ABSTRACT
Perhaps no single diagnostic category or type of patient has consumed more attention from theoreticians, diagnosticians, and therapists than the so-called “borderline” cases. Although borderline cases have been variously described in the clinical literature for over four decades (Stone, 1980), the attention focused on these demanding and perplexing cases has been intense since the early 1970s. Questions about the nature of borderline conditions—whether they represent a personality disorder (Spitzer, Endicott, & Gibbon, 1979), a stable personality configuration or syndrome (Grinker, Werble, & Drye, 1968; Gunderson & Singer, 1975), a mild form of schizophrenia (Kety, D. Rosenthal, Wender, & Schulsinger, 1968; Kety, 1985), a variant of affective disorder (Akiskal, Djenderedjian, T. Rosenthal, & Khani, 1977; Akiskal et al., 1984; Jacobson, 1953; Klein, 1977), a range of severity of functioning (Kernberg, 1975; Millon, 1981), or an unvalidated wastebasket diagnosis (Widiger, 1982)—have been and continue to be vigorously debated. Even the choice of the designation borderline has been subject to disagreement (Millon, 1981).
