Heads I win, tails you lose: Interpersonal aspects of borderline personality disorder.

Since borderline personality disorder was identified as a distinct psychiatric syndrome in the 1970s, it has been recognized as a disorder marked by disturbance in interpersonal functioning. Understanding the borderline patient's characteristic modes of relating to self and others is therefore of significant theoretical and clinical importance. This article seeks to examine multiple facets of borderline personality disorder believed to contribute to interpersonal dysfunction, including: common communication patterns observed in borderline patients, such as double-bind communication; the primitive or paleologic thinking that results in misperception of benign interpersonal phenomena; and the destabilizing effect of a persistent pattern of stimulation and frustration (idealization and devaluation) on human relationships. This discussion of communication dilemmas and paradoxes is believed to represent a novel contribution to the literature on borderline psychopathology. It is argued that a broader recognition of these psychodynamic processes will yield improvement in psychotherapeutic models and treatment of this severe and disabling disorder.