This work is an excellent exploration of the historical meanings regarding the etiology of borderline personality disorder as compared to looking at the diagnosis in terms of childhood trauma. The authors of this paper intensively explore the constructs on which the diagnosis of borderline personality disorder has been based, and successfully reframe them from the perspective of abuse survival. This includes exploring the symptom of “self-destructiveness” which is considered to be the “quintessential feature” of the diagnosis. They recognize that self-injury has been historically interpreted to be an action of manipulativeness based on anger. The authors, however, explore it in context of three types of experiences associated with trauma: 1) rage and humiliation secondary to learned helplessness, 2) the repetition compulsion, and 3) the frequency of actual revictimization. These are much more accurate assessments of the role SIV serves in the lives of trauma survivors.
Of particular interest is the discussion regarding the usefulness of the borderline diagnosis and its validity, as well as the negative implications that automatically come with the label. The authors encourage the development of a viable substitute for the diagnosis. The final commentator on the subject states that “As long as we use the term ‘borderline,’ we contribute to poor treatment.” How refreshing.