There are subsets of patients whose presentations elude a precise diagnosis. All diagnoses are asymptotic to nature as they are constructs imposed on the world. Nonetheless, a greater degree of accuracy and precision is possible and beneficial for most patients. This is particularly true for patients with borderline personality organization (BPO) who present with psychotic symptoms. For the purposes of avoiding a misconstrual of the meaning of psychotic experiences in these patients, a brief synopsis of borderline personality organization, in contradistinction to borderline personality disorder, may prove to be of some clinical utility. The BPO construct presciently anticipates the trend toward a dimensional model of personality disorders and has the potential to enrich and inform these developments.