TWO THERAPISTS FOR ONE PATIENT: THE ATTACHMENT THEORY AS A FRAMEWORK FOR CO-THERAPIES IN BORDERLINE PATIENTS TREATMENTS
Treatments in multiple settings are very common in the management of borderline personality disorder (BPD).
The potential of multiple setting treatment is such that it is recognised in the American Psychiatric Association's proposed treatment guidelines for BPD.
The general consensus of clinicians on the importance of using different therapists and different settings simultaneously in treating patients with BPD is not supported by a unifying theoretical model explaining the specific effects of multiple therapist-multi-setting approach in treating BPD.
This paper provides an attachment theory-based possible theoretical explanation of why a patient with BPD could benefit from simultaneous relationships with more than one therapist. According to our hypothesis, the complex relational configuration created by the simultaneous presence of therapists working in different settings may constitute an ideal basis to prevent or correct some of the consequences of disorganised attachment which are present in BPD. Such consequences are likely to result in an unstable or unfruitful relationship for both the patient and therapist.