Borderline Personality Disorder

The history of the concept of borderline personality disorder

The individual with BPD oscillates violently between dejection and disillusionment and episodes of euphoria and explosive episodes of irritability, impulsive anger and self-destructive behavior.

The history of the concept of borderline personality disorder
Daniel Calder

The diagnostic label “borderline” is perhaps the most controversial in the history of psychiatry and psychoanalysis. While it was relatively recently formally classified as a personality disorder in the DSM-III, the term “borderline” has historically been used to designate a kind of mid-point between non-psychotic mental illness and psychosis. Unlike personality disorders such as avoidant personality disorder and narcissistic personality disorder, furthermore, the “borderline” syndrome has not always been associated with specific symptoms, but, instead, has frequently been used as a kind of fundamental, structural characteristic of the subject.

Theodore Millon, like others on the DSM-III Task Force, insisted on the use of alternative and more clearly defined designations. As he prepared a working draft for the syndrome in 1975, he suggested the term “cycloid” personality. Indeed, many embers of the committee quite vigorously disputed the appropriateness of the use of the term “borderline” on the grounds that the term is inappropriately vague, whereas the particular syndrome to which it is applied is actually a quite specific psychological syndrome. Theodore Millon said the following in 1978, in his final memo on the issue:

“I very much like the description of the borderline personality disorder; it portrays a very important population that has not been adequately described in previous DSM publications. However, I would like to register my strong agreement with the point raised…to the effect that the label, borderline, is perhaps the most poorly chosen of all the terms selected for the DSM-III. I know a small segment of the profession feels that this is the most apt descriptive term for this population, but frankly, I find the word, borderline, to mean, at beset, a level of severity and not a descriptive type…Unless the word is used to signify a class that borders on something, then it has no clinical or descriptive meaning at all. If we look at the clinical description that we have created for this disorder I am sure we can find a label that is more suitable and communicative than borderline.


One Comment

  • Caz

    It’s most distressing of all when people with BPD try so hard to be brave and bare their souls and be vulnerable as they think it helps other people to see them as ‘normal’ and to be accepted and yet they are still humiliated and abandoned. Any effort is huge effort and yet usually it still accomplishes nothing in their favour.

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