The Role of Incest in Developmental Theory and Treatment of Women Diagnosed with Borderline Personality Disorder

The incidence of incest in the histories of women diagnosed with borderline personality disorder (BPD) has been noted recently by a number of clinicians (e.g., Barnard & Hirsch, 1985; Herman, Perry, & van der Kolk, 1989). However, the experience of child sexual abuse is virtually ignored in the developmental theory of the borderline syndrome. This paper presents a critical review of theoretical and clinical literature on child sexual abuse and BPD to explore three major goals: to describe the overlapping clinical picture of adult female survivors of incest and of women diagnosed with BPD, to examine the ways in which mother-blaming in psychoanalytic thought has contributed to the neglect of this experience in borderline clients, and to integrate treatment strategies from the child sexual abuse literature, traditional object relations theory, and feminist clinical theory.