How Useful is the Borderline Concept?

Psychoanalytic theory is most useful when it is clearly based upon clinical observations and can help the analyst or therapist both to understand the patient and to intervene clinically in ways helpful to that patient and to similar ones. Yet we all know that different clinicians can make careful observations of their patients and arrive at significantly different formulations about the theoretical and clinical issues that explain their patients' behavior and intrapsychic structures.

We realize that the data a patient presents to us are influenced by a number of factors (Adler, 1986). In addition to the personality characteristics of the patient and his or her problems, the setting as well as the personal and interpersonal qualities of the data collector are important. Is the patient talking to a researcher, therapist, or analyst? Is he in a short-term or initial-treatment setting, or in an ongoing psychotherapy or psychoanalysis? What are the clinician's actual personality characteristics, and how do these qualities interact with the specific patient, and therefore play a role in the patient's responses? What theoretical frameworks does the clinician bring to his observations, and to what extent do these frameworks influence his choice of data, leading to, for example, interpretations and other interactions that further influence