Update on psychodynamic thinking regarding the diagnosis of the borderline patient

An ego-psychological diagnostic approach to the borderline patient has been presented and detailed in previous publications. This paper modifies and expands this approach, providing a new, up-to-date model. This new model tries to accomplish the somewhat contradictory tasks of: (1) providing a current generally accepted psychodynamic framework, and (2) being more compatible with DSM-III-R. Both historical and current concepts of the borderline patient are reviewed and related to this new model. The concept of the borderline patient as someone with a specific structural configuration, to be differentiated from the normal-neurotic, the narcissistic, and the psychotic configurations, is retained.