Meetings of the New York Psychoanalytic Society

April 25, 1978. PSYCHOANALYTIC CONSIDERATIONS OF BORDERLINE STATES—REPORT OF THE KRIS STUDY GROUP, 1973-1977. Martin S. Willick, M.D., Chairman.

Dr. Martin Willick, summarizing the Kris Study Group's deliberations and conclusions, condensed the scope of the Group's inquiry into the following questions. 1) Does "borderline" define a specific diagnostic entity, or does it refer to a supraordinate group of patients who are more severely disturbed than neurotics but not as impaired as psychotic patients? In either case, can we describe the features common to this group that justify our distinguishing them from patients with other pathological conditions? 2) Can we come to a conclusion about etiology which relates to genetic, dynamic, economic, and developmental considerations? Are there particular kinds of conflicts involved or a particular developmental period that is of crucial importance? 3) Which ego functions are impaired in borderline states? Can we specify the significant pathology interfering with object relations, and can we describe defensive operations in these patients? 4) Can patients who are regarded as borderline be treated by traditional psychoanalysis, and what is the nature of the transference established by such patients during treatment? 5) Is there a general consensus in the literature about the specific attributes of borderline patients, and do these attributes coincide with those found in the patients surveyed by the Study Group? How do its findings compare with those of Dr. Otto Kernberg, who has written about borderline states in the most comprehensive, sophisticated, and careful way?

Dr. Willick indicated that the Study Group responded to these questions as follows:

• 1The term borderline does not refer to a specific diagnostic entity, whether viewed from a psychiatric or a psychoanalytic perspective. It may be loosely applied to a group of patients who, although not psychotic, are severely disturbed. What unites them are major disturba