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It is impressive to note the degree to which the author of this work is familiar with and influenced by the thinking of American psychiatric and psychoanlaytic authors. She is deeply influenced by the recent contributions of Kernberg and Kohut, whose explanations of narcissistic states are said to help define limits and provide clearer definitions for the notion of the borderline. She discusses the theories of Kernberg, Mahler, Searles, and Wolberg to make the point that the borderline syndrome is a specific developmental disturbance which characterizes the processes of separation and individuation.
Rohde-Dachser attempts a synthesis and an explanation of the various clinical manifestations of the borderline patient. She sees the borderline syndrome as a special strategy for the solution of conflicts in the area of ego development, genetically derived from processes of separation and individuation in which pathologically created points of fixation and certain repressions of the ego come to be manifested as the borderline phenomena. Essentially she sees the borderline syndrome as one of the sequelae of the renouncing of autonomy.
A particularly valuable aspect of the book is the author's regularly combining an explanation of an aspect of the structure of the borderline personality with a consideration of the way in which the ideas being focused on are reflected in the attitude taken by the therapist in his attempt to help the patient. For example, discussing the concept of ego deficit or ego weakness, she suggests that those who use this concept could easily fall into an attitude of therapeutic nihilism and assume that borderline patients are psychic cripples who cannot really be helped. Preferring to think of ego deficit in terms of the functions served by such a deficit, she then speaks of such ego weakness as a defensive operation which undermines cognitive functions, functions of perception, etc. Thus, the problem of structure is conceived of as a problem re