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Guest
·This is in response to another thread where folks were asking "what does borderline mean?"
The word Borderline is very over-used in psychiatry - and different theories (or schools of thought) will each use it differently. There is no such "THING" as "borderline." You need to ask in what context the word is being used.
The term you probably hear the most these days is BPD (Borderline Personality Disorder). All the personality disorders are basically "clusters' of traits and symptoms that seem to describe a type of person. They're not "things" you have but a type of thinking/personality/behavior that a person has developed from early childhood. Psychosis is really not going to figure into this kind of diagnosis - except that sometimes BPD type folks do have wild mood swings and may have delusions, obsessions, etc. that seem barely in touch with reality.
There is a more common use of the word borderline that many psychiatrists and psychoanalysts use - although the general public doesn't use it or hear it as much. But this use of the word was around LONG before the Borderline Personality Disorder term was created. Here the word refers to a "level" or "structure" of functioning. Those levels are usually: Neurotic, Borderline or Psychotic. Doctors may try to assess what Level the person's symptoms/disorder is organized around - it tells them if the person might benefit from anti-psychotic meds, if the person is likely to ever need hospitalization, if the person will likely be able to handle increased stress/anxiety during an intensive treatment, etc.
Regardless of what disorder a patient has or what symptoms they have) docs would label the patient's Level or Structure of Self as follows:
If self seems to be organized around a Neurotic Level of Functioning the person will be able to keep their reality testing totally intact (they basically seem perfectly normal, but have symptoms like anxiety, etc. that cause them problems). They might WORRY that they are losing reality, but they never rant or rave in delusional thought. Symptoms can be very bad, but the Cognitive ability is not in jeopardy.
Psychotic Level of Functioning means the person breaks out of reality under the slightest stress - they "decompensate" and entertain delusions, become non-functional, literally fall apart. Definitely will be in and out of the hospital and their overall ability to function will get worse as they age. Each break does damage. (whereas the higher levels, the person bounces back intact after/if symptoms can be cleared up)
Then the Borderline Level of Functioning is somewhere in the middle of those two. If someone's Self is organized around a Borderline structure, it means they do not have the Ego Strength of the rest of us, they CAN have breaks with reality, they MIGHT enter psychosis under extreme trauma, etc. This is probably what Ninnu's doctor meant by using the word "borderline" - as Ninnu had a trauma-induced psychosis, and seems to be capable of drifting INTO that psychotic state, but not as often or as severely as someone on a lower level.
A person with an anxiety disorder will either have a personality organized at one of those three levels. In other words, an anxiety disorder can be on the neurotic level, the borderline level or the psychotic level of functioning - based on the person's core psychological STRUCTURE. If a person is structured in a borderline phase, any and all symptoms they have will cluster in a borderline level. Likewise, a psychotic. A person with a psychotic level of function will experience anxiety differently from the rest of us - that person's anxiety is experienced on a lower structural level within the self.
The vast majority of us here are structured on a neurotic level. So any symptoms we get, anxiety, dp, dr, obsessiveness, depression, etc..will all reside in that level - which is why the doctor is much less concerned with "what I have NOW" in terms of some new symptom. The important thing is HOW I'm put together and where (on which level) all my mental experiences will cluster.
Then there are OTHER uses of the word "borderline" (as in "borderline schizophrenic" or "borderline behavior" and many others). Point being, you need to know HOW the professional is using the word rather than jumping to conclusions that the word itself MEANS somethign omminous.
Peace,
Janine
The word Borderline is very over-used in psychiatry - and different theories (or schools of thought) will each use it differently. There is no such "THING" as "borderline." You need to ask in what context the word is being used.
The term you probably hear the most these days is BPD (Borderline Personality Disorder). All the personality disorders are basically "clusters' of traits and symptoms that seem to describe a type of person. They're not "things" you have but a type of thinking/personality/behavior that a person has developed from early childhood. Psychosis is really not going to figure into this kind of diagnosis - except that sometimes BPD type folks do have wild mood swings and may have delusions, obsessions, etc. that seem barely in touch with reality.
There is a more common use of the word borderline that many psychiatrists and psychoanalysts use - although the general public doesn't use it or hear it as much. But this use of the word was around LONG before the Borderline Personality Disorder term was created. Here the word refers to a "level" or "structure" of functioning. Those levels are usually: Neurotic, Borderline or Psychotic. Doctors may try to assess what Level the person's symptoms/disorder is organized around - it tells them if the person might benefit from anti-psychotic meds, if the person is likely to ever need hospitalization, if the person will likely be able to handle increased stress/anxiety during an intensive treatment, etc.
Regardless of what disorder a patient has or what symptoms they have) docs would label the patient's Level or Structure of Self as follows:
If self seems to be organized around a Neurotic Level of Functioning the person will be able to keep their reality testing totally intact (they basically seem perfectly normal, but have symptoms like anxiety, etc. that cause them problems). They might WORRY that they are losing reality, but they never rant or rave in delusional thought. Symptoms can be very bad, but the Cognitive ability is not in jeopardy.
Psychotic Level of Functioning means the person breaks out of reality under the slightest stress - they "decompensate" and entertain delusions, become non-functional, literally fall apart. Definitely will be in and out of the hospital and their overall ability to function will get worse as they age. Each break does damage. (whereas the higher levels, the person bounces back intact after/if symptoms can be cleared up)
Then the Borderline Level of Functioning is somewhere in the middle of those two. If someone's Self is organized around a Borderline structure, it means they do not have the Ego Strength of the rest of us, they CAN have breaks with reality, they MIGHT enter psychosis under extreme trauma, etc. This is probably what Ninnu's doctor meant by using the word "borderline" - as Ninnu had a trauma-induced psychosis, and seems to be capable of drifting INTO that psychotic state, but not as often or as severely as someone on a lower level.
A person with an anxiety disorder will either have a personality organized at one of those three levels. In other words, an anxiety disorder can be on the neurotic level, the borderline level or the psychotic level of functioning - based on the person's core psychological STRUCTURE. If a person is structured in a borderline phase, any and all symptoms they have will cluster in a borderline level. Likewise, a psychotic. A person with a psychotic level of function will experience anxiety differently from the rest of us - that person's anxiety is experienced on a lower structural level within the self.
The vast majority of us here are structured on a neurotic level. So any symptoms we get, anxiety, dp, dr, obsessiveness, depression, etc..will all reside in that level - which is why the doctor is much less concerned with "what I have NOW" in terms of some new symptom. The important thing is HOW I'm put together and where (on which level) all my mental experiences will cluster.
Then there are OTHER uses of the word "borderline" (as in "borderline schizophrenic" or "borderline behavior" and many others). Point being, you need to know HOW the professional is using the word rather than jumping to conclusions that the word itself MEANS somethign omminous.
Peace,
Janine
