- Mark L Ruffalo: Assistant Professor of Psychiatry, University of Central Florida College of Medicine; Adjunct Instructor of Psychiatry, Tufts University School of Medicine.
Borderline personality disorder is a disorder marked by a pattern of contradictory, paradoxical, and self-defeating behavior, yet the communication methods of patients with the condition have remained largely unexamined since the disorder was first described nearly a century ago. This article applies communication theory to the study of borderline personality disorder in an attempt to understand patients' characteristically paradoxical modes of relating. Three types of double-bind communications are examined-the "be spontaneous" paradox, the covert contract, and the Kafka trap. The potential psychodynamic mechanisms and interpersonal effects of double-bind communication in patients with borderline personality disorder are briefly explored.