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The author compares treatment based on object relations with treatment based on ego psychology. Essential to the object relations approach are three basic assumptions: 1, that borderline patients are particularly sensitive to abandonment and defend heavily against this fear; 2, that long-term hospitalization is more helpful than either short-term hospitalization or avoidance of it altogether; and 3, that therapy conducted with the borderline patient is ineffective if disruptive outbursts are kept to a minimum. Treatment based on these assumptions leads to chaotic, destructive regressions, and from a clinical viewpoint, the burden of proof lies with the advocates of long-term hospitalization and regression-promoting psychotherapy, compared to a more active, limit-setting, insight oriented technique. Psychoanalytic technique is not applicable to borderline patients: they are not able to use a fully developed transference relationship, since they do not defend against infantile drives in the same manner as do neurotic patients. The following treatment recommendations are made. 1. An early positive rapport must be established at the outset of treatment; if the initial reaction is indifferent or negative, and cannot be resolved, a change of therapist should be recommended. 2. No active mobilization of the negative transference should be made. 3. Limit-setting techniques are suggested whenever the patient begins to lose sight of the rational goals of treatment, which is often signaled by a preoccupation with how the patient feels about the therapist. 4. The therapist should encourage the patient's conscious understanding of the fact that the main purpose of treatment is to increase self-awareness through insight. 5. Countertransference reactions in response to