The "Borderline" as the Sociocultural Origin of Borderline Personality Disorder—and Psychiatry

What are borderlines? Typically, they are markings that identify what is both accepted and rejected, and as such, they are places of both inclusion and exclusion. The Oxford English Dictionary (1989) defines borderline as "a frontier-line, or a boundary between areas or between classes." It also gives a second definition, applying borderline to the experiences of "verging on the indecent or obscene" and "verging on insanity." While the second definition seems to capture characterizations of women diagnosed with borderline personality disorder, the first definition reflects the experience of psychiatry at the borderlines of medicine. In this paper, I examine the implications of borderlines for both the borderline patient and psychiatry. Three sociocultural influences on the development of borderline personality disorder that place women on the borderline are examined: childhood abuse and neglect, postmodernity, and the feminization of women. Finally, biomedical psychiatry's attitude towards the borderline patient as "difficult" will be used to understand psychiatry's own position on the borderline as a marginalized medical specialty.