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Grotstein, J.S. (1984). A Proposed Revision of the Psychoanalytic Concept of Primitive Mental States, Part II—The Borderline Syndrome-Section 3 Disorders of Autistic Safety and Symbiotic Relatedness. Contemp. Psychoanal., 20:266-343.

(1984). Contemporary Psychoanalysis, 20:266-343

A Proposed Revision of the Psychoanalytic Concept of Primitive Mental States, Part II—The Borderline Syndrome-Section 3 Disorders of Autistic Safety and Symbiotic Relatedness

James S. Grotstein, M.D.

The Pathogenesis of the Borderline Disorder

MOST STUDENTS OF THE BORDERLINE syndrome have postulated that the disorder begins in the rapprochement subphase of separation-individuation (see especially Kernberg, 1975). Masterson (1975), (1976), and Masterson and Rinsley (1975), and Rinsley (1977), (1978), (1980), (1981) have hypothesized a rewarding object relations unit (RORU) and a withdrawing object relations unit (WORU), comprising a split object relations unit (SORU). They postulate that the mother of the future borderline patient withdraws love and affection from him/her when (s)he undergoes separation and individuation and rewards him/her when the future patient regresses back into a symbiotic merger with the mother. Searles (1981) and Gunderson (1981) believe that the symbiotic stage of development is very important in terms of the borderline.

Kleinian writers have traditionally thought of the borderline syndrome, like other psychotic states, as being due to disorders in the paranoid-schizoid position (Rosenfeld, 1965).

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