The purpose of this paper is to examine the phenomenon of the increasing popularity of the Borderline Personality diagnosis. Using the diagnosis itself as a projective device, what can we learn about our profession from examining some of its reflections.
The diagnosis is examined in terms of a number of dimensions, including prevailing cultural-societal pressures, the patient-therapist relationship, implications for our metapsychology, and its effect on the education and training of psychotherapists.
Some of the conclusions of the paper are that, although the popularity of the diagnosis is, in part, a humane response to an increasingly disturbed patient population, there are other, less noble motives. They include a faddishness of our profession, an implicit pejorative statement about the patient and a distancing effect on the patient-therapist relationship, talmudic confusions in terminology and concepts, and the distortions inherent in a locational-spatial metaphor (borderline) to describe psychodynamics and psychopathology.