A Critical Review of Psychotherapeutic Treatments of the Borderline Personality: Historical Trends and Future Directions

Abstract

The borderline personality was originally thought to be on the border of psychosis and treatability. Most psychoanalytic writers of the 1940s-1960s gave these patients subschizophrenic labels and emphasized a supportive, limited treatment approach. They noted that these patients often regressed and became worse with analytic treatment. Nevertheless, in the 1970s a major impetus for a renaissance and revitalization of psychoanalytic thought was a recasting of the theory and therapy of the borderline personality. Renewed optimism and vigor characterized the intensive, exploratory treatment approaches to these writings. The 1980s, however, curiously show a fragmentation of and retrenchment from these views, and a return to many of the treatment recommendations of the earlier authors. The literature on the treatment of the borderline personality is critically examined from a historical perspective in this review. Highlighted, in particular, are the commonalities, trends, empirical studies, and future directions in the treatment literature.