Borderline personality disorder: from understanding ontological addiction to psychotherapeutic revolution

Eur Arch Psychiatry Clin Neurosci. 2020 Dec;270(8):941-945. doi: 10.1007/s00406-019-01029-6. Epub 2019 Jun 4.

Abstract

Bypassing a reductionist view of existing diagnostic categories, ontological addiction theory (OAT) is a new psychological model of human functioning. Borderline Personality Disorder (BPD), defined as "a pattern of instability in interpersonal relationships, self-image and affects, and marked impulsivity", is not only common (up to 20% of psychiatric inpatients), but also strongly associated with suicide attempts and death by suicide. Therefore, BPD constitutes a major public health concern. As a consequence of an underlying condition of ontological addiction, self-harming behaviors can be conceptualized as addictions, suicidal acts reflecting an experiential avoidance strategy against unbearable psychological pain. The present paper aims at: (1) understanding BPD daily life experiences from the perspective of OAT; (2) offering psychotherapeutic perspectives for this mental disorder. The diagnostic category of BDP may be understood as a simple label reflecting several extreme types of manifestations resulting from the Self-grasping ignorance that underpins ontological addiction. Therefore, development of psychotherapeutic interventions targeting ontological addiction appears to be a promising future direction.

Keywords: Affective disorder; Borderline personality disorder; Dimension; Ontological addiction.

Publication types

  • Review

MeSH terms

  • Behavior, Addictive / physiopathology*
  • Behavior, Addictive / therapy
  • Borderline Personality Disorder / physiopathology*
  • Borderline Personality Disorder / therapy
  • Humans
  • Interpersonal Relations*
  • Object Attachment*
  • Psychotherapy*
  • Self Concept*