Treatment of the Young Borderline Patient: Fostering Individuation Against the Odds*

As time goes on, it seems that the total human life process is getting divided into smaller and smaller units. Apparently, this is the inevitable correlate of technological change and the social fragmentation that accompanies it. It was not all that long ago that childhood went unrecognized as a stage of life qualitatively different from adulthood,1 and the discovery of adolescence as a special developmental phase is largely a product of this century. In psychoanalytic writing, the tendency toward increased subdivision can be seen in the work of the interpersonal theorists who first emphasized the stresses and opportunities of adolescent development7,23 and later in the monumentally influential work of Erikson on the life cycle.3,4 On a more popular level, note also the impact of Gail Sheehy's Passages.20

Particularly as the gap between reaching biological maturity and finding the opportunity to be a fully contributing member of the larger society widens (it is no accident that spokespeople for the New Left picked age thirty as a time of “establishment”), we are seeing more manifestations of adolescent-like psychological issues in the early adult years. Keniston has proposed that we formally label the period of (roughly) the twenties as “youth.” Speaking about this phase, he has emphasized the existence of parallel opportunities for both creative ego-expansion and destructive ego-diffusion during the culturally induced hiatus between full dependency and full responsibility.9