People with neurotic personality organisation can generally maintain relatively clear boundaries between their internal experiences and external reality. They are also more likely to maintain a stable and coherent sense of self across different situations.

This does not mean that they are free from emotional conflict, anxiety, or psychological distress. Rather, they may experience internal conflicts while retaining a relatively consistent sense of who they are.

Mature defence mechanisms, such as repression or rationalisation, can help manage uncomfortable thoughts and emotions. These defences can allow a person to continue functioning while psychological conflicts are experienced and processed.

At the borderline level of personality organisation, the experience of identity may be less stable and integrated. Kernberg described this in terms of identity diffusion, where different and sometimes contradictory experiences of the self may be difficult to bring together.

Primitive defence mechanisms, particularly splitting, may become more prominent. This can contribute to experiences in which people, relationships, or aspects of the self are perceived in particularly extreme ways — for example, as entirely good or entirely bad.

Reality testing can nevertheless remain relatively preserved. However, emotional regulation, relationships, and the person's sense of self may become significantly more unstable, particularly during periods of stress.

At the psychotic level of personality organisation, difficulties with identity integration and reality testing can become more pronounced. The distinction between internal psychological experience and external reality may become significantly compromised.

Primitive defensive processes such as denial, projection, and psychotic distortion may become more prominent. A person may experience greater difficulty maintaining a coherent sense of self, particularly when confronted with overwhelming emotional or interpersonal experiences.

In severe circumstances, psychotic experiences or distortions may emerge, affecting how events are interpreted and connected. Rather than experiences being organised through a coherent understanding of cause and effect, beliefs or perceptions may begin to organise the person's experience of reality.

What happens to personality structure during a crisis?

From Kernberg's perspective, structural identity is not simply about “who we are” as a person. It also concerns how coherently and stably we can experience ourselves across different situations and relationships.

During periods of enduring crisis, trauma, or intense stress, these underlying patterns can become particularly visible. They may influence how we regulate emotions, relate to other people, interpret experiences, and make sense of ourselves.

A crisis can challenge our established understanding of who we are. A relationship may end. A significant loss may occur. Trauma may disrupt our assumptions about safety. A major life transition may force us to reconsider values, roles, or expectations that previously felt stable.

In these moments, the psychological task is not simply to eliminate uncomfortable emotions. It can also involve integrating different aspects of our internal experience while continuing to navigate an emotionally demanding external reality.

The role of integration

If crisis can expose fragmentation, conflict, or instability within our experience of ourselves, then psychological growth can involve developing greater capacity for integration.

Integration means being able to recognise that different experiences, emotions, thoughts, and aspects of ourselves can coexist without necessarily needing to be separated into completely opposing categories.

We can, for example, feel angry with someone while still caring about them. We can acknowledge our strengths while recognising our limitations. We can experience uncertainty without immediately needing to resolve it. We can recognise that another person's behaviour may have hurt us without reducing that person entirely to the experience of being hurt.

This capacity to hold complexity can contribute to a more coherent and reflective experience of the self.

Understanding the patterns beneath our reactions

One of the challenges of psychological self-awareness is that defence mechanisms often operate outside conscious awareness. We may therefore experience our reactions as automatic, obvious, or completely justified without immediately recognising the psychological process taking place underneath them.

Broadening our perspective can help us become more curious about the connection between our thoughts, emotions, beliefs, and behaviour.

For example, a strong emotional reaction to a situation may be influenced not only by what is happening in the present but also by previous experiences, expectations, relational patterns, and beliefs about ourselves or others.

Recognising these connections does not mean dismissing our emotions. Instead, it creates an opportunity to understand them more deeply.

From repetition to new possibilities

When we begin to recognise the dynamics that repeatedly shape our experiences, we may gain a broader and more reflective understanding of ourselves.

We may start to ask questions such as:

These questions can create space between an emotional trigger and an automatic response. Within that space, new possibilities can emerge.

Integration as a pathway toward stability

Self-awareness and psychological work can help reduce the distance between our internal experiences and the way we respond to reality.

Developing greater awareness of our emotional and cognitive patterns can help us recognise when we are responding from old relational dynamics, defensive patterns, or deeply held beliefs.

With reflection, openness to new perspectives, and a willingness to experiment with different ways of responding, we can gradually strengthen our capacity to navigate difficult experiences while maintaining a more coherent sense of ourselves.

The goal is not to become a person who never experiences anxiety, anger, sadness, uncertainty, or conflict. Psychological stability is not the absence of difficult emotions.

Instead, it can involve developing the capacity to experience those emotions without losing our sense of ourselves — to hold different parts of our experience together, reflect on them, and respond in ways that are increasingly aligned with our values and relationships.