Borderline, an operational clinical concept?
The borderline syndrome has often been discuseed in the literature, especially by psychoanalysts. In this paper an attempt is made to formulate the meaning of the concept 'borderline'. The diagnosis 'borderline' may well differ from one country to another, from one clinic to another, and even from one psychiatrist to another. Some people say that 'borderline' does not exist at all, others maintain that it means a temporary state somewhere on the way from neurosis to psychosis, whereas still others regard borderline as a relatively consistent clinical entity. A correct diagnosis of a borderline state is of great relevancy to psychotherapy.
The author describes the characteristic pathology and the factors that possibly play a role in the origin of the borderline state. He makes observations regarding the method of diagnosing and the psychotherapy of the borderline patient, and the attempts to show that the concept 'borderline' does not need to be a waste basket into which all puzzling cases are dumped.
Neither should it be considered as the indication of a syndrome on the border of neurosis-psychosis, as the term borderline unfortunately suggests.
The author concludes that the diagnosis borderline state should be used for a specific syndrome, only when the five conditions are fulfilled which he describes.