This chapter focuses on the borderline child in order to accomplish several
interrelated objectives. First, I reconsider our thinking in relation to etiolog-
ical factors, moving more in the assumptive direction that this disorder is in
many instances related to exogenous, environmental factors (i.e., various
forms of abuse and neglect), subsumed under Terr's ( 1991) Type II trauma,
rather than reflecting a primary etiological base related to endogenous, in-
ternal influences and conflict, which is the more traditional perspective
( Kernberg, 1975; Mahler et al., 1975; Masterson & Rinsley, 1975). Second, I
illustrate how psychological test material often transcends other diagnostic
information (e.g., interviews, behavioral observations, and rating scales),
in providing for a comprehensive perspective regarding developmental
functioning, especially in relation to ego functioning and object relations
capacity. Third, in a related vein, I arrive at a more complete appreciation
and sense of how psychological test data is utilized in the final formulation,
with a particular emphasis on how TAT and Rorschach material--viewed
primarily via an idiographic and phenomenological perspective--informs
and guides treatment decisions and direction.

Our current diagnostic nomenclature, DSM-IV, still does not easily pro-
vide a clear place for the borderline child, a foster child or stepchild in many
respects. Disruptive, primitive, aggressive, hyperactive, labile, disorga-
nized, withdrawn, and so on, he or she may be diagnosed, or better still, pi-
geonholed, in accord with criteria that accurately describe manifest
behavior and symptomatology, but that fail to recognize central motiva-
tional dynamics and etiological concerns. Frequently referred for severe

-93-