was a young child in distress, s/he never had the opportunity to internalize adequate maternal ‘holding’ behaviour so that now, as an adult, s/he lacks the ability to self-soothe in response to the further distress that s/he will inevitably experience as an adult.
Profound Feelings Of Aloneness :
Buie and Adler further propose that the BPD sufferer’s inability to ‘self-soothe’ at times of high stress leads to a pervasive and profound sense of aloneness; indeed, Buie and Adler consider this deep sense of loneliness to be a core feature of the BPD sufferer’s psychological experience and describe it in the following manner :
‘an experience of isolation and emptiness occasionally turning into panic and desperation.’
Also, according to Buie and Adler, BPD sufferers use the psychological defence mechanism of projection in relation to their profound feelings of inner isolation which means, in short, that they project these feelings onto the external environment, and, as a result of this, perceive the outside world, and life in general, to be empty, meaningless and devoid of purpose.
Longing To Be Held By Idealized Others :
Furthermore, Buie and Adler propose that this inability to self-soothe and self-nurture (due to the original failure to internalize maternal holding behaviour, itself a result of the mother’s dysfunctional interaction with the BPD sufferer when s/he was a young child) leads to intense, desperate longing and desire to be ‘held’ by idealized others.
Separation Anxiety :
Additionally, according to Buie and Adler, such longings perpetually leave the BPD sufferer vulnerable to feelings of extreme separation anxiety.
Because of the BPD sufferer’s proneness to idealize others (see above), Buie and Adler point out that this can lead to him/her (i.e. the BPD sufferer) to develop extremely exacting expectations of such idealized others that it is not possible for them (i.e. the idealized others) to live up to.
This inevitable failure of the idealized others to live up to the BPD sufferer’s stratospheric expectations can then induce feelings of extreme rage and anger in him/her (i.e. the BPD sufferer) directed at the ‘failed’, idealized other.
Implications For Therapy :
In line with their theory, Buie and Adler put forward the view that it is the role of the therapist to provide the holding and soothing functions that the BPD sufferer is not capable of providing for him/herself. The ultimate goal of this is that the BPD sufferer is eventually able to internalize these functions (holding and self-soothing) so that s/he learns to provide them for him/herself in a way that s/he was unable to as a child due to the defective nature of the mothering s/he received.
David Hosier BSc Hons; MSc; PGDE(FAHE).