IMPETUS TOWARD THE EVENTUAL PRODUCTION of this book began in the early 1980s when a group of enthusiastic young people at Westmead Hospital, Sydney, mainly trainee psychiatrists and senior psychiatric nurses, set out with me and some senior colleagues to develop a program for the treatment of a condition then deemed intractable—borderline personality disorder (BPD)—which had only recently been given recognition as a formal diagnostic entity. Out of these efforts developed a much larger program. I wish to thank all those who took part in that pioneering effort.
Four people who took part in that initial endeavour were able to continue with the project. They are Joan Haliburn, George Lianos, Michael Williamson, and Janine Stevenson, who together with Philip Graham, Leo van Biene, Tessa Philips, Anthony Korner, and Jai Bains form the faculty of Master of Medicine (Psychotherapy) at Sydney University, which is devoted to training psychiatric and other mental health professionals in the treatment of BPD by means of the Conversational Model. This faculty has contributed, through seminars, conferences and so forth, to the development of an understanding of BPD derived not only from clinical data, but from neurophysiology, linguistics, and developmental data. I have been extremely fortunate in having such people join me in the quest which this book reflects. They have provided me with immense support.
The research program initially focused on outcome studies, the data for which was mainly gathered by Janine Stevenson. I thank her for her tireless efforts. An essential neurophysiological component was added to the research endeavor by the work of Evian Gordon, who developed a scientific group now called the Brain Dynamics Centre, and led by Lea Williams. This group included Dmitri Melkonian, a mathematician and neurophysiologist. His work has been invaluable in providing the data central to the development of the thesis of psychic disintegration, which is the core of this book. I am very grateful to him for the energy, commitment, and creativity he has brought to the program. Lea Williams and her colleagues have provided another essential element in the research background to this book. She has been studying the cerebral processing of emotion, with a particular focus on the effect of trauma. These findings have provided a unique understanding of the unconscious perception of traumatic experience. She and her collaborators in this venture, Richard Bryant and Kim Felmingham, have given me great support and stimulus.
Help in understanding the phenomena of dissociation and the borderline experience has also come from further afield, from Onno van der Hart in Holland and Bessel van der Kolk at Harvard. I have valued greatly the contribution they have made to the development of our work through their visits to Sydney and other venues.
Our third research theme, linguistics, has been led by David Butt. I thank him for the generosity of his contributions to the program and for the intellectual excitement he has brought to our discussions.
I have also been very lucky in my editors. Allan Schore has been an unfailing source of stimulation and encouragement. His important notion of right-brain-to-right-brain relating in mother–infant interaction marries perfectly with the disintegration theory of BPD outlined in this book, and is an essential element of it. Deborah Malmud’s patience and guidance was a great support while I struggled with this work.
The person to whom I am most particularly grateful is Michelle Phillips, my secretary and assistant. Without her unflagging efforts, skills, and competence in a number of areas, and her steadiness and good humor, I do not think I could have completed this work.
Finally, I thank my wife Susanne, who has provided the necessary “surround” in which creativity can grow.