Since the 1960s there has been a problem in nosology, clinical practice, and psychoanalytic technique concerning whether it is possible to distinguish between “narcissistic disturbances of the personality” (themselves quite often confused with “character neuroses”) and “borderline cases” (which in turn are sometimes confused with “prepsychotic” cases). In the USA, there was a lively debate between Heinz Kohut (1971), who supported this differentiation, and Otto Kernberg (1975), who opposed it.