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A detailed commentary on a clinical study by O'Shaughnessy (1981) is presented from the viewpoint of the model of borderline personality developed in Cognitive Analytic Therapy. The delineation of separate ‘self states’, each with a characteristic repertoire of reciprocal roles, offers a different perspective on the pathology of the patient and on the impact of the analysis. On the basis of this and two previous papers it is argued that the status of defensive or pathological organizations is questionable and that the interpretations generated by Kleinian theory may exacerbate the patient's fragmentation.