Within the domain of personality disorders, borderline personality disorder (BPD) has attracted the greatest attention. The literature devoted to it is more voluminous than that devoted to any of the other recognized personality disorders. This attention and large literature has more to do with the challenging nature of the condition and the difficulties attendant upon treating it, than to its frequency.

Clarify the gradual aims through psychotherapeutic work with a borderline patient. Expose the advantages, characteristics and objectives of the psychotherapeutic approaches used in BPD treatment.

A non-systematic literature review was performed in PubMed about psychotherapy and borderline personality disorder. Only original articles in English language were included.

There are currently three major psychotherapeutic approaches to the management of BPD: the psychodynamic, the cognitive-behavioral, and the supportive. There are special varieties within each: e.g., transference-focused psychotherapy (psychodynamic) or dialectic behavioral therapy (cognitive-behavioral).

Though differing in basic conceptions and in methodology, all approaches aim at the amelioration of both the symptom-aspects that dominate the clinical picture at the outset, and the personality difficulties that remain apparent after the symptoms have been alleviated.

Under ideal circumstances, the borderline patient will have evolued gradually toward a higher level of function, where (acute) management issues have been adequately dealt with or have receded into the background. Psychotherapy, individual and group, becomes the dominant intervention, with such goals as psychic integration, skills training, and the fostering of long-range ambitions relating to friendships, partner choice, and work.