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Over the past 20 years, Otto Kernberg has been one of the key figures responsible for the widespread, burgeoning interest in object relations theories. Kernberg's methodology for innovation has always been conservative (in the best sense of the term) and integrative. While maintaining a deep respect for Freudian tradition, he has introduced many very important shifts in thinking about transference, countertransference, psychic structure, diagnosis, analytic technique, the nature of (and capacity for) love, sexuality, aggression, the hospital milieu, psychoanalytic education, narcissism, and much more. While firmly grounded in Freudian ego psychology, he helped integrate contributions from Kleinian theory and make them accessible to American readers. While deeply committed to drive theory, he helped popularize Fairbairn's relational notions of unconscious structures. While his contributions have always been controversial and certainly have not attained a consensus, he has been a major force to be reckoned with by any contemporary psychoanalytic theoretician.
PD: If we consider the span of nearly two decades from the publication of Borderline Conditions and Pathological Narcissism to today, do you feel there have been any basic changes or shifts in emphasis in your thinking, either in theory and in terms of clinical practice?
OK: First of all, regarding the concept of borderline personality organization, I still feel that it's a very useful concept. In fact, I feel more reassured, now that we have 20 years of research, that the approach of DSM-3 or DSM-4 is flawed: they missed a dimension of severity. The concept of borderline personality organization separates severe personality disorders from the neurotic personality organization of less severe ones. I feel that empirical research indicates a high degree of comorbidity of several of the personality disorders that I put within the frame