IN THIS paper I shall discuss patients who devalue their therapists. I shall describe a group of patients who repeatedly and insistently use devaluation as a major way of handling impulses and affects. This group consists of those in the borderline, psychotic, and severe character disorder categories. Not all such patients use devaluation as a predominant form of behavior in psychotherapy, but we can anticipate its occurrence more often and with greater intensity than in neurotic patients. As a result, these patients may present some serious problems for good psychotherapeutic work and elicit responses in the therapist which are destructive to the therapeutic process.
Kernberg1 discusses devaluation as one of the specific defensive operations used by the borderline personality. Neurotics also may devalue their therapists. The relative lack of intensity and persistence of the devaluation, as well as their ability to maintain a good object relationship in
Adler G. Valuing and Devaluing in the Psychotherapeutic Process. Arch Gen Psychiatry. 1970;22(5):454-461. doi:10.1001/archpsyc.1970.01740290070009