Psychotic Character Versus Borderline

It is the purpose of this communication to suggest abandoning the diagnosis, borderline. In its place we propose the diagnostic category psychotic character. When we use a diagnostic term it traditionally gives some clue about the clinical condition we are discussing. When we say schizophrenia we are already saying something about the illness. This is equally so when we use the diagnostic term manic depressive. The diagnosis borderline gives us no clue about the clinical syndrome. Furthermore, the term and concept borderline by its very vagueness and diffuseness deprives us of a means to understand this clinical condition dynamically. Dynamic thinking brought to bear on the clinical pictures of a syndrome, enables us to formulate a more coherent frame of reference which facilitates the understanding of the phenomenology more clearly, as well as leading to a rational therapeutic approach. Out of this understanding evolves a rationale for substituting the concept psychotic character for that of borderline.

The diagnosis psychotic character in its very title suggests that this is a characterological disorder influenced by the underlying psychotic process. This lends a more meaningful perspective to this condition dynamically, genetically, and therapeutically. The diagnosis borderline does not lend anything beyond a word and should be abandoned.

In doing so I am by no means advocating the abandonment of the clinical syndrome subsumed under the concept borderline. These same clinical features are manifested in the psychotic character. At the same time the suggestion to use the concept of the psychotic character as a framework for this condition is by no means a semantic exercise substituting one term for another, but rather is it to lend a more meaningful guide to these conditions clinically, dynamically, genetically, and therapeutically.

II. BORDERLINE TERM AND CONCEPT

I should like to review the use of the term borderline and in doing so highli