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William Goldstein has accepted an intriguing challenge in writing an “Introduction” to the complex subject of “Borderline Conditions.” I believe that he has largely succeeded in this goal, within the psychoanalytic framework. He combines a broad overview of the borderline with an in-depth examination of the borderline's psychopathology. Targeted as his readers are psychiatric residents, psychology students, psychiatric social workers and other mental health professionals. He hopes to increase his readership, adding that the book also “can be a useful reference for more experienced therapists.”
The book is divided into four parts. The first part is “Ego Psychology” and discusses ego functions in the borderline. The second part is concerned with “Diagnosis and Psychodynamics.” It traces the psychoanalytic history of the borderline from its origins to its inclusion in DSM-III. Part three deals with the “Differential Diagnosis” of the borderline condition. In the fourth part, “Treatment” of the borderline is outlined.
Throughout the book there is a strong emphasis on Otto Kernberg's contributions to the concept of the borderline. Other psychoanalytic clinicians and theoreticians are mentioned, some in detail, but clearly Kernberg's work provides Goldstein with a springboard from which to study the ego functions of the borderline. Others who have thoroughly studied the borderline whom Goldstein mentions include Kohut, Rinsley and Masterson, Adler and Buie, Abend, Porder and Willick and finally Zetzel. All of these clinicians have also written about how psychotherapeutic treatment should be conducted with the borderline and this is reviewed in the final chapter.
Goldstein establishes an ego psychological functioning approach with which he builds an ego profile of the borderline patient. He characterizes the borderline as having four ego strengths and four ego weaknesses. The ego strengths include satisfactory reality testing, thought processes, interpersonal relations and ad