Hysteria and Borderline Disorder: Similarities and Differences

The borderline disorder is at the center of a thriving debate, in psychoanalytical circles: especially in Anglo-American influenced environments, there is a tendency to ascribe some specificity to the borderline disorder, while in French and often Lacan-inspired circles the tendency is to consider the disorder as a variation within the wider spectrum of hysteria.

In this short contribution, I would like to put forward some elements for discussion; elements that would allow for a better evaluation of the similarities and differences between the two clinical frameworks.  Without a doubt, they have many overlapping traits

Both frameworks are characterized by a deep sense of foreboding pervading all relations. There is a continuous and restless quest for a sort of aggressive dependency, a spasmodic swaying between idealisation and devaluation of the other, a tendency to action, to impulsiveness, a constant overwhelming ambivalence at all levels.

In both frameworks we can see dangerous behaviors of both pharmacological and sexual nature.  But it is anyway possible to make some distinctions.


In hysteria, the dominant theme is the person’s own sexual being.  The hysteric seems engaged in the spasmodic questioning of their own sexuality: “is it more masculine, feminine, is it unstable, is it acceptable, has it got something about it that makes it incomplete or even monstrous?”

These doubts could be read in the framework of castration; of lacking, and therefore of the restless quest for compensation, that brings the hysteric to swaying endlessly between the sense of being everything and the sense of being nothing.

All of this happens at a sexual level and can be connected with early sexual experiences, often traumatic in nature, where sex was denied and glorified at the same time.

The denial of sexuality resulted in sex being felt as belonging in an idealized realm, with the effect of an alternation between having everything and having nothing.

In the case of glorification, the same early traumatic sexual experience that put sex in the foreground, would trigger mysterious and inaccessible characters, where horror and fascination got inextricably intertwined.

So the hysterics continually ask themselves what kind of sexuality they have and what recognizable character it has.

From there emerges the spasmodic need to seduce, to be liked, to provoke a total attraction, as if in an extreme and all-encompassing vortex, that could finally provide peace. ‘I am liked therefore I am’ could be the motto of hysteria.

But in this compulsion to seduce, to be liked, to trigger in the other an all-encompassing and almost annihilating desire, hides a fundamental desire to immerse themselves, along with the other, in an undifferentiated sea, that would finally placate the anxiety of being something, sexually.

We can understand why depression is always around the corner: the refusal from the other is not perceived as being abandoned but as a reaffirmation of the fact that they are nothing, that their sexuality is shapeless and undifferentiated.  “If I am not incredibly beautiful, I am not alive!”; “If I am not the siren who attracts all men in her abyssal sea, I am the one to fall in the same abyss I want to drag them into!”

In the borderline patient, the problem does not concern sexual life but life in general.

In the history of the borderline patient, the recurring trauma can be described as an attack on existence. The borderline patient is not questioning sexuality but death itself.

The traumatizing act does not destabilize my sexuality but triggers a sense of complete impotence, lack of defense, of deathly and unbearable passivity.

We can imagine the whole borderline life as an attempt to bear this impotent passivity, turning it around: if I attack you, I feel active and alive, rage makes me come back to life.  If I do not attack you, I stay in your power and you can dispose of me as you please.

If at the basis of hysteria there is the deep depression of not being sexually defined and therefore of feeling abandoned by the other who does not give one recognition in this sense, at the basis of the borderline existence there is a distressing and painful sense of being prosecuted.  “Everybody can hurt me, everybody did hurt me, everybody will hurt me!”

It is not therefore the organized delusion of the paranoid, but a sense of persecution that is diffused and pervasive and that is identified with life itself. This helps us in therapy.


We must help the hysteric to stop mixing up the need for love with the desire to blind the other with his/her light.  What the hysteric wants is not only love, but the total and annihilating love of the blind, of the charmed, of the hypnotized.

The siren charmed the sailors, Circe and Calypsos charmed Ulysses, they depersonalized him into a fantasy of total absorption in their beauty.

The very difficult job of the hysteric is to renounce the desire to blind and instead to enter a love that has limits and pitfalls; the river flows, it doesn’t need to be in full force all the time.

It’s a difficult and long task, full of depressive traps, but this is the real cure for the hysteric.  In the borderline patient, the problem is different.


The rage that accompanies passivity moved away from the frustrating other to occupy the whole of the world. This furious and desperate rage is not perceived as rage but as anxiety, uneasiness, angst.

Here, therapy involves trying to give limits to this tendency toward universalising; to including the world and themselves in the rage and the hatred.

Therefore the history of the borderline patient is important: not only the past but also the present.  To fence the rage limits masochism and the tendency to a sort of general philosophy of hatred and destruction.

There is no doubt, anyway, that hysteria and borderline disorder do overlap in some areas.

If both are connected with traumatic experiences, sexual in the case of the hysteric and vital in the case of the borderline, there is no doubt that in some cases the sexual trauma could be experienced as an attack on life itself. Vice versa, the attack on psychic life, that characterizes trauma in the borderline patient, can be eroticized and therefore touch vast areas of sexual life so that the doubt about one’s own sexuality can be perceived as being able to put into question one’s whole life.

Our basic suggestion is that considering the destruction that we have described could help the therapist to understand the main core of the theme and act consequently.


Published by I.S.A.P. - ISSN 2284-1059