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The prognosis for intensive, long-term psychotherapeutic treatment of patients with borderline personality organization has been dealt with. The prognostic elements reflected by the patient's presenting illness and personality have been outlined. Summarizing these prognostic elements briefly, the prognosis of patients with borderline personality organization depends on: (1) the descriptive diagnosis of the predominant type of character pathology, and the extent of ego and superego pathology revealed by pathological character traits; (2) the nonspecific manifestations of ego weakness present, especially the degree of impulse control, anxiety tolerance, and sublimatory potential; (3) the degree to which integrated, abstracted, depersonified superego structures are present, as reflected in patients' capacity for concern, guilt, depression, insight, and the extent and structural implications of antisocial trends; (4) the quality of object relationships.
I have stressed that the prognostic indicators available in the initial examinations facilitate the selection of those patients for intensive psychotherapeutic treatment who can better use the limited therapeutic resources presently available. These initial prognostic indicators also highlight areas of prognostic uncertainty which may then be clarified during the treatment process.