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Because of the borderline’s perfectionism and tendency to perceive things in black-and-white extremes, he attempts to obliterate unpleasant feelings rather than understand or cope with them. When he finds that he cannot simply erase these bad feelings, he becomes even more frustrated or guilty. Since feeling bad is unacceptable, he feels bad about feeling bad. When this makes him feel worse, he becomes caught in a seemingly bottomless downward spiral.
Unlike many people afflicted with other mental disorders—such as schizophrenia, bipolar (manic-depressive) disease, alcoholism, or eating disorders—the borderline can usually function extremely well in work and social situations without appearing overtly pathological. Indeed, some of the hallmarks of borderline behavior are the sudden, unpredictable eruptions of anger, extreme suspiciousness, or suicidal depression from someone who has appeared so “normal.”
But the borderline remains stuck—a child in an adult’s body.
The term borderline was first coined by Adolph Stern in 1938 to describe a group of patients who did not seem to fit into the primary diagnostic classifications of “neuroses” and “psychoses.”2 These individuals were obviously more ill than neurotic patients—in fact, “too ill for classical psychoanalysis”—yet they did not, like psychotic patients, continually misinterpret the real world. Though, like neurotics, they displayed a wide range of anxiety symptoms, neurotic patients usually had a more solid, consistent sense of identity and used more mature coping mechanisms.
