Clinical Practice SWES Practice Exam

What defense mechanism is likely demonstrated by a client diagnosed with borderline personality disorder when she fluctuates between idealizing and devaluing therapists?

1. Projection

2. Displacement

3. Splitting

4. Reaction formation

The correct answer is: Splitting

The behavior of fluctuating between idealizing and devaluing therapists is characteristic of splitting, which is a defense mechanism commonly associated with borderline personality disorder. This mechanism involves seeing people, situations, or oneself in black-and-white terms, where they are either all good or all bad, with no balance in between. In the context of a client with borderline personality disorder, splitting occurs as a way of managing emotional pain and instability. When the therapist delivers support or helps the client feel understood, the client may idealize them, viewing them as perfect and invaluable. Conversely, if there's a perceived slight or disappointment, the client may shift to devaluing the therapist, seeing them as entirely incompetent or harmful. This swing can create instability in the therapeutic relationship, reflecting the underlying emotional volatility and difficulties in interpersonal relationships that characterize borderline personality disorder. Understanding this behavior as a manifestation of splitting emphasizes the importance of consistency and emotional support in the therapeutic setting, helping both the client and therapist navigate these intense fluctuations effectively.