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This book represents the Kris Study Group's four-year discussion and review of borderline states. In addition to the New York Psychoanalytic members, Kernberg participated in one extended meeting.
The book includes a historical review of the borderline concept as well as a review of works of Freud which tie in with the concept. The authors give particular emphasis in their review to the work of Jacobsen, Kernberg, Klein, Kohut, Mahler, and Masterson. They present four cases in depth which are utilized for illustrating the main categories around which the book is organized: object relations, reality testing, defenses, and transference and technique.
The authors do a masterful job in bringing together and examining different points of views on this sometimes fuzzy clinical syndrome. Several of their conclusions are contrary to the more commonly accepted thinking on the borderline. Whether or not the reader agrees with their conclusions, their treatment of the topic offers much food for thought. For example, they conclude that borderline patients are not developmentally arrested but that borderline symptomatology reflects regression from oedipal issues and conflict. In contrast to the common emphasis on oral etiology, they stress that contributions from all psychosexual stages—oral, anal, and oedipal—play an important part. Their conclusions, however, appear to me biased in favor of oedipal etiology. Their attempt to tie in Freud's thinking with contemporary thinking on the borderline also seems somewhat forced and arbitrary.
The authors take issue with the work of Kernberg and Masterson, and Rinsley, criticizing it as reductionistic on the basis of its emphasis on orality and splitting (Kernberg), and abandonment depression (maternal abandonment at rapproachment—Masterson and Rinsley). They criticize Kernberg's belief that borderlines utilize primitive defenses—splitting, projection, projective identification and denial—to the exclusion of higher level neurotic defenses