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 Founding of CBT, and Beck’s Foundational Errors: A Critique of CBT as Ideology (Part 2)

Psychoanalysis was the first of the systematic talking therapies. The first couple of generations of psychoanalysts consisted principally, with some notable exceptions, of Central European Jews from Vienna, Budapest, Berlin and elsewhere. By the 1930s, this part of Europe had fallen to fascism, and this cataclysm was ominous (and eventually catastrophic) for Jews. A diaspora ensued, with Freud himself relocating to London, and many others moving there also, with other prominent destinations including Paris and the Americas. In these diverse environments, various sub-schools of psychoanalysis emerged, with considerable differences in their theory and practice. ‘Ego psychology’ was the sub-school which dominated psychoanalysis in the US to such an extent that it came to be identified (by some) as the only ‘true’ form of psychoanalysis. It was out of this context – post-war US, mass demand for psychological interventions, and the growing influenced of managed care – that Beck’s CBT first emerged.