The Borderline Diagnosis and Integration of Self

The subject of borderline conditions has been a major focus of psychoanalytic interest for more than 20 years. Despite-or perhaps because of-all that has been written, it has remained, in many ways, a frustratingly elusive concept. It has been framed in many different ways, including in terms of ego defects, defensive systems, object relations, narcissism, instincts, false self, and identity diffusion (14). It has meant a level of ego organization, a type of personality structuring, a position within a range of psychopathologies, and a rubric for a potpourri of symptoms. If it is definable, there has been a reasonable enough accumulation of data to accomplish the task. If confusion still accompanies attempts to encompass it in a more scientifically agreeable way, then perhaps it is the scope and structuring of the concept that shouId be examined; this is the subject of the paper.

The term borderline was originally chosen to characterize clinical pictures that could not be assigned easily to any established category and that did not lend themselves to clear delineation (18). The picture was of a person who was close to being psychotic without actually having overt or fixed psychotic symptoms, much like that often seen in the early stages of schizophrenic decompensation in which there is a frantic clutching at many methods of keeping one's self intact, except that in the borderline state the syndrome does not progress to a full-blown psychosis (7). The result was a group of symptoms that defied the usual classifications. Borderline was an apt term, for the dictionary meanings fit just the kind of impressions the quasi-psychotic behavioral patterns create:

situated near a border… situated between two points or states … intermediate … verging on one or the other place or state without being definitely

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assignable to either one … not clearly fixed or convincing … manifesting typical but not altogether conclusive characteristics … apparently existent but lac