The Borderline Concept

December 13, 1989

Adler's (1989) stimulating and valuable article applying some of Kohut's ideas to the treatment of borderline states contains serious misunderstandings of our (1984a) views. Adler mistakenly attributes to us a formulation claiming that borderline states are an entirely iatrogenic result of the therapist's empathic failures and that, in essence, the therapist is to blame for the patient's psychopathology. In response to such erroneous impressions and characterizations of our ideas by Adler (1984) and others, we have attempted to clarify our views in subsequent publications (e.g., Brandchaft and Stolorow, 1984b), (1987); (Stolorow et al., 1987). For example, in our book with Atwood (Stolorow et al., 1987) we wrote:

[T]he psychological essence of what is called "borderline" does not rest in a pathological condition located solely in the patient. Rather, it lies in phenomena arising in an intersubjective field, consisting of a precarious, vulnerable self in a failing, archaic selfobject bond.

We wish to clarify some potential sources of misunderstanding of our point of view. Conceptualizing borderline phenomena as arising in an intersubjective field is not equivalent to claiming that the term "borderline" refers to an entirely iatrogenic illness … [T]he failing, archaic selfobject bond is not always with a therapist or an analyst, although this will become increasingly more likely as the patient's selfobject needs are engaged in the therapeutic transference. More importantly, the claim of an entirely iatrogenic illness would be markedly at variance with our concept of an intersubjective field and would overlook the contribution of the patient's archaic states, arrested needs, and fragmentation-prone self to the formation of that psychological field. If we view the therapeutic situation as an intersubjective field, then we must see that the patient's manifest psychopathology is always codetermined by the patient's self disorder and the therapist's