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And all is always now
Among the many books and articles that Peter Giovacchini has written, it is more than gratifying to read his latest text on the theory and treatment of borderline patients. The title, however, is too modest. Although ostensibly addressing the borderline patient, the book's usefulness is not limited to that diagnostic category. The text is clear in its exposition, focused in its technical recommendations, and sensible in its understanding of psychoanalysis. This is no vade mecum teaching us “the right way,” nor is it consequently, a “new” theory that dispenses with whatever preceded it. Instead, it is the work of a mature analyst, giving us the fruits of his many years of labor.
That psychoanalysis has treated, since its beginnings, borderline symptomatology, identified as that or not, is one of Giovacchini's repeated, and well-documented points. In part I, the author, in the shadow of Winnicott, formulates his guiding thesis, a thesis he elaborates with numerous clinical examples as the text unfolds. Giovacchini writes: “The treatment of borderline patients has caused clinicians to revise their views about the therapeutic process. In many instances, the formation of a holding environment is more important than insight producing interpretations” (p. 85). A holding environment enables insight to become personal knowledge and only as such can it in any way be mutative. Giovacchini presents numerous and detailed clinical examples evidencing the type of sensitivity that enables a patient to find his own psychic place. In this context, his observations on the futility of much “resistance analysis” become clear: all too easily such an approach issues in an adversarial relationship, a stance which most clinicians recognize as not particularly productive, whether with the borderline or the classical neurotic patient.