The inside without and the outside within: a philosophical, developmental and clinical study of borderline experience

2017-02-06T06:15:39Z (GMT) by Cammell, Paul
This work is a multidisciplinary project that explores the “borderline” concept as it is adopted in psychological, psychiatric and psychoanalytic theory in notions of “borderline phenomena”, “borderline personality organization” and “borderline personality disorder”. I argue that usage of the borderline concept has become overburdened by ethical ambiguity and a lack of conceptual clarity because prevailing theories focus upon approaches that are excessively individualistic, categorical, intrapsychic, and atemporal. I argue that the borderline concept has become a problematic limit concept that requires an interpretative framework of elucidation to understand how it is applied in developmental theories and clinical work. I choose to see the borderline concept as arising in a culturally and historically determined context that has constituted borderline experience as something that is problematic (conceptually and ethically) for suffering individuals and clinicians alike. My methodology firstly involves the philosophical elaboration of a hermeneutic ontological approach to understanding this developmental and clinical field. In the first “philosophical” section of the project, I describe the philosophy of Martin Heidegger, and explore and elaborate how his philosophical approach was developed or advanced by a group of philosophers who followed him within a certain philosophical tradition. I develop this hermeneutic ontological orientation as an open framework developed in terms of four themes, those of relationality, temporality, embodied affectivity and technicity. In the second “developmental” section of the project, I advance this orientation by considering development in terms of those four hermeneutic ontological themes, engaging with a group of psychoanalytic theorists, before I critically analyse what several prevalent contemporary theories uphold as the developmental determinants of borderline personality disturbance. And in the third and final “clinical” section, this orientation is further advanced in terms of those four hermeneutic ontological themes by elucidating clinical approaches to borderline disturbance where many of the ambiguities which pervade this clinical field, often related to the use of broad and ambiguous concepts such as dissociation, self, trauma and abuse, are arguably overcome. The central methodology of this project is to elaborate an interpretative framework originating from Heideggerian philosophy and referred to as a hermeneutic ontological orientation. Not only do I attempt to historicise and critically appraise the borderline concept and other implicated concepts, but I also attempt to contextualize them within a more open and complex field of understanding that favours approaches to interpretation that focus upon the fundamentally relational, temporal, embodied, affective and technical aspects of our existence. Throughout my study I aim to enhance the developmental and clinical understanding of individuals presenting within the context of borderline experience whilst avoiding the various forms of closed, reductionistic or objectivist forms of understanding I have critically engaged.