Foreword

About These Pages

This content was originally published on borderlinezone.org — a website that has been providing information on Borderline Personality Disorder and related mental health conditions since 2002. The pages have been modernized and restructured on borderliner.ch to keep them accessible for years to come.

These pages do not claim to be exhaustive and are revised and expanded whenever time and circumstances allow.

Because the disorders and their interconnections are complex and multi-layered, these pages are structured in the same way. As a result, you will inevitably need to read quite a bit to build a comprehensive understanding.

Every effort has been made to avoid clinical jargon and to present the information in language that anyone can understand. This has not always been entirely successful.

Detailed depth-psychological explanations and precise descriptions of biochemical processes are only touched upon — enough to offer a glimpse into the subject.

A Flashlight in the Dark

These pages are meant to give you an overview. They are merely a flashlight shining into a vast, branching darkness. Whatever you see through the beam of that flashlight — do not judge too quickly. Allow yourself the calm and the patience to reflect on certain things.

We are always open to constructive criticism and welcome suggestions. We cannot please everyone, but we can reach many.

Why These Pages Exist

Many of you have come to these pages looking for explanations and help.

If we have been able to help even one of you in any way, then these pages have been worth the effort. There are many theories, and nothing is truly provable — or rather, we cannot say with certainty “this is how it is.” The reader will notice that the author follows Freudian theories. But Jung, Adler, the Frankfurt School, and many others also inform this work.

To this day, there is no proof that S. Freud, A. Freud, Adler, Jung, and others were right — because there is no counter-proof either. All we know is: it works. Psychology, psychiatry, and the therapies we use are all built on these “facts,” and many people have been helped through them. Still, the principle holds: where there is no counter-proof, there is no proof of correctness either.

Different Perspectives

You will not find answers to every question on these pages. To some readers, it may appear that we take the opposite side and pass judgment on the person with Borderline. This is not the case. However, from the perspective of the Borderline personality, there is no doubt that we stand on the “black” side.

We have tried to illuminate both sides with an objective — if sometimes harsh — approach.

On the Word “Ill”

We would also like to reframe the way the reader thinks about the word “ill” — or more precisely, to cast it in a different light. Away from the attitude of “something is wrong in your head” or the use of “you’re sick” as a negative judgment, even an insult.

When someone stands before you with a broken arm in a cast and a sling, you accept it as perfectly normal — you can see that they are injured. You do not attach a negative label to their condition; you do not stigmatize. On the contrary: you offer your help and support.

It is different when someone has a “broken arm in the head.” You cannot see it, and what you cannot see, you cannot explain. This leads to a kind of fear and helplessness. The worst part: the person themselves views it as something negative, and society stamps them the same way.

These pages aim to help change this attitude — at least regarding the conditions described here. They are meant to help you see these things for what they are: “a broken arm in the head.”

Since there is no “healthy,” we should accept that every person has rough edges. Everyone has quirks — some more, some less.

The question is: How do they and those around them deal with it? Are they harming themselves and/or others?

Body and Mind as One

Western dialectics, and Western medicine along with it, still separate body from mind (or soul). Successful approaches that view the body as a unified whole and consider the interplay between body and soul do exist. Unfortunately, these insights have not yet reached every physician.

Eastern dialectics, by contrast, view the human being as a unity of body and soul — and this unity, in turn, as part of the greater whole (the universe). Represented in the symbol of Yin and Yang, it encompasses not only masculine and feminine, good and evil, fire and water, positive and negative. No — it embodies the principle that one cannot exist without the other. Everything is interconnected.

It embodies the principle of truth: no truth exists without its contradiction.

A Chinese proverb says:

“Only those who are able to recognize the contradictions and reconcile them within themselves will see the truth.”

Reason and Emotion

We in the West try to explain everything rationally. As you can see, there is an interplay between reason and emotion. We all know the saying: “The head says no, the heart says yes” — or “reason and emotion have always been at odds.”

It is Yin and Yang.

Put simply: Let your head and your gut become one, and feel your way through. Only then will you truly understand.

Notes on Diagnostic Criteria (ICD-10)

Listing the essential characteristics of a disorder in a precise format brings obvious advantages, but some fundamental problems with the use of such criteria remain unresolved.

What Diagnostic Criteria Contain

What are currently called diagnostic criteria are a mixture of items, some of which describe the diagnosis of the current disorder, some the most common patient type, some the consequences of the disorder, and some the relative priorities for disorders within a hierarchy of diagnostic significance.

The Term “Disorder”

The editors of Chapter V (as with DSM-III and DSM-IV) decided to use the term disorder to describe what is being classified. This avoids a debate over the meaning and usefulness of terms like illness, disease, and similar concepts.

In Chapter V (F), “disorder” is used to describe the existence of a clinically recognizable set of symptoms or behavioral abnormalities that, in most cases, are accompanied by distress and impairment of functioning.

Defining Boundaries

High reliability in describing emotions, experiences, and behavior inevitably brings many challenges when attempting to define the boundaries between different disorders and to distinguish between mild and severe degrees of the same disorder.

The classification of affective disorders in this and all other current psychiatric classification systems suffers from many problems of this kind — particularly the frequent difficulty of distinguishing between different levels of severity in depressive states.

Neurosis and Psychosis

An important feature of modern classification that surprises clinicians in many countries is the absence of the traditional distinction between neurosis and psychosis.

In ICD-10, this distinction has been abandoned in favor of general descriptive characteristics or content. Nevertheless, many clinicians still find the terms neurosis and psychosis useful as general descriptive concepts.

The following meaning for “psychotic” is specified: Its use does not imply any assumptions about psychodynamic mechanisms, but simply indicates the occurrence of hallucinations, delusional disorders, or certain forms of severely abnormal behavior — such as severe states of agitation, overactivity, pronounced psychomotor inhibition, and catatonic disturbances.

Copyright

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