The Borderline Case1

The panel was opened by the Chairman, Leo Rangell, who in his "Introductory Remarks" presented first a brief review of the development of our interest in borderline states, and pointed to the increased attention which these have been receiving in recent years. This inevitable course, following the early deliberate limitation of psychoanalysis to the hysterias, to neurotics and to the transference neuroses in general, came about from the merging of two opposite directions. These were (1) the gradual increased understanding downwards of the transference neuroses themselves, beyond and below the phase of the oedipal conflicts, to the deeper pregenital structures; and (2) an upward direction, from work with the narcissistic neuroses, which in the meantime had also subsequently been found to be accessible. These both resulted in a traversing of the differences between the neuroses and psychoses and a natural interest from both directions in the borderland between them.

A corollary to this historical development was a parallel interest in psychotherapy and in modified psychoanalytic procedures concomitant with this increased concern with the borderline disorders. This historical course pushes our frontiers into a widening are and results, as in the earliest phase of psychoanalysis, in mutual reverberations between therapy and research, on the one hand sharpening our therapeutic armamentarium while at the same time yielding an increased clarification of the earliest anxieties and dynamics and psychic structures. The challenge, in this area of multiple and almost infinite variables, is (1) for us to become more precise about the syndrome itself, and (2) to objectify as much as possible the therapeutic moves, on the scientific and rational basis of our metapsychological understanding of genesis, etiology, and dynamics. Toward this there is a need for a combination of extensive and intensive observations.