I really, really dislike this label, even though it isn’t one that I have collected (so far) in my career as a client and patient. Many therapists don’t understand the etiology of the cluster of symptoms that comprise “borderline personality” and therefore cannot work effectively with “borderline” clients.

For this reason, borderlines have gotten a bad reputation among therapists. They are considered difficult, unpredictable, boundary-breaking, ungrateful, and unchangeable. They are often subtlety or not so subtly discriminated against. In clinics, they are assigned to the junior staff, in private practice they are “referred out,” and in hospitals they are treated firmly, but with little empathy. Not always, but often.

It’s illuminating to consider where the term “borderline” comes from. In the early days of psychoanalysis, it was considered possible to analyze neurotic, but not psychotic, patients. Neurotic people got better as they talked freely about their pasts and their troubles, but psychotics tended to become more disorganized mentally if asked to free associate.

It was soon discovered that a group of people started off looking neurotic, and then suddenly, often temporarily, acted psychotic. Thus they were considered “on the border” between neurosis and psychosis.

If you read the old case histories, you may notice that these patients look to our eyes like high-functioning trauma survivors who were having flashbacks in the therapy hour. Some appear to be multiples that switched periodically. Since analysts in those days had no idea what a flashback was, they assumed that their patients had tricked them into thinking they were neurotic when they really were psychotic.

When clinicians started to study borderlines more closely, it was hypothesized that the mother’s behavior caused the syndrome. A mother that alternately pulled her baby very, very close and then became distant and rejecting set the child up for a lifetime of boundary problems. Makes sense, doesn’t it? Alternate invasion and rejection of the child’s very self could very well lead to huge difficulties with relationships. In this scenario, the father, other relatives, family friends, teachers, and clergy are ignored, and so is the possibility of physical and sexual abuse. There are many ways of stimulating and then abandoning a child, many ways of messing with forming boundaries. And needless to say, ritual abuse utilizes them all.

When people make the connection between early catastrophic abuse and present behavior, when they learn what flashbacks are, when they go, “Aha! So that’s why I always expect nice people to turn into monsters,” they have a chance, for the first time, to gain control over their lives and their behaviors. This is as true of borderline behavior as of any other symptom of childhood abuse.

What it comes right down to, is that, as ritual abuse survivors, we live on the border of past and present. We are not unchangeable; we are trauma survivors.

from Survivorship Notes, Monthly Notes, September 2000