On “Borderline” Diagnoses

In retrospect, it is ironic, perhaps, that it was within psychoanalysis that the category of the ‘borderline’ was invented. More specifically, it derived from the ego psychology of the US, which situated the borderline as a category of exclusion between neurosis and psychosis. There are strong grounds for concern about the aims, ethical underpinnings and conceptual rigour of ego psychology (see here for a brief summary). As I’ve tried to point out elsewhere, the blunders of ego psychology did not prevent it from having a formative influence on many other forms of North American psychotherapy, including those that prevail in the Anglophone world today. In general, for an idea to have emerged from ego psychology constitutes a serious objection to it; if it is also taken up by bureaucrats and panel-beaters of the psyche, this amounts to a refutation.

The Other, clinical and empirical: A review of Fonagy et al. on Affect regulation, mentalisation, and the development of the self

The following is taken from a presentation delivered late in 2011. Despite the age of the piece, I thought it worth sharing, as it touches on issues from more recent debates such as the nature of psychosis, the meaning of neuroscientific data, and the ethics of treatment. My views on certain matters below, such as phobia, or the nature of signification, have changed since then, but my views on Fonagy are more or less the same.

 
Anglophone psychology has long objected to the alleged individualism of Freud and
psychoanalysis. Psychoanalytic theory, they say, focuses on the intrapsychic, not the
intersubjective. Adler was one of the first to add a “social‟ element to psychodynamic
theory, positing a lack of “social interest‟ as the cause of every neurotic illness (Adler,
1928/1998). Later, a number of largely US-based psychoanalysts, led by Heinz Kohut,
championed an “intersubjective‟ or “relational‟ psychoanalysis.