A critical review of psychotherapeutic treatments of the borderline personality. Historical trends and future directions.

The borderline personality was originally thought to be on the border of psychosis and treatability. Most psychoanalytic writers of the 1940s-1960s gave these patients subschizophrenic labels and emphasized a supportive, limited treatment approach. They noted that these patients often regressed and became worse with analytic treatment. Nevertheless, in the 1970s a major impetus for a renaissance and revitalization of psychoanalytic thought was a recasting of the theory and therapy of the borderline personality. Renewed optimism and vigor characterized the intensive, exploratory treatment approaches to these writings. The 1980s, however, curiously show a fragmentation of and retrenchment from these views, and a return to many of the treatment recommendations of the earlier authors. The literature on the treatment of the borderline personality is critically examined from a historical perspective in this review. Highlighted, in particular, are the commonalities, trends, empirical studies, and future directions in the treatment literature.