Borderline Personality Disorder and Psychosis: A Case Managed by Transference-Focused Psychotherapy

Transient stress-related paranoia is the descriptive definition of psychotic phenomena associated with borderline personality disorder. Although psychotic symptoms usually do not qualify patients for a separate diagnosis in the psychotic spectrum, statistical probabilities predict the co-occurrence of cases with comorbid borderline personality disorder and major psychotic disorder. This article presents three perspectives on a complex case of borderline personality disorder and psychotic disorder: one from a medication prescribing psychiatrist who is a transference-focused psychotherapist responsible for care, one from the anonymous patient, and one from a specialist in psychotic disorder. A discussion of clinical implications concludes this multidimensional presentation of borderline personality disorder and psychosis.