ABSTRACT
This chapter summarizes the present “state of the art” regarding borderline patients as reflected in the prevalent contemporary thinking within the psychoanalytic community, discusses a consensus statement for consideration of the IPA Research Committee; and describes major unresolved controversies and open questions that require further research in the future. The key differential characteristic between neurotic personality organization and borderline personality organization is the presence of normal identity integration in neurotic patients, in contrast to the syndrome of identity diffusion in borderline patients. The acute shifts in countertransference experience from moment to moment, corresponding to the shift in the patient’s fragmented transference expression, are eminently useful in the therapist’s analysis of the transference–countertransference constellation. The controversy regarding the importance of carrying out a descriptive-structural diagnostic assessment of patients extended to the nature of the diagnostic instrument utilized to arrive at a diagnostic formulation.
