Splitting and identification with the aggressor in assaultive borderline patients

The author describes two borderline inpatients with assaultive behavior that was not controllable by medication. These patients use splitting to separate all-good and all-bad part representations, which hinders tolerance of ambivalence and control of aggression. Drive breakthroughs may reinforce their feelings of omnipotence. Interpreting episodes to the patient in this psychodynamic framework can aid their integration of self-representations and their ability to control aggression. Therapists and staff should resist the temptation to "give in" to such patients in order to forestall explosions.