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Book Review: Borderline Bodies: Affect Regulation Theory for Personality Disorders

“The body,” says Clara Mucci, “is the essential go-between in the relationship between the self and other.”

In personality disorders, this relationship between the self and the other is especially troubled. However, this “other” can be the body itself.

Mucci describes psychosomatic disorders as an outcome of the “problematic junction between mind and body.” The body can also act as an imprinting device in which earlier generations transmit their trauma onto us.

In her new book, Borderline Bodies: Affect Regulation Theory for Personality Disorders, Mucci places the body at the center of treatment, viewing it both as the recipient of trauma and the internalized persecutor, inflicting further harm.

“It is likely that when there is insecure or disorganized attachment in the first, traumatized generation, the second and third generations of survivors might develop personality disorders when vulnerability and even epigenetic factors combine with other environmental factors,” writes Mucci.

Interpersonal traumatization can exist on three levels. We can have early relational trauma, maltreatment, abuse, and identification with the aggressor, and we can have massive and intergenerational trauma.

Mucci explains, “The development of a personality disorder, characterized by a series of difficulties and relational dysfunctions between self and other and evident in the exchanges between patient and therapist in clinical work, finds its origin in developmental deficits (lack of attunement between infant and caregiver starting from the very early relationship or serious difficulties encountered by the caregiver attending to the child starting from pregnancy, plus maltreatment and abuse).”

In relationships, we exchange our corporeal selves. One body meets another body and in this intermedial space, neurobiological and affective exchanges lay the groundwork for how we learn to relate to others and to ourselves.

“Contrary to any theory that still privileges ‘innate aggressiveness’ and a predominance of the ‘fantasmic element’ over the reality of the rearing conditions, I view temperament as epigenetically formed,” writes Mucci.

Personality features, contends Mucci, originate in the psychobiology of the child, and the attachment exchanges that occur between the psychobiological bodies of the mother and child.

How children learn to regulate emotions, and the attachment styles they develop play a pivotal role in their future health.

Mucci writes, “If we view the right brain as the first and foremost ‘body,’ intended as a corporeal reality that is intersubjectively and epigenetically construed and shapes individual differences and personality characteristics, we are better equipped to understand how the nature of the subject is shaped through relational embodiment and mimicry, as Vittorio Gallese maintained (Gallese, 2009), and how in fact ’embodiment shapes the mind’ (Lemma, 2015, p. 2).”

Mistuning naturally occurs, but it can also be repaired regularly when the mother is emotionally available and remains accessible to the child even after momentary disruption. Through this process, the child learns to take in stimuli both from the outside and from within their own body.

Mucci writes, “Through right-brain-to-right-brain nonverbal visual-facial, tactile-gestural, and auditory-prosodic communications, the caregiver and infant each learn the rhythmic structure of the other and modify their behavior to fit that structure, thereby co-creating a moment-to-moment, specifically fitted interaction.”

The body represents for the subject the first source of relationship with the mother and also influences their relationship with the clinician.

Mucci writes, “We have evidence that representations of parents and of the self develop in synchrony (Bornstein, 1993) and that these representations become models that influence expectations and behavior with respect to the environment.”

Moreover, the right hemisphere is the neurobiological foundation of the unconscious. It is here where social and emotional behaviors are learned, and homeostatic regulation between the body and motivational states occur.

Psychosomatic disorders, Mucci tells us, therefore represent a narcissistic preoccupation with the self, whereby the body has taken the place of the external world. Mucci describes the case of John, a 23-year-old male with somatic complaints and hypochondria so severe he can only have a good day when he remains in his mind, studying, and not disrupted by physical symptoms.

She writes, “In my mind (and in accord with both McDougall’s and Green’s theories), hypochondriasis is on the dividing line between borderline disorders and psychosis — at the extreme and most pathological end of narcissism — where the encounter with the other is impossible, as in different ways is the case with antisocial personality disorder (which implies destructiveness toward the other and violence and breaking of rules).”

The body is a gift from our parents, but it is also our gift. Placing this body at the forefront of treatment, Borderline Bodies is a revolutionary way to understand how personality disorders develop, and importantly, that their symptomatology can be remedied. Drawing on psychanalytic theory, it bridges epigenetics, attachment theory, and relationships — particularly the healing relationship that ensues between the clinician and the client.

Borderline Bodies: Affect Regulation Theory for Personality Disorders

W.W. Norton & Company, November 2018

Hardcover, 480 Pages

Book Review: Borderline Bodies: Affect Regulation Theory for Personality Disorders

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Claire Nana

Claire Nana is a regular contributor and book reviewer for Psych Central.

APA Reference
Nana, C. (2019). Book Review: Borderline Bodies: Affect Regulation Theory for Personality Disorders. Psych Central. Retrieved on September 28, 2020, from
Scientifically Reviewed
Last updated: 21 Mar 2019
Last reviewed: By a member of our scientific advisory board on 21 Mar 2019
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