Special Review: The Borderline Patient: Update on the Diagnosis, Theory, and Treatment from a Psychodynamic Perspective

This paper presents an overview regarding the borderline patient, including historical background, diagnosis, developmental theory, prognosis, and psychotherapy, all from a psychodynamic perspective. Five clinical vignettes are presented, reflecting various aspects of borderline patients. An “ego-psychological diagnostic approach” based on ego strengths and ego weaknesses, and leaning on the work of Kernberg, is detailed. The paper compares and contrasts the developmental theories of Kernberg and Adler, noting their clinical usefulness and relationship to etiology. Relying on Stone, prognosis is discussed. After a brief section on referral yield, the paper concludes with a discussion of psychotherapy.