An Historical Review of the Borderline Concept

Abstract

An overview of the origin and evolution of the borderline concept is presented. Relevant historical trends are identified and a framework is setablished on which to base further study. The works of Kraepelin, Freud, and Bleuler are seen to lay the foundation for later systems of diagnosis and classification. Early metapsychologists provided insight into the psychological dynamics of the borderline patient, while the early descriptive psychopathologists contributed significantly to our phenomenological description of this patient population. Robert Knight in the early 1950s and John Gunderson in the mid-1970s synthesized the work that preceded them. Of the recent psychostructural writings, Otto Kernberg was considered representative. Roy Grinker's research epitomized a more descriptive and empirical approach to the problem of diagnostic criteria. Family and genetic studies as well as an evolving body of pharmacological literature are briefly reviewed. DSM III and the work of Robert Spitzer are considered current endpoints in an attempt to integrate and delineate varying conceptualizations of the borderline patient.