The 'Self' and Borderline Personality Disorder: Conceptual and Clinical Considerations

Area of Science:

• Psychiatry
• Psychology
• Neuroscience

Background:

• The concept of 'self' is frequently used as an organizing construct in borderline personality disorder (BPD) research and clinical practice.
• Significant variation exists in how researchers define and utilize the term 'self', often using it interchangeably with related concepts or features.
• The heterogeneity and comorbidity of BPD, alongside limitations in psychiatric nosology, complicate the unqualified use of the term 'self'.

Purpose of the Study:

• To address the definitional ambiguity of 'self' in the context of borderline personality disorder (BPD).
• To explore the utility of a self-construct as an explanatory principle for BPD, potentially reframing it as a 'self-state' disorder.
• To synthesize recent neuroscientific and sociopsychological findings to support a multi-level, functionally constituted entity of the self.

Main Methods:

• Review and synthesis of existing literature on the concept of self in relation to borderline personality disorder (BPD).
• Integration of neuroscientific and sociopsychological research findings.
• Development of a tentative description of 'Self' as an explanatory construct for BPD.

Main Results:

• Evidence supports a supra-ordinate, functionally constituted self entity operating across multiple levels, from core to reflective and relational aspects.
• Key insights have emerged regarding emotional and social-cognitive dysregulation, self-awareness, relationality, identity, and self-coherence in BPD.
• Many BPD-related self-disorders overlap with trauma-related and dissociative disorders.

Conclusions:

• A clearly defined and evaluable construct of 'Self' could serve as a valuable explanatory principle for borderline personality disorder (BPD).
• BPD may be more accurately construed as a disorder of self-states and relationality, rather than solely a disorder of specific aspects like mood or memory.
• Further refinement and evaluation of the proposed 'Self' construct are necessary for its clinical and research application.