ABSTRACT
In his synopsis of our viewpoint, Gerald Adler states that we “use the term ‘borderline’ to refer to an entirely iatrogenic illness” (our italics), which he believes is “an oversimplification of a very complex subject.” We believe that this is an oversimplified characterization of our views. We have conceptualized borderline phenomena as arising in an inter subjective field consisting of a precarious, vulnerable self and a failing, archaic selfobject. This formulation could not possibly be compatible with a claim that the term “borderline” refers to an ”entirely iatrogenic illness” for at least two reasons. First, as seen in the case of Caroline, the failing, archaic selfobject is not always a therapist or an analyst, although this will become increasingly more likely as the patient's selfobject needs are engaged in the therapeutic transference. Second, and most important, the claim of an entirely iatrogenic illness would be markedly at variance with our concept of an intersubjective field and would completely overlook the contribution of the patient's archaic states, needs, and fragmentation-prone self to the formation of that psychological field. If we view the therapeutic situation as an intersubjective field, then we must see that the patient's manifest psychopathology is always codetermined by the patient's self disorder and the therapist's ability to understand it.
