New Uses of Countertransference for the Inpatient Treatment of Borderline Personality Disorder*

The author describes the uses of countertransference for the inpatient treatment of borderline personality disorder. Differences from usage in the dyadic outpatient situation are noted. In particular, the countertransference induced in staff may provide a crucial signal function reflecting the patient-ward system. Understanding these feelings provides information not only about the patient's inner world but also about general system features such as the staff's needs, therapeutic capacity and unresolved feelings from previous borderline patients. The signal function may also have diagnostic and treatment implications. A conceptualization of counter-transference that encompasses the unique system aspects of inpatient psychiatry is helpful in the care of borderline patients.