Journal of Clinical Research & Bioethics

Abstract

The Role of Clinical Psychiatry in Nurturing Autonomy in Female Japanese Patients with Pathological Personality Traits

Masayo Uji

Few studies have examined patients with pathological personality traits in terms of their competency to exercise autonomy, despite the increasing number of these individuals who visit psychiatric clinics in Japan. The purpose of this study was to assess such patients’ competencies using medical record data focusing not only on the therapeutic relationship but also on the patients’ social relationships throughout their life histories. Two patients were evaluated: one with borderline personality disorder and another with the “as if personality”, a concept of personality prototype proposed by Helene Deutsch in 1942. Their clinical materials were analyzed from psychosocial viewpoints. I attempted to identify the points in their lives at which any competency weaknesses originated. I further discuss their competencies in decision making and exercising autonomy using psychoanalytic theory, in particular Winnicott’s contributions. Finally, I propose the role of contemporary psychiatry in nurturing patients’ autonomy, in order to help them live more comfortably in Japanese modern society.