Am J Psychiatry 1984; 141:1528-1532
Copyright © 1984 by American Psychiatric Association
Abuses of the borderline diagnosis: a clinical problem with teaching opportunities
DE Reiser and H Levenson
The authors identify six ways in which the borderline diagnosis is commonly
abused to express countertransference hate, mask imprecise thinking, excuse
treatment failures, justify the therapist's acting out, defend against
sexual clinical material, and avoid pharmacologic and medical treatment
interventions. The paper focuses on diagnostic abuses that trainees present
to clinical supervisors and educators. It attempts to show educators how to
discern these abuses and turn them into teaching opportunities. These
abuses are seen not only in trainees; they also occur in the professional
community as a whole. Clinicians should expect the same diagnostic rigor of
themselves that they expect of their students.
