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In a recent empirical study, Gunderson & Singer (1975) articulated those features characteristic of the borderline patient. This paper is an attempt to order those findings within a single theoretical framework based on the development of object relations. This theoretical framework was presented in a previous paper (Horner, 1975a).
This developmental paradigm traces the evolution of object relations from the stage of normal autism, through the process of attachment to the stage of normal symbiosis and then through the sub-stages of the separation-individuation process (Mahler, 1968) to the stage of identity and object constancy. Various forms of psychopathology are specifically related to failure at various points along this developmental continuum.
Relevant to this paper is the location of the narcissistic personality disorder at the earliest point of the separation-individuation process as a fixation of infantile attachment with a failure of complete somatopsychic differentiation. The schizoid personality is located at a point further along the continuum where it is defined as a flight from the borderline position.
The value of such a framework within which to integrate diverse clinical observations is a most pragmatic one, in that our interventions on behalf of the patient, whether it be how we structure our relationship with him or the content of our interpretations, can then be more accurate and appropriate. Inevitably we shall also be more effective in helping him resolve his apparently unresolvable dilemma.
The proposed model is based on the hypothesis that, of the various functions of the ego, object relations is primary, since it is within the dyadic mother–child matrix that all other ego functions develop. Pathology of that relationship will have reverberations in all other areas of ego functioning. Spitz (1965) pointed out that 'from the beginning of life, it is the mother, the human partner of the child, who mediates every perception, every action, e