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Every substantive to which the adjective “borderline” has been applied has revealed how elusive and overdiagnosed (as Millon puts it) the disorder (or whatever it is) has been. Nevertheless, it is beyond any reasonable doubt that clinical researchers, psychoanalysts, developmental psychologists, geneticists, and biogenic theorists have provided us with undisputable and enlightening key features essential to all of us who work with this kind of patient. Unfortunately, general etiologic models proposed in earlier decades have revealed themselves to be too partial, and parochial loyalty has often generated anachronistic pseudoexplanatory theories.
It is hard to say if what we know best is that we do not know enough, or if we get so much data, many of which are probably necessary but none of which is certainly sufficient, that it is getting more and more difficult to conceive of an etiopathogenetic model consistent enough not to leave anything out.
This seems to be the current state of the art: (1) research from many different fields points to the stress-diathesis model that Stone (1980) first proposed; (2) we have many fascinating and acute clinical descriptions and clinical explanations, but both point to a rich, complex, and variegated picture in which aspecific symptomatology (depression, anxiety, self-destructive behavior) is linked to aspecific induction of intense (but different emotional reactions in interpersonal partners, to aspecific cognitive disturbances and affective disregulations, and to aspecific levels of social (mal)adaptation. But aspecificity notwithstanding, it seems that when all these elements are put together a clear picture emerges, and certainly “borderline” is a diagnosis on which agreement between clinicians, even from different theoretical backgrounds, quite often occurs.