The myth of the alliance with borderline patients

Abstract

The author questions the concept of a therapeutic alliance in the psychotherapy of patients with borderline and narcissistic personality disorders. The motivating elements in their treatment are the emerging, sustaining transferences, which also allow the patients to appreciate the real qualities of their therapist. As they internalize aspects of their interactions with the therapist, including the therapist's real characteristics that are lacking in themselves, the patients gradually develop the capacity to work collaboratively with him or her. When a solid therapeutic alliance is established, the patients have reached a neurotic level of functioning.