We rarely hear an exposition of the history of borderline states as complete and nuanced as Dr. Kouretas’s paper on the subject of this pathology that has been singled out for special attention in the United States. As a brief introduction to the discussion, I’d just like to mention the context in which the term arrived in France.
In listening to Dr. Kouretas, I was reminded of a remark made by the late Serge Leclaire when I first met him, at St. Anne’s Hospital, in the small group that at that time constituted the French Psychoanalytic Society. He said, “There’s a lot of talk about the psychoanalysis of the psychoses, but we ought to get back to treating neuroses.” The terms psychosis and neurosis give a good idea of the spirit in which psychoanalysts worked in those days. We essentially thought in terms of two structures, two frameworks, one in which psychoanalysis was at home—the neuroses—and another into which we ventured—psychosis.
But this structural duality became less and less adequate. When the term prepsychosis came on the scene (a term used from a very structural perspective and especially with reference to children), to be followed several years later by the term borderline, which we translated as état-limite,1 we began to see a new possibility opening up, a path leading to two different orientations. The first was to try to revise our nosography. We could outline a third domain whose boundaries would lie between neurosis and psychosis, in effect creating a new nosographic entity. This would allow us to describe a structure, a mode of organization, and a mode of development. Another approach, one to which I have always felt closer, was to reject the nosographic viewpoint and instead to consider the borderline state as a limit with respect to any reference, to the nosographic concept as well as to the concept of psychosis.
But what was on the other side of this border? New boundaries of thinking about anomalies that neither the paradigm of neurosis nor that of psychosis had allowed us to see before. Dr. Kouretas’ talk illustrated these anomalies very well: identity diffusion, a concept defined by Erikson in connection with adolescence and taken up again by Kernberg; projective identification; the reference to narcissism; emptiness of thought; and so forth. In the end, the borderline state opens up for us adventures in thought that we have to explore and not a mental illness that we have to describe. It is just such adventures that this colloquium will offer us.
1. Translator’s note: literally. “border-state.” Limite also means “boundary” and “limit,” and Dr. Widlöcher will go on to make use of this range of meanings.