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Stewart, H. (1988). My Work with Borderline Patients: By Harold Searles. Northvale, New Jersey: Jason Aronson. 1986. Pp. 409.. Int. J. Psycho-Anal., 69:569-571.

(1988). International Journal of Psycho-Analysis, 69:569-571

My Work with Borderline Patients: By Harold Searles. Northvale, New Jersey: Jason Aronson. 1986. Pp. 409.

Review by:
Harold Stewart

A new book from this author arouses high expectations of a stimulating and individual journey through difficult psychopathological territory, and we are not disappointed. The ripe experience of forty years treatment of patients with borderline pathology has been set down in a collection of papers given over a number of years and gathered together in a coherent sequence to give rise to this book. It presents Searles' distinctive voice in the development of theory and technique in work with these states.

The book is divided into four sections. The first part is called 'Basic Principles' and deals with techniques of therapy and transference responses. The second is 'Disturbances in Ego-functioning' and deals with the non-differentiation of ego-functioning in the borderline individual, with dual and multiple-identity processes, with jealousy involving an internal object, and with a case report on a borderline thought disorder. The third part is called 'Countertransference' and deals with countertransference as a path to understanding and helping the patient and with countertransference experiences with jealousy involving an internal object. The last section is on 'Handling Inevitable Issues' and deals with the development in the patient of an internalized image of the therapist, with two chapters on separations and loss, and a final chapter on the role of the analyst's facial expressions in therapy.

The chapter on basic principles of technique opens the book and Searles makes his own basic position clear: 'In recent decades we have learned … that we attach generally less significance to isolated traumatic events in the patient's developmental years, than to ongoing attitudes on the parts of various childhood-family-members toward the patient (and on his part toward them), and upon the prevailing emotional atmosphere, day after day, which pervaded the early home … our psychoanalytic technique has shifted such … interpretations are important … but of far greater importance is the emotional atmosphere or climate of the sessions, day after day and year after year' (p.

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