Abnormal bodily experience in borderline personality disorder: Clinical issues and psychopathological perspectives

Borderline personality disorder is one of the most controversial disorders in the contemporary psychopathological scenario. Despite its prevalence both in clinical settings and in nonclinical ones, BPD is far behind other major psychiatric disorders in awareness and research, remaining strongly stigmatized by mental health professionals themselves who want to avoid situations that are di cult to manage. Several consequences result from this “sidelining”. The most serious one is that still little is known (or, rather, there is still little consensus) about BPD core psychopathology and its related neurobiology. This theoretical and clinical gap becomes particularly evident when a speci c issue in borderline psychopathology is investigated: the bodily experience. This paper aims to ll the gap by presenting an overview on the topic. Through a review of recent literature conducted by narrowing down the search to PubMed articles published in the last ten years, we rst describe the multifaceted abnormal bodily experience of borderline patients and then propose a key for understanding it. Some controversial points emerge from our search: a) Bodily experience in BPD is very complex and can manifest itself in di erent forms (i.e., self-harm and suicide, pain paradox, somatic symptoms and related disorders) and contexts (i.e., psychiatric and medical settings); b) Bodily experience in borderline patients has been little investigated over time; c) The existing literature on bodily experience in BPD is somehow “biased”. Each of these points is discussed in detail and an attempt to organize all these data in a psychopathologically meaningful way is finally proposed.