Psychotic character versus borderline

The clinical syndrome designated by the diagnostic term borderline, exists. However, the diagnosis borderline as such gives no clue about the clinical or psychodynamic feature in this syndrome. Furthermore, the use of the concept borderline by its very vagueness and diffuseness deprives us of a means of understanding these conditions clinically and dynamically. It thereby makes it more difficult to treat these patients with appropriate understanding. I therefore believe it should be abandoned. The diagnosis psychotic character has previously been proposed by the author for this syndrome. It relates more appropriately to the clinical and psychodynamic features and is more consonant with an understanding of the syndrome. The diagnosis suggests, among other frames of reference, the underlying psychotic process which typifies these patients. It provides frames of reference which facilitate understanding these conditions psychodynamically and genetically. Out of this understanding a more meaningful therapeutic approach may evolve. We therefore feel that the term and concept borderline should be abandoned.