Giovacchini redefines his particular use of the term, borderline, as different from the broader definitions of Masterson and Kernberg. The patients he calls borderline suffer from "a pervasive sense of inadequacy and helplessness" that results from primitive developmental fixations "involving symbiotic and even presymbiotic stages." The author describes the behavior in therapy of a mother and her grown children (all borderline as he defines it), suggesting that this behavior indicates the very early level of ego deficit in these people. He observes that the mother's striking inability to recognize her own bodily clues and those of her children deprived the children (as she herself was probably deprived in her own infancy) of the ability to learn the most basic recognition and control of their own drives. In order to have any chance to alter this painful, difficult situation, the therapist must avoid countertransference reactions which repeat the early jarring environment, but must create a "holding environment" which will, it is to be hoped, give the patient a second chance at development.