The diagnosis Borderline Personality
Disorder is likely to evoke associations in mental
health professionals of threats of or enactments of self harm,
demands for admission to the psychiatric ward (the ‘brick mother’)
and above all, frustration and irritation, often borne from a
feeling of therapeutic helplessness or inadequacy.
The word borderline conjures a
boundary between territories on a map and if one thinks of the mind
as a country, the patient who occupies that land cannot find a
secure place in which to live. No territorial boundary in the
country of the mind will be respected as they search without a map
or a compass, randomly roaming in a longing for an idealised place
in which they will find freedom from mental pain.
The professional who encounters and is drawn
into the world of the borderline patient will be invaded, and will
be occupied by an unseen unconscious enemy they did not see coming
who seeks to colonise the country of their mind.
The unconscious experience of becoming part of
the borderline experience for the professional is emotionally
bloody and messy. Any clarity of purpose or therapeutic strategy
will be destroyed in favour of a feral conflict in which rules play
no part and primitive instinct, of nature red in tooth and claw,
governs the game.
Without knowing quite how and often against
their will, the professional is drawn into a level of primitive
emotional functioning they may not initially recognise but as they
do see who they have become they will witness echoes of formers
aspects of themselves which can cause shame, guilt and
This regressive emotional echo in the
professional may be of feelings of disgust, retaliation, dread or
perhaps excitement and desire but the emotions felt will invariably
cause a conflicted wish to conceal what is happening, leading to a
mute withdrawal in which silence hides a shameful secret. This is
the dangerous professional equivalent of keeping mum.
I use the pseudo-diagnostic term
Borderline Professional Disorder to describe the
professional emotional experience of being disturbed by and
mirroring the borderline whose primitive processes resonate in
professionals and evoke shame in their being reminded of parts of
them selves they sought to forget or undo in their helping
The cartoons which follow are based on
psychoanalytic ways of thinking about the transference and
counter-transference experiences of being with and trying to
understand some of what is happening unconsciously that leads to
the experience of being disturbed.