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A great deal has been written about the nature of borderline personality. We maintain that borderline psychopathology emanates from particular disturbances in mental representations-impairment in the ability to maintain and use benign and integrated internal images of self and others-and that these troubled ways of thinking drive the troubled interpersonal relations, affective instability, and impulsivity associated with borderline. Aspects of borderline self-other representational disturbances are present across a wide theoretical spectrum, and a number of research methodologies already exist to assess the phenomena. We conclude that borderline attributes exist on continua, and summarize important features as: (1) unstable mental images of self and others, often marked by self-loathing and attributions of malevolence to others; (2) interactions with others organized around a fundamental need for care that is felt to be necessary for basic functioning; (3) fear of others based on expectations of being mistreated and disappointed and/or terror of having one's identity subsumed by another person; (4) difficulty considering multiple and/or conflicting perspectives, with a tendency toward concrete, all-or-none, or black-and-white, thinking and distortion of reality; and (5) sadomasochistic interpersonal interactions in which a person alternatively inflicts suffering on others and suffers at the hands of others.
A brilliant young woman, H., struggled mightily with "symptoms" commonly associated with borderline personality disorder (BPD): affective instability, self-injurious behaviors, and impulsivlty. During the early years of her multi-year treatment, the most striking attributes of H., and of most patients in the borderline realm that we have encountered, were constantly shifting self-states and wildly fluctuating views about others. For example, one day she would be making plans to become a fashion model, while the next day she could barely stand to look at her reflection in a mirror. In her relationship with her female partner, B., H. vacillated between being totally Invested in the "brilliant" life plans her partner put forth for them, and feeling like she needed to break up because B. was a "controlling bitch." Her private fantasies were filled with horrid, persecutory images, and she suffered greatly. Even though H. and her therapist were meeting multiple times per week, one never knew what to expect from session to session, as H.'s fragmented sense of self contributed to great variations in her emotional state and...