For David Scharff, his very first patient as a psychiatric resident was a 14-year-old girl who looked, in the parlance of the medical profession, much “older than her stated age.” Judy was a well-built teenagervoluptuous, in fact-who alternated in her demeanor between being churlish and seductive. If this young doctor didn’t respond to her anger, she would try using her feminine charms. Although chronologically young, she was not inexperienced in the sexual arena; she had a history, which she flaunted, of incest with her older brother, and more recently she bragged of having seduced several boys “to see if she had any sexual feeling.” On the inpatient unit, she alternated between acting seductively toward staff and enraging them. She was also prone to breaking windows at will, threatening suicide when she didn’t get her way, and scratching her wrists with sharp objects. She was diagnosed with what was then a new category: borderline personality disorder.