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This rather modestly titled study of research and clinical experience of borderline children is in fact a very important contribution, bringing together some widely varying views and theoretical ideas. The first part of the book, ‘Crossing The Borders’, takes the reader on a detailed tour of the research findings in the USA and the British-based psychoanalytical schools. There have been many attempts to identify and define borderline phenomena in different traditions, as well as different countries and continents. The aim in this book is to ‘synthesize’ some of the ideas from the schools of psychoanalysis and developmental psychology and to find common ground or a bridge between them to attempt a harmonized clinical approach.
In the first chapter Lubbe looks at the historical origins for diagnosing borderline psychotic disorder (BPD) in children. It is clear that this ‘in-between’ area of functioning, which may have neurotic and psychotic features, is not an easy syndrome to define and it raises many questions about what could and should be included in its symptomatology. Indeed, there are many theorists who disagree about the domain in which borderline children can be diagnostically placed.
Originally BPD in children was understood as emerging from the study of borderline adults. However the early psychoanalytical work with children formed the basis for defining the condition as clinically distinct in itself, and this served to inform the clinical work with adults. Borderline refers to the area between psychosis and neurosis where phenomena of both types may be present at any time. The patient within the borderline range may cross the border in either direction, rather than inhabiting one zone more permanently. These children do not fit in established categories. They are not autistic or schizophrenic and their problems are in part due to ‘specific developmental imbalances’ (p. 36). It is somewhat gratifying that psychotherapeutic treatment is evidently successful in