Giftedness and psychological abuse in borderline personality disorder: Their relevance to genesis and treatment

This clinical study of 23 borderline outpatients and 38 outpatients with other personality disorders provides evidence that individuals who become borderline frequently have a special talent or gift, namely a potential to be unusually perceptive about the feelings of others. We postulate that this talent is derived from an innate characteristic rather than simply arising from early environmental influences. We also present evidence that chronic, severe, pervasive psychological abuse, or 'mind abuse,' is the most frequent and significant form of caretaker abuse (vs. sexual or physical) in the childhood histories of this disorder. Our data support the hypothesis that the interaction of a child's gifted characteristics with this abuse creates a tragic drama that is etiological for BPD in a substantial number of cases. We propose that the abuse markedly perverts not only use of the perceptual talents (e.g., powerfully compelling projective identification) but overall psychological development. We discuss how these issues are relevant to the conduct of effective therapy.