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“As-if pathology is essentially imitative, a way of life built on an endless series of transient identifications in which the individual acts as if he or she were sensitive, empathic, conservative, religious, or even rebellious—all dependent on what others want the individual to be” (p. xiii). This definition would find acceptance from who first introduced the topic. She became interested in a type of pathology she observed that “should” have produced psychosis or schizophrenia, but did not. Little has been written on the subject since. Thus the intention of the present authors, who attempt to elaborate on the subject, since they believe there to be a great many more patients of this type than are written about.
The authors place the as-if “phenomena” on a continuum and call in the “quiet borderline.” This places these patients in the “borderline” category diagnostically. They are “quiet” in contrast to the “noisy” borderline patients about which there is much written. By “quiet” the authors point out that there is an appearance of normalcy and an unwillingness to be in conflict with the environment, an avoidance of feelings of weakness or dependency, excessive passivity and severe identity problems. They believe this not to be defensive in nature and the “as-if” person not to be schizoid.
Etiology is explained from the viewpoint of internalized object relations. The relationship between the child and the mother in the first three or four years of life is the focus. A further interactive perspective used to explain etiology is family interaction. The stress is on what happens in the individual's social world. The authors use the second perspective to explain the first. There is an absence of any attempt to explain the as-if personality through a study of the drives.