Beyond the Fringer. Studies on Borderline Personality

5 
 
 
and psychotherapists. One of the reasons, as Migone points out, which move this 
paradigm is that this phenomenon, really because placed midway between 
neurosis and psychosis, was opportunity of fight between not really near 
disciplines, what psychiatry and the psychoanalysis (the first curing the 
psychoses, the second before the neuroses). Ne turned out like that that the 
professionals of the sector, finding him in front of these strange patients, hes son 
found again to see the limits of the reference theories again and to “compare its 
weapons with those of the enemy”. The everything, to my modest opinion, to 
benefit of the science, because it was possible try to find a ground council of 
comprehension of the trouble. And it is what is happening at the day of today, in 
which one tends to exclude an only theoretical and therapeutic model about the 
comprehension and the care of the pathology in order to adopt a multidisciplinare 
model. 
 And the purpose of this degree thesis is this: try to do a little more than light 
on this charming and discussed characteristic of psyche human. 
 
 
 
 
 
 
 
 
 
 
 
 
 To You everybody a cordial reading. 
6 
 
 
Chapter 1 
Evolutionary aspects of the term “borderline” 
 
 
 
 
 Negotiating him of a trouble of personality, before passing in review the 
authors who contributed a tale spreading term, the val suffers pause briefly on 
the origin of the personality term. The scientific concept of personality (deriving 
person from atino, masks, theatrical personality), one has for the first time in 
France in the half of ‘800, to describe the hypnotic phenomena and dissociation of 
the conscience (Danziger, 1997). He was in a particular T. Ribot way in 1885 
which started understanding the study of the personality following a naturalistica 
optics and scientific: according to this author, in fact, in order to a greater 
comprehension of the psychic phenomena one had to turn to the physiology and 
pathology use. He was seeing the investigation as clinical as a laboratory 
experiment, and as such needing a duct systematic study by clinical observations. 
William James (1890) uses it in a general meaning, describing states of rivalry and 
conflict in the conscience of himself and among different personalities. In such a 
sense the health, psychic, individual, comes to constitute it like a product of the 
the various member relation of the personality, in their dynamic balance. But we 
go back to the central theme of this thesis. 
 The term “borderline” comparve in the Adolph Stern study of 1938 to describe 
those subjects fundamentally narcissistes, ipersensitives, potentially to risk of 
negative reactions to the therapy and with gaps in the reality exam: these aspects 
will be developed aheader. Before then only red (1890) explicitly talked about 
“borderline insanity” in defining those human swinging cases between reason and 
madness. the matter on the use of the term, and his birth as pathology, derived 
from a part from the entrance of the psicanalisi to beginning century to Sigmund 
7 
 
 
Freud work (especially thanks to the work of 1914 “introduction to the 
narcisism”)
2
, and from the other evolving of the psychiatric taxonomy, with the 
jobs of Emil Kraepelin and Eugen Bleuler on the schizophrenia. 
 Its much not very clear and changeable tie with this illness gave rise, in the 
more than forty year space, to several definitions: “latent psychosis” 
(Bychowski), “latent schizophrenia” (Rorschach), “atypical schizophrenia” 
(Kasanin), “schizophrenia whips” (Wizel), “reversible schizophrenia” (Bleuler), 
“first-aid schizophrenia” (Zilboorg), only to mention some. Appears clearly, 
therefore, what conceptual heterogeneity of the phenomenon existed in the years 
that they preceded the work of Otto Kernberg of 1967 and the consequent 
realization of the DSM-III of 1980. 
 The work performed by Stern of ‘38 was letting notice as a wide group of not 
identifyable patients from the diagnostic criteria of the psychoses, néné as less 
from that of the neuroses existed; he described such about ten than clinical 
symptoms, between which they were standing out the narcissism, the poor 
tolerance to the frustrations and insecurity feelings rooted in the depth; then 
these strokes will meet again in all the jobs of those authors who will face the 
theme of the marginal syndrome. 
 An interesting study performed few years after that of Stern was that of 
Helene Deutsch of 1942 on “personality as-though”: the author described a 
character form to the normal appearance, but that was revealing a more in-depth 
analysis a heavy characterized personality trouble here assuming the people’s 
characteristics with which the subject one was reporting. 
 The second work for importance order in this field was an article written by 
Robert Knight in 1953 on the “been borderline”: the author stressed for the first 
                                                 
2
 Was in this work that the Viennese doctor faced and distinguished two big groups of neurosis, of 
transfert and narcissistics, the first manageable with the psychoanalytical method to detriment of 
the second, since incompetents to develop an analytical transfert. 
8 
 
 
time the personological structure (taken again then by Kernberg), to detriment of 
the symptomatologic picture, commonly used thin to then. Knight was placing so 
the attention on the strong weakness of Ego, especially in the “processes of 
secondary thought, the integration capacity, the reality exam, the maintenance 
of the object relations, the adaptation to the environment and the defences 
against primitive unconscious impulses” (Knight, 1953). However this author was 
pointing out as these weaknesses did not reach that catastrophic weakening of 
theirs of the psychotic states. 
 Another milestone in the evolution of the concept of borderline was the work 
developed by Roy Grinker and coll. in 1968. Even though of formation 
psychoanalytic, Grinker he had as aim of the research the definition of behaviours 
well identifyable and estimateable necessary to the borderline trouble diagnosis. 
51 hospitalized subjects were examined with heavy psychic not referable 
pathology to the schizophrenia. The obtained data (based on the observation of 
observable behaviours) allowed the Grinker equipe to arrive to outline four 
distinct borderline personality subgroups, in their turn assembleable in two big 
classes: the first characterized before by intense interpersonal relations, negative 
affectivity and tendency to the acting-out while the second characterized like to 
“personality as-though” described by Deutsch
3
. All the subgroups were 
categorized by anger (what principal affection) feelings, interpersonal intense but 
disturbed relations, a pervasivo empty space and solitude and at last the 
sensation of a discontinuity in its identity sense. 
 Therefore we reached to examine the work of Otto Kernberg. 
He goes up again at an article of 1967 the publication which gave a turn point in 
optics of the borderline phenomenon: in “Borderline Personality Organization” 
(J. am. Psychoanal. Ass ., vol. (15, 641-85) was identifying in patients with a 
                                                 
3
 They were characterized by a passive adaptation to the circumstances and the tendency to the 
identification with stereotyped behavioural models. 
9 
 
 
heterogeneity of symptoms of the most various (multiple phobias, obsessive-
compulsives, paranoid starting points, symptoms strong anxiety always present, 
etc). How doing part of a character and stable mode in the time. 
The present discriminating elements in this character structure outlined by the 
author are four: 
• an Ego’s weakness; 
• the tendency of the predominance of the primary process and the 
• getting archaic defence mechanisms (first among everybody the split); 
• disturbed interpersonal relations. 
  The 1974 was the year of the publication of the developed studies a French 
psychologist, J. Bergeret. The author transalpino places the borderline pathology 
(or structures of personality limit cases, as he calls her) midway between neurosis 
and psychosis, pointing out the aspect least rigid, least solid and definitive
4
; 
furthermore it tends to focus its attention more on the intrapsychic dynamics 
than on the sintomatologici aspects. 
 Crucial concept is that of Ego anaclitic, a mode of working of Ego of the 
subject which, in conditions of threat of loss of the object, causes a strong anguish 
which can give rise to psychotic short and transient reactions. Linked up to the 
concept of anaclitic Ego is the constant presence of a depressing anguish of loss of 
the object, characterizing the way of acting (and the relative interpersonal 
relations) of this character. 
 1975 saw the publication of a study of two authors who were ideally 
continuing the one developed by Grinker some year before: 
                                                 
4
 A preorganized neurotic Ego (and, analogously, a preorganizzato psychotic Ego) he remains in 
the membership picture and will organize himself in a definitive way according to the relative 
structuring, line neurotic or psychotic. An impossible iter, according to Bergeret, with the 
structure of personality of the limit states. 
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J. G. Gunderson and M. T. Singer. They identified, on the basis of a revision of 
the clinical literature concerning the borderline theme, a present series of 
characteristics in it, which took (Diagnostic Interview for Borderline, DIB, then 
subsequently seen again, DIB-R) to the building of a semi-strutturata interview 
so. 
Gunderson found so seven characteristics discriminating between such a trouble: 
i) interpersonal unsettled and intense relations; 
ii) self-destructive behaviour; 
iii) abandonment fear; 
iv) chronic dysphoria; 
v) cognitive distortions; 
vi) impulsiveness; 
vii) poor social adaptation. 
His principal merit is in the reliability of the methodical proposal, reducing the 
big obstacle of the inference by who examines the subject
5
. 
 1979 was the year in which the bases were prepared to make this trouble be 
included in the manual of the A.P.A, the DSM-III
6
 (what the light will see a year 
later): the task was entrusted to R. L. Spitzer. 
 The borderline term was thin then applied in two nosographic different 
situations: a referred to troubles of the behaviour, of the affectivity and the 
thought (a clinical area very near the schizophrenia), the other inherent for the 
more to a character versant (reported principally to the jobs of Kernberg and 
Gunderson). Therefore Spitzer thought to insert the pathology at issue in the 
board Ego (Personality Troubles) and keep distinct with separate diagnostic 
                                                 
5
 According to Stone, 1980 (and quoted also from Migone, 1990), following about the diagnosis 
proposed by Kernberg 1/10 of the population would turn out being diagnosed as Borderline 
Personality Trouble, since he gets down to 1/30 adopting the Gunderson DIB.