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March 1970

Characterological Problems: The Need to be Helped

Arch Gen Psychiatry. 1970;22(3):245-251. doi:10.1001/archpsyc.1970.01740270053007

CLINICIANS are constantly faced with the seemingly increasing number of patients who do not fit current diagnostic categories. These patients, instead of presenting definitive symptoms, confront the psychiatrist with vague ill-defined complaints. The latter usually consist of distressing general questions such as who and what they are, and what the purpose of their life is, ie, where they fit into the general scheme of things. Some authors have referred to such reactions as existential crises, and Erikson1 has described an acute variety of this type of disturbance as the "identity diffusion syndrome" which occurs in some adolescents.

I will not attempt any further diagnostic categorization. This would be a difficult task that has been discussed by many authors. Suffice to mention here that Knight2 very early called attention to this group and coined the term "Borderline Syndrome." Since then there has been much discussion