Personality Disorders, Narcissism and Borderline-Organization

Patients with a borderline organization or other personality disorders suffer from a structural disorder. Their metacognitive processes are fixed in a character resistance and cause severe relationship disorders in the present. However, they experience the rigid defenses they developed in childhood as part of their identity. This fixation also disrupts the therapeutic relationship. The therapist is required to make an internal paradigm shift. She justifies her own appropriate negative affect, triggered by the patient's character resistance, in the therapeutic relationship and uses it in a therapeutically beneficial manner. In doing so, she uses the principle of response instead of interpretation. The constellation of metacognitive ego states enables the patient to gain ego control over his neurotic acting out in equivalence mode. This work is a central action method in disorder-specific psychodrama therapy. The therapist works not only with dysfunctional parts of the self, but also works out the positive meaning of the patient's rigid metacognitive defense pattern within the framework of his or her self-regulation. The treatment of metacognitive disorder is the prerequisite for long-term success in the therapy of people with a personality disorder. The disorder-specific psychodramatic action methods qualitatively enhance the depth psychological, behavioral and systemic psychotherapy of people with personality disorders.