The Borderline Syndrome: A Behavioral Study of Egofunctions

The Borderline Syndrome: A Behavioral Study of Egofunctions

The Borderline Syndrome: A Behavioral Study of Egofunctions

The Borderline Syndrome: A Behavioral Study of Egofunctions

Excerpt

This book contains the first reported results of a lengthy research program on hospitalized borderline patients whose ego-functions were studied through multiple observations on their daily behaviors. In general the informal diagnostic term of borderline as well as several synonyms in our nosological classification have long been used without standard definition as a convenient term with which to label cases of clinical unclarity. In this first systematic investigation of the phenomena clinically observed for at least several decades as borderline, we have attempted to understand what the term really denotes, define its characteristics, and determine whether it encompasses subgroups or categories.

In a sense we have been working upstream against the forces opposing concepts of syndromes and accurate diagnostic criteria. The unpopularity of diagnosis and knowledge of the life history of describable entities is a reaction against the "disease" concept in psychiatry and the over emphasis on individual dynamic processes. Yet the pendulum has swung too far away in the direction of concern only with "the problem" of a specific patient. In truth there can be no science of psychiatry without classification and no sound classification without modifying the repetitive old observations and descriptions. Psychiatry needs a fresh look derived from modern theories of process and new methods of description, rating, and statistical analyses.

It is our hope that the clinician will now be able to diagnose with some degree of accuracy the borderline syndrome in general and each of the subgroups in detail, that future investigators can use the hypothesized subgroups for correlations with causes, course, natural history of the disturbance, and the effectiveness of various therapies, and finally, that our methods may prove useful for other clinical investigations of unclear syndromes and others whose clarity is more myth than substance. For some readers our method of observing, describing and then rating traits . . .

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