The diagnostic category of borderline personality disorder (BPD) has come under increasing criticism in recent years. In this paper, we analyze the role and impact of epistemic injustice, specifically testimonial injustice, in relation to the diagnosis of BPD. We first offer a critical sociological and historical account, detailing and expanding a range of arguments that BPD is problematic nosologically. We then turn to explore the epistemic injustices that can result from a BPD diagnosis, showing how they can lead to experiences (...) of testimonial injustice which impede patient engagement in meaning-making activities, thereby undermining standard therapeutic goals. We conclude by showing how our arguments bolster ongoing efforts to replace the diagnostic category of BPD with alternatives such as complex post-traumatic stress disorder. (shrink)

It is generally agreed that vague predicates like ‘red’, ‘rich’, ‘tall’, and ‘bald’, have borderline cases of application. For instance, a cloth patch whose color lies midway between a definite red and a definite orange is a borderline case for ‘red’, and an American man five feet eleven inches in height is (arguably) a borderline case for ‘tall’. The proper analysis of borderline cases is a matter of dispute, but most theorists of vagueness agree at least in the thought that (...) borderline cases for vague predicate ‘ ’ are items whose satisfaction of ‘ ’ is in some sense unclear or problematic: it is unclear whether or not the patch is red, unclear whether or not the man is tall.1 For example, Lynda Burns cites a widespread view as holding that borderline cases “are not definitely within the positive or negative extension of the predicate. … Border- line cases are seen as falling within a gap between the cases of definite application of the predicate and cases of definite application of its negation” (1995, 30). Michael Tye writes that the “concept of a border- line case is the concept of a case that is neither definitely in nor defi- nitely out” (1994b, 18). (shrink)

Louis Charland has argued that the Cluster B personality disorders, including borderline personality disorder, are primarily moral rather than clinical conditions. Part of his argument stems from reflections on effective treatment of borderline personality disorder. In the argument from treatment, he claims that successful treatment of all Cluster B personality disorders requires a positive change in a patient’s moral character. Based on this claim, he concludes (1) that these disorders are, at root, deficits in moral character, and (2) that effective (...) treatment of these disorders requires a sort of moral education rather than clinical intervention. In this paper, I evaluate the argument from treatment through a critical analysis of two psychotherapeutic interventions that have shown recent effectiveness against borderline personality disorder. I suggest that both Dialectical Behaviour Therapy and Mentalization-Based Treatment indicate that borderline personality disorder is, at root, a deficit in non-moral cognitive and emotional capacities. I suggest that these non-moral deficits obscure the expression of an otherwise intact moral character. In light of this, I conclude that effective treatment of borderline personality disorder requires primarily clinical intervention rather than moral edification. (shrink)

John Broome has argued that value incommensurability is vagueness, by appeal to a controversial about comparative indeterminacy. I offer a new counterexample to the collapsing principle. That principle allows us to derive an outright contradiction from the claim that some object is a borderline case of some predicate. But if there are no borderline cases, then the principle is empty. The collapsing principle is either false or empty.

Many feminist researchers have been critical of the psychiatric category of borderline personality disorder 1 and have emphasized the gendered nature of the diagnosis. It is estimated that people diagnosed with BPD comprise 1 to 2 percent of the general population in the United States in a given year, and that women represent 75 percent of those diagnosed.2 Critics have argued that the diagnosis reinforces double-binds for women and pathologizes traits associated with both conventional femininity, such as emotionality, dependency, and (...) self-destructiveness, and unconventional femininity, such as rebelliousness and sexual promiscuity (Lester 2013; Potter 2009; Shaw.. (shrink)

This article defends the existence of _borderline consciousness._ In borderline consciousness, conscious experience is neither determinately present nor determinately absent, but rather somewhere between. The argument in brief is this. In considering what types of systems are conscious, we face a quadrilemma. Either nothing is conscious, or everything is conscious, or there’s a sharp boundary across the apparent continuum between conscious systems and nonconscious ones, or consciousness is a vague property admitting indeterminate cases. Assuming mainstream naturalism about consciousness, we ought (...) to reject the first three options, which forces us to the fourth, indeterminacy. Standard objections to the existence of borderline consciousness turn on the inconceivability of borderline cases. However, borderline cases are only inconceivable by an inappropriately demanding standard of conceivability. I conclude with some plausible cases and applications. (shrink)

Persons with borderline personality disorder are often described as affected by extreme emotional fluctuations and by the sudden emergence of uncontrollable and disproportionate emotional reactions. Borderline persons frequently experience their own self as dim and fuzzy, are deprived of a stable sense of identity and unable to be steadily involved in a given life project. We will interpret these typical features as fluctuations between a clearly normative emotion such as anger and the more diffuse and confusing background of bad moods (...) like dysphoria. Our main focus will be on dysphoria. The intentional structure that characterizes much of human emotional experience, we shall argue, is absent in dysphoria. If we imagine emotions as fluxes of intentionality that innervate the body and connect it to the world, dysphoria is empty intentionality, so to speak, devoid of the moderating power of language and representation. Dysphoria exerts a centrifugal force which fragments the borderline person's representations of herself and of others, inducing a painful experience of incoherence and inner emptiness, a feeling of uncertainty and inauthenticity in interpersonal relationships, and an excruciating sense of futility and inanity of life. But it also entails a sense of vitality, although a disorganized, aimless, and explosive one -- a desperate vitality. (shrink)

In his Material Beings, Peter van Inwagen distinguishes two questions about parthood. What are the conditions necessary and sufficient for some things jointly to compose a whole? What are the conditions necessary and sufficient for a thing to have proper parts? The first of these, the Special Composition Question (SCQ), has been widely discussed, and David Lewis has argued that an important constraint on any answer to the SCQ is that it should not permit borderline cases of composition. This is (...) a far-reaching claim, since many plausible-seeming accounts of composition do permit borderline cases. Ned Markosian has recently directed our attention to the second, the neglected Inverse Special Composition Question (ISCQ). I will argue that those who accept Lewis’s constraint on answers to the SCQ should accept an analogous constraint on answers to the ISCQ, and I will discuss the effects of such a constraint. (shrink)

The Pyrrhonian sceptic Favorinus of Arelata personified indeterminacy, cultivating his (or her) borderline status to undermine dogmatism. Inspired by the techniques of Favorinus, I show, by example, that ‘vague’ has borderline cases. These concrete steps lead to a more abstract argument that ‘vague’ has borderline borderline cases and borderline borderline borderline cases. My specimens are intended supplement earlier non-constructive proofs of the vagueness of ‘vague’.

Several researchers point to disorganized attachment as a core feature of borderline personality disorder (BPD). However, recent studies suggest that specific internal working models (IWMs) of each parent combine to account for child outcomes and that a secure relationship with one parent can protect against the deleterious effects of an insecure relationship with the other parent. It was thus hypothesized that adolescents with BPD are more likely to be disorganized with both their parents, whereas non-clinical controls are more secure with (...) at least one of their caregivers. Thirty-six adolescents with BPD and 30 control participants (aged 13-19) were included. Psychiatrist diagnosis was verified with the SIDP-IV and comorbidity was assessed using the Kiddie-SADS. Reported trauma was assessed with the Childhood Trauma Questionnaire. Attachment IWMs of each parent were assessed with the Attachment Multiple Model Interview (AMMI), which enables separate coding for each attachment figure and in which disorganization is conceptualized as conflicting attachment strategies within a specific relationship. Results of a logistic regression analysis suggested that beyond insecure attachment, being disorganized not just with one but with both parents is particularly characteristic of adolescents with BPD. Conversely, belonging to the non-clinical group was predicted by higher security scores with the father and lower deactivation with the mother. Although higher levels of childhood abuse or neglect were reported by adolescents with BPD, the retained attachment dimensions predicted group membership over and above reported trauma. These findings have important implications for clinical intervention and highlight the protective role fathers may have. (shrink)

Once common, therapeutic privilege—the practice whereby a physician withholds diagnostic or prognostic information from a patient intending to protect the patient—is now generally seen as unethical. However, instances of therapeutic privilege are common in some areas of clinical psychiatry. We describe therapeutic privilege in the context of borderline personality disorder, discuss the implications of diagnostic non-disclosure on integrated care and offer recommendations to promote diagnostic disclosure for this patient population. There are no data in this work.

To accommodate vague statements and predicates, I propose an infinite-valued, non-truth-functional interpretation of logic on which the tautologies are exactly the tautologies of classical two-valued logic. iI introduce a determinacy operator, analogous to the necessity operator in alethic modal logic, to allow the definition of first-order and higher-order borderline cases. On the interpretation proposed for determinacy, every statement corresponding to a theorem of modal system T is a logical truth, and I conjecture that every logical truth on the interpretation corresponds (...) to a theorem of T. the interpretation is extended to predicate logic. A borderline case of a predicate 'F’ is neither determinately F nor determinately not-F. Traditional sorites arguments are seen to fall apart early in their gradual stepwise passage from truth to falsity. (shrink)

The present study constructed a moderated mediation model to examine whether borderline pathological celebrity worship may be associated with higher levels of impulsive buying intent. The mediating role of empathy and the moderating role of gender were also examined. A total of 1,319 participants recruited from a college through the campus network. The results indicated that borderline pathological celebrity worship could positively predict individuals’ impulsive buying intent; the predictive effect of borderline pathological celebrity worship on impulsive buying intent could be (...) mediated by empathy; and gender moderated the predictive effect of borderline pathological celebrity worship on impulsive buying intent. Specifically, relatively higher levels of borderline pathological celebrity worship were found to be associated with higher impulsive buying intent among men. However, this was relatively less significant among women.ConclusionThe results contribute to previous findings by demonstrating that borderline pathological celebrity worship could affect impulsive buying intent. Moreover, the mediating role of empathy and the moderating role of gender were also revealed. (shrink)

In The Borderline Culture: Intensity, Jouissance, and Death, Željka Matijašević examines contemporary culture through psychological borderline theory.

Most philosophers of art assume that there are three categories with regard to arthood, namely ‘art’, ‘artful’ and ‘non-art’ and that, therefore, a definition must be able to account for ‘artful items’, also called ‘borderline cases of art’. This article, however, defends the thesis that, since there is no agreement over which items fall under the category ‘artful’, the ability to account for borderline cases of art should not be used as a criterion for evaluating definitions of art. The defended (...) thesis is important, not merely because it reveals that virtually all alleged descriptive definitions of art have strong recommendatory consequences, but also because the thesis has implications for the artefacts that are considered to be borderline cases of art. (shrink)

_The Borderline Psychotic Child_ reviews the history and evolution of the borderline diagnosis for children, both in the USA and the UK, bringing the reader up to date with current clinical opinion on the subject. Using a range of clinical case studies, the book attempts to harmonise US and UK views on borderline diagnosis in the light of new developments in theory at The Menninger Clinic, The Anna Freud Centre and The Tavistock Clinic. Providing an introduction to the borderline concept, (...) and a systematic overview of current theoretical thinking and clinical practices from leading practitioners in the field, _The Borderline Psychotic Child_ will make informative reading both for professionals and students in the field of child analysis. (shrink)

Individuals with conditions like borderline personality disorder experience chronic, pervasive impairments that interfere with moral functioning. Even in recovery these individuals are plagued by residual symptoms, requiring diligence and management. First, I stipulate that some individuals who recover from BPD act morally. I argue that by acting morally while managing residual symptoms these individuals expand the boundaries of traditional Aristotelian virtue. Individuals who recover from BPD are simultaneously virtuous and outside the boundaries of traditional Aristotelian virtue if they meet the (...) following conditions: they experience marked, unchangeable morally-relevant difference in moral faculties; act morally at approximately the same rate or better than other moral agents; and act morally for the right reasons. These individuals challenge the boundaries of traditional Aristotelian virtue by demonstrating that many views of temperance and virtue are too restrictive. I evaluate multiple interpretations of McDowell’s [1] silencing view and call for a more inclusive virtue ethics that embraces continence in the vein of Foot’s [2] corrective view. (shrink)

ArgumentSociologists and historians have long favored externalist over internalist accounts of practices in the clinical disciplines. This has been particularly true in the case of the so-called new patient or borderline personality, which a range of commentators have located in culturally resonant narratives of decline. I argue here that these narratives, while pleasing, do not hold up as history; most problematic is their assumption that the appearance of the borderline portends the emergence of altogether novel forms of modal personhood. Internalist (...) accounts of the category's consolidation are equally problematic in asserting a coherence and a stable referent that repeatedly proves elusive. In the end, I suggest that a complex account of disciplinary practice that attends to knowledge production in the clinical encounter supports the conclusion that the new patient was new to psychoanalysis. Whether or not he was altogether new cannot be established, undermining the critics' certitude and prophecies of decline. (shrink)

An exploration of the roots of terrorism suggests one primal source arises from so-called “self-made” males who find difficulty forming community attachments. Those who fail to see that they live within the boundaries of humanity fail to recognize where dark ambitions of their souls fester and where inter-subjective reality begins. They suffer from what psychiatrists call borderline disorders. Cut off from a lived community, they become monsters of humanity.

This article argues that public health campaigns have an ethical obligation to combat fat stigma, not mobilize it in the “war on obesity.” Fat stigma is conceptualized, and a review is undertaken of how pervasive fat stigma is across the world and across the lifespan. By reviewing the negative impacts of fat stigma on physical health, mental health, and health seeking behaviors, fat stigma is clearly identified as a social determinant of health. Considering the role of fat stigma in public (...) health, and the arguments made for using stigmatisation in public health campaigns to promote population health, it is concluded that it is a violation of public health ethics to use stigma as a tool in combatting fatness. The article concludes by making recommendations of how public health in New Zealand can combat, rather than reinforce, fat stigma. (shrink)

Atypical emotion interpretation has been widely reported in individuals with borderline personality disorder ; however, empirical studies reported mixed results so far. We suggest that discrepancies in observations of emotion interpretation by iBPD can be explained by biases related to their fear of rejection and abandonment, i.e., the three moral emotions of anger, disgust, and contempt. In this study, we hypothesized that iBPD would show a higher tendency to correctly interpret these three displays of social rejection and attribute more negative (...) valence. A total of 28 inpatient iBPDs and 28 healthy controls were asked to judge static and dynamic facial expressions in terms of emotions, valence, and self-reported arousal evoked by the observed faces. Our results partially confirmed our expectations. The iBPD correctly interpreted the three unambiguous moral emotions. Contempt, a complex emotion with a difficulty in recognizing facial expressions, was recognized better by iBPD than by healthy controls. All negative emotions were judged more negatively by iBPD than by controls, but no difference was observed in the neutral or positive emotion. Alexithymia and anxiety trait and state levels were controlled in all analyses. (shrink)

Borderline Personality disorder is a severe personality dysfunction characterized by behavioural features such as impulsivity, identity disturbance, suicidal behaviour, emptiness, and intense and unstable relationships. Approximately 2% of the population are thought to meet the criteria for BPD. The authors of this volume - Anthony Bateman and Peter Fonagy - have developed a psychoanalytically oriented treatment to BPD known as mentalization treatment. With randomised controlled trials having shown this method to be effective, this book presents the first account of mentalization (...) treatment for BPD. The first section gives an overview of BPD, including discussion of nosology, epidemiology, natural history, and psychosocial aetiology. It additionally summarises the present state of our research knowledge about effective psychotherapeutic treatments and use of medication. The second section outlines the authors' theoretical approach and contrasts it with other well known methods, including DBT, CAT, and CBT. In the extensive final section, the authors outline their clinical approach starting with how treatment is organised. A detailed account of the transferable features of the model is provided along with the main strategies and techniques of treatment. Numerous clinical examples are given to illustrate the core techniques and detailed information provided about how to apply aspects of the mentalization based treatment approach in everyday practice. Aimed at mental health professionals, along with counsellors, psychotherapists, and psychoanalysts, the book will be a valuable tool, providing an effective means of treating those suffering from Borderline Personality Disorder. (shrink)

Some philosophers seem to think that borderline cases provide further cases of apparent faultless disagreement. My aim here is to argue against such a suggestion. I claim that with respect to borderline cases, people typically do not respond by taking a view—unlike what is the case in genuine cases of apparent faultless disagreement. I argue that my claim is indeed respected and actually accounted for by paradigm cases of semantic and epistemic views on the nature of vagueness. And I also (...) argue that my claim turns out to be, initial appearances notwithstanding, compatible with other claims in the literature—to the effect that, in appropriate circumstances, there are indeed, or there might well be, “macho,” admissible, forced, and hesitant responses to borderline cases. (shrink)

In this paper I will investigate Kristeva’s conception of dance in regard to the trope of the borderline. I will begin with her explicit treatments of dance, the earliest of which occurs in Revolution in Poetic Language, in terms of (a) her analogy between poetry and dance as practices erupting on the border of chora and society, (b) her presentation of dance as a phenomenon bordering art and religion in rituals, and (c) her brief remarks on dance gesturality. I will (...) then follow this latter movement to the 1969 essay “Gesturality,” to critically examine where Kristeva situates the powers and limits of gesture (and thereby dance) in relation to language. Next, I will move to the later text, The Sense and Non-Sense of Revolt, where the image of dance figures prominently in what I will term Kristeva’s joyful re-choreographing of Freud’s text Totem and Taboo. I will also see how her treatment of dance links more directly to Kristeva’s feminist concerns, insofar as she understands the process of choreography as a kind of maternal function neglected in most psychoanalytic thought. (shrink)

The 1918 discovery of oil in the bed of the Red River, which forms the border between Texas and Oklahoma, led to a U.S. Supreme Court case that involved the extensive use of expert witnesses in fields such as geology, geography, and ecology. What began as a dispute between the two states soon became a multisided controversy involving those states, the federal government, Native Americans, and individual placer‐mining claimants. After the federal attorneys introduced scientific experts into the dispute, including the (...) plant ecologist Henry Chandler Cowles and the geographer Isaiah Bowman, fresh from negotiations at the Paris Peace Conference, Texas attorneys fielded their own team of opposing experts. Charged with the task of determining the location of the border, defined as the south bank of the river at the time of the 1819 treaty with Spain, the scientific experts presented the court with volumes of evidence and elaborate arguments, much of it contradictory and involving creative interpretations of existing theories. The case exhibited all the now‐familiar features of a trial using expert witnesses, for which it represents an early, overlooked, and particularly complex example. (shrink)

When the borderline cases of art occur in non-art categories, the debate of artistic status arises not only with regard to the individual cases but also with regard to the category to which they belong. The identity of the individual case tends to be defined in connection to the category it belongs to. It tends to formulate that, if the individual case is art, then the entire category is also art, and if the category is not art, then the individual (...) case is also not art. Such a view inevitably hampers the artistic status of works arising from the non-art categories. This article argues that the individual cases and their belonging categories need not be strictly interlocking and that they could possess multiple identities depending on the context that they are present. Thus the point shifts from whether the case is or is not art in its absolute sense to ‘when’ is it art. (shrink)

El representacionismo defiende que el carácter fenoménico de la experiencia queda completamente determinado por su contenido intencional. El representacionismo es una teoría muy atractiva dentro del proyecto de naturalizar la consciencia según la hipótesis de que la relación de representación puede a su vez ser naturalizada. Para este propósito, los representacionistas con inquietudes naturalistas acuden normalmente a teorías teleosemánticas del contenido mental. No se ha prestado, sin embargo, demasiada atención a la interacción entre el representacionismo y las teorías teleosemánticas del (...) contenido mental. Este artículo da razones para pensar que tal interacción no es venturosa. En particular, argumentaré que aquellos que abrazan la conjunción de ambas teorías están comprometidos con la existencia de experiencias imposibles. (shrink)

Representationalism maintains that the phenomenal character of an experience is fully determined by its intentional content. Representationalism is a very attractive theory in the project of naturalizing consciousness, on the assumption that the relation of representation can itself be naturalized. For this purpose, representationalists with naturalistic inclinations typically appeal to teleological theories of mental content. Not much attention has been paid, however, to the interaction between representationalism and teleological theories of content. This paper will provide reasons to think that such (...) an interaction is not felicitous. In particular, I will argue that those who endorse the conjunction of these two theories are committed to the existence of impossible experiences. (shrink)