Early Affect-Confusion: The Borderline Between Despair and Rage - Part 1 of a Case Study Trilogy

Richard G. Erskine


This three part case study illustrates the principles, theoretical concepts, and relational methods of Integrative Psychotherapy in the treatment of a client who continually experienced early affect-confusion and lived on a “borderline” between intense neediness and rage, despair and self-reliance, impulsivity and manipulation. Part 1 describes the behavioral dynamics of a 38 year old female client who required a two-part treatment approach that emphasized an inter-subjective relationship, consistency, and respect while helping her to acknowledge and value her relational-needs and to engage in a relationally contactful form of anger.


integrative psychotherapy; affect-confusion; phenomenological inquiry; borderline; affective attunement; relational psychotherapy; transference; disorganized narrative; therapeutic relationship; empathy; vulnerability; core beliefs; behavioral management

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