The term “borderline” means in-between one thing and another. Originally, this term was used when the clinician was unsure of the correct diagnosis because the client manifested a mixture of neurotic and psychotic symptoms. Many clinicians thought of these clients as being on the border between neurotic and psychotic, and thus the term “borderline” came into use.
The term “borderline” has been used in a number of ways that are quite different from the DSM-IV criteria for borderline personality disorder (BPD), and that the misuse of this diagnostic label has long been criticized. In some circles, “borderline” is still used as a “catch-all” diagnosis for individuals who are hard to diagnose or is interpreted as meaning “nearly psychotic,” despite a lack of empirical support for this conceptualization of the disorder.
Additionally, with the recent popularity of “borderline” as a diagnostic category and the reputation of these clients as being difficult to treat, “borderline” is often used as a generic label for difficult clients or as an excuse for therapy going badly.
The essential feature of Borderline Personality Disorder is a pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity that begins by early adulthood and is present in a variety of contexts.
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Last reviewed:
On June 22, 2007
By John M. Grohol, Psy.D.
