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Originally, this term was used when the clinician was unsure of the correct diagnosis because the client manifested a mixture of neurotic and psychotic symptoms. Many clinicians thought of these clients as being on the border between neurotic and psychotic, and thus the term “borderline” came into use.The term “borderline” has sometimes been used in a number of ways in society that are quite different from the formal diagnostic criteria for borderline personality disorder (BPD). In some circles, “borderline” is still used as a “catch all” diagnosis for individuals who are hard to diagnose or is interpreted as meaning “nearly psychotic,” despite a lack of empirical support for this conceptualization of the disorder.Additionally, with the recent popularity of “borderline” as a diagnostic category and the reputation of these clients as being difficult to treat, “borderline” is often used as a generic label for difficult clients or as a reason (or excuse) for a patient’s psychotherapy going badly.

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