This paper presents a synthesis of content and assessment of the methodological rigour of published literature related to concepts of emotional pain and distress in women with a diagnosis of borderline personality disorder (BPD). In the past two decades, there has been an increase in research about the prevalence of BPD, interventions, and relative effectiveness of various forms of treatment. However, there are few studies regarding emotional pain and distress in women with BPD. Emotional pain has been reported as an adaptive response to repetitive traumatic experiences in childhood. Searches of the EBSCO host, OVID MEDLINE, CINAHL, and PsycINFO databases were carried out using the following search words: borderline personality disorder, emotional pain, distress, self, suffering, women, for the period 1996-2006. Fifteen papers were assessed for methodological rigour, followed by the analysis of the concepts of emotional pain and distress. Three themes emerged from the literature, the emotionally abused and neglected child; struggling with emotions leading to self-injury; and social problems related to difficulties regulating emotions. A high prevalence of reported childhood abuse was revealed. Emotional pain was described as intense for women suffering from BPD. A further synthesis of research findings is recommended to provide information on the effectiveness of interventions.