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This volume is the latest in a series of distinguished yet practical books on topical issues in psychiatry. Its contributors represent a significant enough spectrum of psychiatric expertise to warrant calling this book a true seminar with a wide range of opinions. Yet all the contributors seem to be integrative and supplemental rather than conflictual in their approaches to the subject. The emphasis is upon the new “darling” of psychiatry and psychoanalysis, the borderline state. Mack, the editor, presents a noteworthy and in-depth review of the literature on the borderline state which, in my opinion, beautifully culls the origin and development of the borderline concept from the psychiatric and psychoanalytic viewpoints from the remote origins in character pathology and the schizoid personality up to the present state of our knowledge. I thought it the best review and most thoughful reflection of the history of the subject I have yet read.
Adler and other contributors in this volume seem to be stating that the borderline state typifies the existence of a personality type or types “who have stable character structures but who can shift transiently into psychosis with sufficently severe stress.” Over and over again most of the contributors emphasize the contributions of Kernberg who characterizes the borderline personality organization (as distinguished from the borderline state) as a “constellation of symptoms, defenses, and specific aspects of ego strength or weakness as well as a developmental history.” He stresses, as Adler points out, the importance of “lower level” defenses which include splitting, projection, and projective identification—but mainly gross splitting between pleasurable and unpleasurable self-object-affect units. Kernberg's theories, despite his many claims to the contrary, seem heavily imbued with the psychoanalytic psychologies of Klein and Fairbairn.
Many of the authors in this volume have also referred to the work of Kohut and have emphasized