Summary
The final paper named The Experience of Psychotherapeutic Alliance is based on
evaluation of experiences of six therapists working with patients diagnosed with
Borderline Personality Disorder (BPD). The paper focuses on exploration of topics the
therapists discuss and consider to be important to them. Another aim of this study is to
discover relations between these topics and to find a structure in the answers received.
The topics may represent any contents: thoughts, feelings, physical sensations, behaviors
and their representations. The development of psychotherapeutic alliance with a patient
with BPD is explored as well.
The theoretical part of this paper is a summary of different approaches towards a
therapeutic alliance, its historical evolution, and latest research in this field. It also tries to
define the diagnostic concept of BPD from different perspectives, describing each
concept of therapeutic approach to patients with BPD, including the most recent ones.
Results of latest research on therapeutic alliance in the treatment of BPD are quoted
frequently.
The data was obtained through semi-structured interview with narrative features,
during which the examined subjects were encouraged to talk freely about two of their
patients, who had received one to one therapy for BPD.
The inclusion criterion was the diagnosis of BPD in both patients presented,
preferably one male and one female. We had chosen six psychotherapists with relevant
experience. Three of them were males and three were females. Two of them are
psychologists, four of them are doctors and all six of them are certified specialists in
clinical psychotherapy. The sample of therapists covered a broad spectrum of
psychotherapeutic schools: psychoanalytic psychotherapy, Gestalt therapy, personcentered
(Rogerian) psychotherapy, cognitive-behavioral therapy and other dynamic
therapeutic approaches.
The interviews were accompanied by „life-line-method", in which the respondents
tried to express the course of therapy with a hand drawn line.
As a result we got six analyzed statements, from which we created a list of all topics
common to more than one statement.
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All topics, with special attention paid to the topics most frequently occurring in the
statements, were compared to the up-to-date research on treatment of BPD in the
discussion.
The therapists mostly referred to the topics of boundaries in the therapeutic alliance:
patients' tendency to attack the boundaries and to test the acceptance of them by the
therapist, and the therapists' struggle to maintain the boundaries in place.
Often the topics of alternating attitude towards the patient in the course of therapy
were presented, ranging from compassion to anger. The therapeutic alliance is in many
cases perceived as a parent-child relationship and the progress in therapy as a symbolic
growing up of the patient. These findings correspond to the theoretical concepts of Otto
Kernberg and Peter Fonagy (projective identification, splitting, mentalization).
This research can be a foundation for future exploration of this field; it can be
compared to similar research of the patients' perspective on these topics.
The results give us valuable data from the field of BPD treatment and
psychotherapy in general. The results can be used for further analysis of other similar
research projects in the field of BPD treatment.
The significance of this research lies not only in deepening of the knowledge of this
field, but it can also help starting therapists to better understand the treatment of patients
with BPD.
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