The essential nature of borderline psychopathology

We suggest that the core features of borderline personality disorder (BPD) are the intense inner pain commonly reported by borderline patients and the awkward means they use to manage and express this pain. In this model, the pain has both affective and cognitive components. The awkward means of managing and expressing this pain are behavioral and interpersonal in nature. The etiology of these core features of BPD seems to lie in the interaction of a kindling event or events, which can be traumatic or normative in nature, and a vulnerable or hyperbolic temperament. The treatment and nosological implications of this model are discussed.