ABSTRACT
Environmental factors have always been thought to play a significant role in the etiology of borderline personality disorder (BPD). Despite the recent interest in and data to support major biologic and genetic contributions to the development of the disorder (1-5), environment is still thought to be significant. The aspect of the environment that has been thought to be of significance in the development of BPD, however, has changed over the 60-odd years during which the BPD diagnosis or its progenitor descriptions have been utilized (5,6). As with much of psychiatry during the first twothirds of the 20th century, the environmental factors that were initially believed to contribute to the development of BPD were thought to result from the internal or intrapsychic environment, especially from a strong aggressive drive and failed attempts to defend against the expression of those aggressive wishes (7,8). These theories were then expanded to capture the nature of the external environment, most notably to the study of the family environment of the infant and child who was later to develop BPD. These theories explored the nature of attachment to as well as separation
from the important parental or parental-surrogate figures in the child’s life (912), and followed the trends prevalent in psychoanalytic thought at the time, which focused on object relations and object relations theory (13-15). These object relations conceptualizations have more recently expanded beyond attachment to include theories of abuse and the impact of abuse upon object relations (16) and the expression of symptoms of BPD (17-19).
