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Dr. Celani believes that Fairbairn's object relations approach to development and psychopathology leads to specific and uniquely valuable treatment strategies for borderline personality disorders. The first chapter is a historically organized overview of Fairbairn's main theoretical ideas; the second chapter is a discussion of Celani's view of the borderline syndrome; and the final three chapters delineate the treatment techniques Celani finds embedded in Fairbairn's theoretical revision of psychoanalytic theory.
The strongest part of the book is the summary of Fairbairn's reconceptualization of psychoanalytic theory from a drive to an object relations psychology. In the second chapter, 11 characteristics of borderline personality organization are discussed, but the fundamental issue for the borderline personality is, according to Celani, fixation on exciting/rejecting bad objects and the defenses organized around it. Consequently, Celani views the critical therapeutic task to be the separation of the patient from bad objects.
Celani adopts Fairbairn's view that introjection of the good object is the mutative therapeutic factor. Because he believes that borderline patients cannot tolerate unflattering remarks, he advocates active interventionist strategies, rather than interpretation, to separate the patient from frustrating bad objects and foster the perception of the therapist as the good object. The primary strategy is to point out the frustrating and disappointing qualities of the bad object and deflect the patient's negative feelings from the self or the therapist onto the frustrating object. He also suggests coaching the patient on how to separate behaviorally from the object. The therapist “counterprojects” the negative transference by deflecting it to the external, frustrating/exciting object, and