Why is it called borderline personality disorder?

History of borderline personality disorder

The first known use of the term “borderline” was by psychologist Adolph Stern in 1938. ^[5] He used it to describe patients who were “on the border” between diagnoses of “neurosis” and “psychosis.” ^[5] It was characterized as a mild form of schizophrenia. 

Then, in the late 1960s, psychoanalytic psychiatrist Otto Kernberg redefined it as “borderline personality organization.” ^[4] He believed it fell somewhere in between the neurotic and psychotic personality organizations. He recognized that it was not a type of schizophrenia but an enduring pattern of emotional irregularity. His work was vital in establishing many symptoms of BPD recognized today. 

In 1980, borderline personality disorder was officially listed as a diagnosis in the DSM-III. ^[4] It is now recognized that BPD is not actually “on the border” of any other disorders. Instead, it is understood as a distinct pattern of emotions, thoughts, and behaviors.

Alternative names for borderline personality disorder

Today, borderline personality disorder is a controversial term that many psychologists believe is confusing and inaccurate. They also suggest that it adds to the stigma of the disorder. In fact, out of 400 leading personality disorder experts surveyed, 68.7% wanted to change the name within the DSM-V. ^[2]

Now that we know that it is not on the border of other disorders, clinicians have suggested other terms that more accurately reflect the emotional instability of BPD. One alternative name already used is emotionally unstable personality disorder (EUPD). While less common than BPD, this term is regularly used by the World Health Organization (WHO). ^[1]

Other suggested names include emotion dysregulation disorder and emotional intensity disorder (EID). ^[2]