Borderline Personality Disorder No Longer Belongs in Clinical Practice

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June 9, 2023 – According to the authors, “Borderline Personality Disorder” emerged as a category during the heyday of psychoanalysis where it was used to denote situations that straddled the borderline between anxiety disorder and psychosis.

Despite its classification as a personality disorder (PS), the authors argue that the characteristics of BPD do not match the consensus understanding of other personality disorders. For example, the diagnostic criteria are not persistent personality traits but rather variable symptoms and behaviors. They explain: “The triad of unstable moods, erratic relationships, and disturbed behavior can be easily noticed, but that does not make it a personality disorder. Chronic sleep disorders, for example, create the same symptoms.

An ever-present and unquestioned characteristic of a distinct personality disorder is the presence of character traits, characteristics that reflect individual functioning, that are generally unchanging over time and that, when disturbance becomes disordered, are maladaptive (maladaptive). The wide variety of emotional instability has no place in this paradigm.”

The authors acknowledge that BPD does meet some medical need. The symptoms are easily recognizable in many of the people seeking treatment. They are common (particularly from adolescence onwards) and in some cases it can be comforting to assign a name to such a complex phenomenon as BPD. But whether this reassurance benefits the clinician or the person seeking treatment is a matter of debate.