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To the Editor: Arnold Mitchell has made an important contribution to the literature in his fine paper, "The Borderline Diagnosis and Integration of Self" (Am. J. Psychoanal., 45: 234-250, 1985), by placing the borderline diagnosis in holistic perspective. Mitchell's review and elucidation of the confusions and pitfalls surrounding the diagnosis hone in on questions that: merit fur- ther discussion. His paper prompted me to reflect on some of these. Mitchell implies in his "continuum of maladaptive defenses" that as a result of psychic conflict, we may move from relative health toward neu- rosis and then to borderline symptoms and defenses. He follows Homey in describing moves away from wholeness. Yet, if Homey were writing today, as a dialectical thinker, it's quite likely that she would accept the plausibil- ity of another process which occurs simultaneously, in the opposite direc- tion, toward integration, and would incorporate the work that has been done in this regard into her theory. Of course, Homey did just this in posit- ing constructive forces and the real self. But I am referring specifically now to developmental psychoanalysis, which Homey addresses indirectly: While we may start out whole and healthy, paradoxically, we cannot be all that
The American Journal of Psychoanalysis – Springer Journals
Published: Jun 1, 1986
Keywords: Clinical Psychology; Psychotherapy; Psychoanalysis
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