Music therapy interaction patterns in relation to borderline personality disorder (BPD) patients

Abstract

Music therapy for patients suffering from borderline personality disorder (BPD) has been a standard treatment option for many years in in-patient psychiatric work. The BPD symptoms, such as identity disturbance, emotional regulation and unstable relationships, lead to challenging and stormy therapy sessions for all therapists of all disciplines. In music therapy, difficulties in treatment include, for example, the patient’s refusal to play, extreme loud music or withdrawal from the process. This article presents the method and results of a systematic qualitative research of 20 BPD female patients undergoing individual psychoanalytical music therapy in an acute psychiatric context. The aim of the research was to identify typical interaction patterns, arising from the relationship between patient and therapist and also from the significance of music. The method “forming types by understanding” is based on the well-known sociological research method of “ideal types”. ed results are generated by contrasting cases, and the research process is validated through communicative validation. In total, it was possible to identify 10 typical interaction patterns within music therapy, reflecting typical BPD themes such as regulation of proximity and distance, splitting phenomena, trauma genesis, aggression and mentalization. The 10 typical interaction patterns of BPD patients have provided a way of accessing individual music therapy cases and making them much easier to understand. The interaction patterns help to maintain and reconstruct the therapist’s capacity to play, improvise and to mentalize.