Analysis of Ego Psychology and Social Work Book by Eda G. Goldstein - Assignment Example

Position PaperIn Ego Psychology and Social Work, chapter 12, The Diagnosis and Treatment of the Borderline Client, Eda G. Goldstein states that the borderline diagnosis is frequently used on individuals who exhibit some entrenched, maladaptive, rigid patters and characteristics that impair the normal functioning or cause subjective stress. The author emphasizes that borderline individuals show severe personal and relationship issues and often engage on substance abuse and affected by other conditions, such as eating disorders, self-destructive behavior, and violence.

The author also points out those borderline individuals are difficult to deal with and maintain when giving treatment because they become mostly dependent on therapy that gives them a sense of connection and safety. However, there has been debate on what constitutes the characteristics of borderline and what does not with respect to developmental concepts (Goldstein, 1995).The explanations of the causal factors of borderline have been linked to hereditary and constitutional factors or developmental factors.

Early studies linked borderline to schizophrenia but this view did not last. Recently, biological research has revealed that borderline individuals suffer from underlying mood disorder.The main treatment concern that has followed the controversy in the characteristics of borderline individuals is whether to provide them with supportive interventions or classical psychoanalytic psychotherapy that has special modifications. Other considerations have been whether to provide short-term or long-term interventions or to be given drugs instead of psychotherapy.

These debates have occurred because of lack of research on the treatment outcome of borderline individuals (Goldstein, 1995).In diagnosis, clinical methods have been associated with a medical method. However, many clinicians who prefer psychodynamics have favored the use of developmental diagnoses to establish how the problems arise when an individual adapts to the environment. Clinical methods have been criticized because of the failure of conception of causality to include environmental, interpersonal, and cultural contexts, labeling as opposed to individualized understanding, the unreliability caused by different view of clinicians to criteria, socio-cultural bias, and the use of diagnosis as a means of social control.

The causes of borderline conditions reflect the developmental origins of borderline disorders, for instance on a child’s inability to integrate good and bad self and object representations. They interfere with the fourth stage of development where a child cannot relate the three dimensional conception of himself or other people. In the conflict model, the absence of maternal affiliation during the rapprochement sub phase causes borderline.Clinical interventions require that the borderline pathology be seen as a range of developmental difficulties that require individualized therapeutic interventions.

Therefore, the goal is to help borderline clients sail through a particular crisis. In developing and maintaining a working alliance, a worker must deal with the characteristics of the client that may disrupt the working alliance. This may be done by developing a therapeutic holding environment, addressing primitive defense issues and negative transference, controlling, impulsive behavior and regression (Goldstein, 1995).I agree with Goldstein that when working with borderline individuals workers should be real, provide validation and affirmation, as opposed to remaining neutral.

In addition, treatment must help borderline individuals develop, restore, and strengthen their adaptive and coping abilities in the form of Ego-building. Workers must also work with the families of borderline individuals with adequate support. Group intervention must be avoided in most cases. However, they can be used to develop skills and promote ego functioning. ReferencesGoldstein, E.G. (1995). Ego Psychology and Social Work Practice. 2nd Ed. New York: Free Press