The Core Conflictual Relationship Theme of Psychotic, Borderline, and Neurotic Personality Organizations

Abstract

Kernberg's (1984) model of personality describes 3 personality organizations (POs)-psychotic, borderline, and neurotic-each of which has specific characteristics in terms of relationship schemas, defense mechanisms, identity diffusion, and reality testing. The Core Conflictual Relationship Theme (CCRT) method (Luborsky, 1998a) is a measure of central relationship schemas as revealed by relationship narratives. It identifies 3 components: the patient's wishes (Ws), the responses from others (ROs), and the responses of self (RSs). The goals of this study were to compare 2 methods for scoring ROs and RSs and to examine whether different POs vary in terms of their relationship schemas as measured by the CCRT. Eighty-one participants were included in this study. A PO diagnosis was made with the Personality Organization Diagnostic Form (Diguer & Normandin, 1997). Results showed that both scoring methods were equivalent in all dimensions. We found more similarities than differences between the 3 PO groups with respect to Ws, ROs, and RSs. The psychotic PO group presented the flattest CCRT profiles, the least negative responses, and the lowest narrative complexity. These results are discussed in relation to Kernberg's model and the development of the CCRT method.