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The term "borderline" is used by psychiatrists to denote a specific diagnostic entity based on criteria related to patient behavior, categorized in DSM-III as a Borderline Personality Disorder. It is also used by psychoanalysts as a metapsychological statement about a certain level of structuralization of the mental apparatus. The psychostructural level of individuals who are described as borderline is characterized by a diffuse, unintegrated identity and distorted perceptions of others. Splitting, denial, and projective identification are typical defense mechanisms. Reality testing may be distorted, but it improves upon clarification of seemingly contradictory statements. While all individuals who suffer from DSM-III Borderline Personality Disorder are likely to be borderline in the psychostructural sense, the reverse is not true. Some are better placed in different diagnostic categories. The author therefore recommends that the term Borderline Personality Disorder be replaced by Unstable Personality Disorder, and that a new, psychostructural axis of assessment be incorporated into future revisions of the Diagnostic and Statistical Manual of Mental Disorders.