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There is a general consensus among psychoanalytically oriented clinicians that the diagnosis of borderline personality disorder refers to a heterogeneous group of illnesses. According to the psychoanalytic concept, these patients are sicker than patients we classify as neurotic, but are not as disturbed as patients who fit into the various categories of psychosis. This definition of borderline personality disorder in terms of severity is in contrast to the one put forward in DSM-III where the syndrome is defined by its descriptive aspects only (APA, 1980). The framers of that diagnostic manual preferred to remain atheoretical in regard to the pathogenesis of most mental disorders because they felt that by confining themselves to descriptive features they could achieve greater consensual validation regarding diagnoses. The descriptive features listed for borderline personality include impulsive behavior, lack of control of anger and/or intense anger, impaired object relations, volatile mood swings, disturbances in the sense of self and identity, separation anxiety, and feelings of emptiness.
The psychoanalytic definition likewise emphasizes these phenomenological features, but also includes, in contrast to the view put forward in DSM-III, some considerations of the developmental level of the pathology. Although there is not firm agreement among psychoanalysts about the etiology and pathogenesis of the borderline group of disorders, most feel that the roots of borderline pathology lie in impairments in development during the second and third years of life, prior to the consolidation of object constancy.