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In the discussions about and the treatment of psychopathology and psychodynamics there has been in the past three decades a shift toward increasing stress on the similarities with the psychoses and emphasizing the archaic nature of the inner processes. With that there has come a special regard both for the diagnosis of “borderline pathology” with a radically altered understanding and approach toward the severer forms of psychopathology and an increasing reliance on “defect psychology.” This change has had great implications for the attitude toward patients and, more specifically, the treatment approach and poses many questions of validity of claims, of coherence with other lines of research, and of clinical, long-range effectiveness.
Abend, Porder, and Willick have made a courageous attempt to explore these claims, one by one, to stem the tide of clinical revisionism and return to a “classical” method of defense analysis and conflict resolution. “In our view, the major principle of technique with borderlines is the need to maintain, insofar as possible, an analytic relationship with the patient … and not to substitute for it an exhortatory, educational, or managerial one” (p. 202).
In the following I hope to add to their presentation from my