borderline personality used to (and still does in some quarters) inspire an avoidance reaction in clinicians and in other members of the public.

how come?

people with borderline personality disorder often experience themselves as living on an emotional roller-coaster. happy and bubbly one minute, angry and hostile the next, in an intense state of distress the next minute.

people with borderline personality disorder often experience themselves as clinging to people one minute, and shoving them away hard the next.

precisely the things that make it hard for the borderline to live with themself can make it hard for other people to live with them.

people with borderline personality disorder often present in intense and extreme emotional distress. they can be the most active help-seeking population. since they often don't know how to regulate their own emotional responses they attempt to obtain emotion regulation from others. this can often manifest as the person pleading for help (i'll feel better if only you don't leave me etc) and in the person believing that others have the power to help them feel better without their understanding that they need to take responsibility for their own emotional responses. this is partly because the person with borderline personality disorder often doesn't know how to regulate their own emotional responses, but it can manifest as an ultimatum: if you leave me i'll have to kill myself, but if you stay then i'll feel better (for example). this can lead to other people feeling manipulated by their demands.

borderline personality disorder isn't as readily managed / controlled by medications as other disorders. this can lead to biologically / medication minded clinicians wanting to pass them on to someone else... people with borderline personality disorder typically aren't very validating of others attempts to help them (a person may rage at their clinician for not alleviating their distress - believing that the clinician would help them if only they knew how bad it was - even though the clinician has been racking their brains as best they can for a medication that is likely to help).

clinicians often used to report that they felt manipulated by their borderline clients. a couple of coping strategies that tend to be employed by borderline clients make it hard for clinicians to deal with them. SPLITTING - a person can swing between idealising their clinician (best doctor in the world) to devaluing their clinician (berrating them for their stupidity / ignorance / uncaring). PROJECTIVE IDENTIFICATION - attempts to induce their (distressing) emotional state in other people because the person thinks that if only they feel it too then they will help them.

it doesn't feel very nice to be the object of borderline rage / demands.

borderline personality disorder used to be a diagnostic dumping ground for patients who seemed to deteriorate despite their clinicians attempts to help them. 'borderline' accompanied by the rolling of eyes was a way for clinicians to indicate 'don't go there' to their colleagues.

more recently theorists such as Linehan have emphasised that borderline personality arises as a response to an invalidating environment. Linehan offers non-judgemental descriptions and explanations of borderline behaviours in an attempt to help clinicians like their borderline patients. she really had done wonders for the disorder (and for people with the disorder).

times are a-changing... but not really for old school biologically / medication focused psychaitrists