On “Borderline” Diagnoses

In retrospect, it is ironic, perhaps, that it was within psychoanalysis that the category of the ‘borderline’ was invented. More specifically, it derived from the ego psychology of the US, which situated the borderline as a category of exclusion between neurosis and psychosis. There are strong grounds for concern about the aims, ethical underpinnings and conceptual rigour of ego psychology (see here for a brief summary). As I’ve tried to point out elsewhere, the blunders of ego psychology did not prevent it from having a formative influence on many other forms of North American psychotherapy, including those that prevail in the Anglophone world today. In general, for an idea to have emerged from ego psychology constitutes a serious objection to it; if it is also taken up by bureaucrats and panel-beaters of the psyche, this amounts to a refutation.