To help my non-recovery oriented colleagues understand the stigma/resentment associated with ‘borderline personality disorder,’ I simply mention this: “Let’s say I call you and say, ‘Hey, I’ve got a referral for you. She’s been diagnosed with borderline personality disorder . . .’” I need to go no further; without fail, my colleague will smile or laugh. We both know that such a referral is a no-no, so much so that it doesn’t even have to be mentioned; it is a given.
Irvin Yalom, at a recent APA division conference, was asked if he continues to work with clients. He responded with something to the effect of, “Well I am not taking any borderline clients.” The audience exploded with laughter. From celebrity to average clinician, it is known that ‘borderline’ people are to be avoided. But wait, it’s not just professionals in the field. A simple Google search for ‘borderline personality disorder’ gets more than 248,000 hits. There are countless best-sellers on Amazon dealing specifically with the ‘disorder.’ The vast majority of the books out there, as a matter of fact, aren’t even for clinicians. Most of them are about how to live with (or otherwise be with) someone afflicted, or how to accept that you’re the one with the disease and how to get proper professional help.
There’s even a Borderline Personality Disorder for Dummies, the presence of which is either funny or sad . . . we can’t decide. Despite the spectacular array of books on the topic, it’s interesting that all of them adopt a consensus on what the disease is and where it comes from. They know, therefore there’s no reason to continue thinking about it other than to figure out how to either overcome the disease or to live with someone who has it. People who had been diagnosed ‘borderline’ have come to see us for years. Our experience of working with these people, somehow, didn’t vibe with the body of literature on the topic.
First of all, why is there so much negativity towards people diagnosed as ‘borderline’? Is it because clinicians are heartless, vindictive people? Certainly, there are some of those, but there are some of those folks in every profession. The vast majority of them, we suspect, did not get into the field to mete out cruelty upon their clients. What is it that they’re being taught that leave them so guarded?
Second, we just don’t buy that psychology and psychiatry know all that many facts about the workings of the mind. Don’t get us wrong, we think they have probably discovered quite a bit that has been beneficial, even life-saving, to countless people in the last (roughly) 100 years. But human experience is complicated, having many interacting facets and features, all of which interact in dynamic and ever-evolving ways. The field has learned a lot, but the majority of the information doesn’t represent anything like a mathematical fact. When people in the field take things as facts, we get a little concerned.
For brevity’s sake, we’ll stick with these two questions. To answer the first, let’s look at what is in the literature about ‘borderline personality disorder.’ It is considered an unremitting, debilitating biological disorder characterized by lack of empathy, being unable to adapt or grow personally, fostering vicious relational cycles, clueless as to their toxic impact upon others, severe impairment in sense of identity, impoverished sense of self, instability in regards to goals/aspirations/values, intense and conflicted close relationships, mistrustful, being emotionally unstable, generally negative, nervous, tense, anxious, depressed, antagonistic, fearing rejection, depressive, disinhibited (impulsive/risk-taking), having transient psychotic episodes, and one or many forms of self-destructive behavior . . . chronic suicidality . . . the list goes on.
By some estimates, the diagnosis is given to women 75% more than men. Theodore Millon, perhaps the world’s leading expert on personality disorders, describes four subtypes of BPD: discouraged, petulant, impulsive and self-destructive. Upon reviewing the criteria, we don’t suspect that most people would want to meet this woman. She sounds like trouble. Moreover, she sounds dangerous. Her chaotic behavior, effecting emotional storms, devouring attention, erratically putting her and others at risk reflects something more like a feral creature than a human person. No wonder people are afraid of them. This has to be one of the most stigmatizing and dehumanizing diagnoses in the DSM. It made sense to me that such a damning diagnosis must have a significant history and, indeed, it does.
Which leads us to the second question. Is this diagnosis as distinct and clear-cut as the DSM purports? Of course not. What is presented by psychology and psychiatry as a distinct diagnosis is really a social construct, the product of many years of beliefs about the (perceived) feminine gone awry. It is not just this, but is also the result of developmental stress and/or trauma. Said differently, what is deemed ‘borderline personality disorder’ is really a person with developmental stress and/or trauma in his or her background set against the context of a cultural history of the ways our culture has thought about women. Far from being biologically rooted, we have all of the data we need to now say that the cause of what is labelled as psychiatric disturbance is a function of early stress and/or trauma. Moreover, we now know that many real physical diseases are also rooted in the same causes. This is found most convincingly and recently in the Adverse Childhood Event (ACE) Study, which is consistent with a large body of research preceding it. And this applies to both men and women.
As an addendum to this idea that trauma can lead to all types of distress, we would like to make something important clear here. Trauma does not have to be a catastrophic event or a series of dramatic events happening over time. When we mention trauma, we mean any sort of experience that renders a person helpless, unsafe or otherwise finding themselves in highly unpredictable circumstances. Traumas are events that make apparent that – on some level, in our daily lives – we don’t have control over of what happens to us. And when people have experiences that really bring this truth about human experience to light, it can lead to major distress.
If so-called ‘borderline personality disorder’ symptoms are really responses to an unpredictable and perhaps unsafe environment then the real shame of it is that we are stigmatizing people that disclose the pain of our human world. We are judging people who have sensitive dispositions and absorb the world around them; people who are essentially struggling with basic life issues. And as a system – the mental health system – that sort of prides itself on exploring human behavior without judgment, this is a failure — not on our client’s part, but on the part of professionals and systems that are supposed to be caring for them.
And THIS is the real shame.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.
Yes! Thank you for this. I have found that even in the “peer” movement or “recovery” movement or however else we’ve decided to describe those of us that are empathetic to the pain of psychiatric labeling, that we too are discriminatory towards those of us who have been given the label “borderline.” Due to my many trips to and journeys within the mental health system, one of my psychiatric labels is “borderline personality disorder,” with my chief “symptom” being “chronic suicidality.”
But why am I “chronically” suicidal? What trauma, what pain might cause such a “symptom”? Perhaps because I am so raw and attuned with the suffering of the world, that I play it back within myself tenfold. But supposedly, my kind lacks empathy. Perhaps the only empathy I lack is with those who would be so callous as to laugh at my suffering, and refuse to lend their own empathetic ear and help.
But that help, I can do without. So perhaps we are all better off, us borderlines, avoiding the mental health system altogether. Perhaps even us more than others.
Thanks, Melodee! I have had a similar experience in the ‘peer’ / ‘recovery’ movement. It seems that the stigma and anger towards this specific label isn’t restricted to the fields of psychiatry and psychology. It is also no accident; it arrives to us as the logical outcome of a long-established history. I outline a lot of this in the book. Anyway, I am glad you enjoyed this article!
If anger is a response to those in need, what personality disorder resides within themselves? If laughter is a coping response, what disorder exists within them? I’m sickened by the article in general. I am glad people find feeling validated by it…..if that helps them.
“But supposedly, my kind lacks empathy.”
Yeah, I love that one. Because behaviour=mental state in the world of psychiatry. They can’t distinguish the two. They can’t understand that empathy is actually a double edge sword – too much of it is bad for you when you’re surrounded by hostility and abuse. Because a very empathic person actually takes in emotions from others and expresses them as their own and it’s often hard to control.
Has it ever happened to you that you got angry or sad or in a very good mood for no reason just going into a room with people? For no reason other than the atmosphere in this room was such? And that it’s so overwhelming that even when you know it’s not your feeling (or rather they were not coming from your experience or internal state directly but from others) you can’t help but feel this way and even act on it? And you end up even more angry or sad or happy than everyone around you?
These people have no idea what they’re talking about. They are trying to tell you how you think and feel and have no clue and this is the worst insult of them all.
I don’ know about all people labelled BPD but I’m sure many of them are actually super empathic people who had the misfortune to grow up or otherwise been exposed to toxic social environments and have ended up with socially unacceptable coping skills. Just like “schizophrenics” and “chronically depressed” and all other idiotic categories.
It is more likely to be the labeler who is lacking in empathy. “BPD” is usually a fancy way of saying, “I don’t like being around her very much.”
Well, I go a BPD label and when I told my friends about it they laughed the idiot who gave it to me out of the park. I was told by a friend of mine I’m the most empathic person she knows. I’m happy I have friends like that because even though I knew it was bs I was still getting this subconscious feeling of being an evil person and wondering if maybe I am the abuser while the whole world around me (except for “professionals”) seemed to realise that it was not the case, quite the opposite. Yet they almost managed to convince me. I feel for all these poor souls who don’t have great friends like I do and who never heard them say “these people have no clue about who you are and this is not your fault”.
“We are judging people who have sensitive dispositions and absorb the world around them; people who are essentially struggling with basic life issues. And as a system – the mental health system – that sort of prides itself on exploring human behavior without judgment, this is a failure — not on our client’s part, but on the part of professionals and systems that are supposed to be caring for them.”
THANK YOU. THANK YOU. THANK YOU for this essay.
As Judith Herman said, “Borderline personality disorder is… little more than a sophisticated insult.” A well-written piece that speaks of the damage done to already wounded and fragile souls, when slapped with incredibly pejorative label.
I am thrilled that you enjoyed this, Meaghan! The label, perhaps more so than the others, really adds a layer of ‘insult’ on top of already very traumatized people.
I am sorry to say that Meaghan using the word “fragile” is just more labelling. It has a hopeless feel to it.
Pretty sad to see that people just feel sorry for others, and yet unconsciously subscribe to “certain personalities”, “certain symptoms”
There are a lot of attitudes out there that are damaging, psychiatry plays one part
Borderine has been called, “A sophisticated insult.”
I think it used to be called Hysteria.
People with these diagnosis have usully suffered gross childhood trauma and the label is used to demean and ignore tramatised people. Irvine Yallom is saying that he does not want to try to help, or be around, seriously traumatised people. That would be like a plumber saying, “I fix dripping taps but I don’t do unblock toilets – it’s too messy and I don’t like going in smelly houses.”
“A sophisticated insult.”
It surely is.
It absolutely is a sophisticated insult, in much the way that hysteria was. Borderline is the new hysteria. We always seem to need a diagnosis that tells women how damaged, and damaging, they are.
It’s great that you both already see where the thread goes — from BPD back into a long-standing history of hysteria. The history behind what exists today as ‘Borderline Personality Disorder’ is sophisticated, fascinating and tragic.
Psychiatry does not want to deal with anything that results from trauma. Perhaps because so few psychiatrists have dealt with their own “stuff” they don’t want to deal with traumatized people because it stirs their unresolved and unworked “stuff” and they don’t like that at all. Rather than admit and look at their own issues that need work, they over-react and malign people with the BPD label, assuring that no one will deal with them.
Or they are abusers themselves. Or if they recognise trauma as trauma they have to actually DO something like report stuff to police etc. Better to blame the victim and put them through years of pointless and harmful “therapy”.
And if they don’t go around physically abusing people, they are psychologically abusive to the people in their care. Out of the four psychiatrists who worked on my case two were absolutely emotionally and psychologically abusive in the way that they dealt with me. Both men sat there with ugly looks on their faces as they literally raised their voices and screamed in my face! All I could think of at the time that each of them behaved in this manner was, “If this is good patient treatment I don’t think I need any of it!” One of them screamed at me that I was stupid because he asked me how I was and I told him not so good because I’d received news the day before that my sister had been murdered and this made me feel like the world was coming down around me! He actually sat there and screamed, “THAT’S STUPID!” At that point I realized that I was not the one with the real issues at all. And this man was allowed to “diagnosis” people with the bologna labels and prescribe drugs as treatment. What a farce. The second guy screamed at me because I didn’t agree with everything that he said. Go figure. Out of the two that were not abusive, one was a good man and the second was very coercive, all done while smiling the entire time.
Yes, you are right when you say that many of them are abusers themselves. All in all, very few of them are willing to do anything at all for trauma survivors, other than fill them to the gills with the drugs.
“And if they don’t go around physically abusing people, they are psychologically abusive to the people in their care.”
Yeah. The whole process of “diagnosing” me was abusive and from everyone I’ve talked to. They insulted me, my family, tried to make me believe my friends are not really my friends, tried to tell me I’m a narcissistic and unempathic person etc. Because they wanted me to fit a diagnosis and when I refused to conform with it or even got upset (how dare I) they added oppositional and antagonistic and a few other adjectives. Never figured out that most of it was specific for them – because I didn’t trust THEM and didn’t want to cooperate with THEM and was nervous around THEM.
But hey, the good thing is now I know how it works and I am proudly anti-psychiatry.
” Out of the two that were not abusive, one was a good man and the second was very coercive, all done while smiling the entire time.”
Well, I’d call the second abusive as well. Actually the worst abuse usually comes with a smiley face and cold eyes and I’ve seen “doctors” like that too in my hospital. I wonder how many of the psychiatrists themselves “lack empathy”.
In my psych grad program, we were assigned to watch Fatal Attraction as an example of BPD, and then we had a class discussion about it. It’s one reason I began to seriously question this field, and chose instead to follow another path. I find it to be a terribly demeaning distraction from what is relevant and humane, and simply used as a tool for ‘othering.’ It seems so much like blatant projection to me, pure judgment and fear. Over the top.
Oh, and this was the most interesting part–it became the favorite and foremost ‘put-down’ among my ultra-competitive fellow-students. “I think he/she is borderline,” usually uttered with good dose of snarky. It certainly was not confined to one gender over another.
I agree Alex…and why it is ‘Fatal Attraction’ that is shown in countless universities to undergrad and grad students is beyond me. It somehow has become the penultimate film on the topic. I think this only shows how little is known about this and similar forms of distress. Anyway, thanks for your comment!
Indoctrination, programming, brainwashing, manufacturing stigma, via stereotyping behaviors.
Most “psychiatric patients” have been insulted in so many ways that it the distinction between a “crude” insult and a “sophisticated” insult has lost its meaning. Let’s face it, women, their concerns and their thoughts are still marginalized by so-called professionals, whether it is expressed in terms of a Borderline diagnosis, an addiction, or simply characterized as a low level, unimportant concern that needs to be dealt with using as little energy and verbiage as possible. The voices of the women themselves are the ONLY ones that matter with regard to these issues; and, this is the last semi-professional article I will be reading on this, or any similar subject.
clearest thing I’ve read all week.
The only thing I’d add is that Lucy Johnstone’s article on alternatives to diagnosis, on this website, proposes Formulation, which simply involves asking people what thier problems are, what caused them and what might help. This is then agreed between the patient and the professional. It highlights and puts at the core of any professional work the person who is distressed voice and is no more than what anyone should do when trying to help someone who is distessed.
Glad you liked it, John. I appreciate too your mention of Lucy’s piece. That is the way to go, at least in my opinion. There’s absolutely no reason to have labels whatsoever. It is entirely possible to simply stick with someone’s own description of where he or she is ‘at’ and what he or she is asking for. This and similar avenues are what I try to present towards the end of the book. I am grateful to a number of different non-psychiatric organizations for allowing me to publish them as resources. Anyway, thanks again!
DSM is called the “Book of insults” for a reason. Also the psychiatric diagnosis is essentially an assembly of pejorative epithets. I was stunned when I read my hospital documents: it was nothing more but a list of adjectives each denoting how much of a screw up I supposedly was (most of them also showing that the people involved didn’t understand or care to understand why I said or did a particular thing – everything was described as a pathology).
These diagnosis are a bunch of crap and it’s sad that people take them seriously, especially those who get them stuck over their heads. But every time you rebel against the label – well, it’s the “lack of insult”. Perfect crime really. their arrogance knows no bonds.
I meant “lack of insight”…
I couldn’t agree more. I say that the DSM / psychiatry should return to the ‘archives’ of other failed quasi-scientific projects, like phrenology.
DSM is called the “Book of insults” – made me laugh!
Good article. BPD is just a modern way to say witch or slut or loony or some other label that allows us to do whatever we like with a person who makes us uncomfortable or shakes our assumptions. To me, BPD describes a traumatized person who is dependent (financially, emotionally, physically or all three) on unloving or even vicious family/guardians/society. They lash about because they are essentially trapped. Out of the trap, with good job, sane relationships, an end to exploitation or scapegoating, and such a person has a chance to heal and change.
Suicide is not illegal. Yet attempting or threatening suicide leads to loss of nearly every significant civil right or liberty and puts the person into grave physical danger from police intervention/incarceration with violent, criminally insane individuals. Saying that life is ugly or not worth living is apparently a tacit crime that allows others to gang up and silence a person.
It seems most people in today’s society have been brainwashed into thinking that suicide and suicide bomber are synonymous. They are miles apart. If people were properly educated in the history and literature of humans, instead of dumbed down by poor schools, indoctrinated by media and corporations and deluded by religious instruction, they would know that sovereignty over one’s own body is an ancient and sacred right–up to and including suicide. Almost every writer throughout history from Tacitus to Goethe has affirmed that death is preferable to a life of servitude to tyranny, or a life without quality–whatever that means to the individual.
Study of literature should me mandatory for all ‘helping’ professions, including cops. A suburb of Mexico City has a program like this for its police and it is (was?) successful. People who don’t understand human life as described by our brightest, bravest artists have no business making any judgements/interventions on their fellow citizens.
Well said, Ann!
“They lash about because they are essentially trapped.”
A great description. As good as: “Traumas are events that make apparent that – on some level, in our daily lives – we don’t have control over of what happens to us.”
People who get trapped into life situations where their needs are not met and/or they are getting abused and can’t find a way out go mad. Whatever form the madness takes. Nothing to do with brain chemistry.
Btw, my toxic relationship told me at some point with a great smile on his face “you’re trapped” and he seemed to enjoy it. But people like him never get stigmatised or abused by psychiatry, they get a pass. It’s the victims that get the blame.
Thank you so very much for writing on this subject. One of the very first pieces of my ongoing “awakening” to the crisis in mental health came through my exposure to attitudes toward the label BPD. This label gets thrown around any time a professional is irritated by a client. At least if that client is a women. If the client is male, NPD or APD are the go to labels, but the effect is the same.
I don’t feel like this gets discussed enough. Thank you again.
I see you’re acquainted with how it work, Andrew! Yes, yes and yes. I often wonder what ‘help’ the mental health system is really doing and, sadly, this includes some purported recovery / wellness programs as well. Time for something different!
Dont’ get me started on Self Esteem, Stress Management Classes, and the like.
I’d rather play dominoes and do some knitting, like we used to at the day centre (I’m being facetious, but they seem to think this is an improvment. Actually they are usually lead by people determined to know as little as possible about the clents)
John: in craft work class I made a Che key chain. The craft worker suggested that maybe I should look for different people for inspiration, and she was more insightful than most. By the way, the key chain was for car keys. One of the things that I was wondering when I got out of the “hospital” was whether I would be allowed to drive.
well the art worker is the most liked, and most skilled, worker in my day centre. She’s fab. The rest should be adminstrators in job centres or running a creche
It’s also a synonym for “hopeless case” and “someone I don’t like”.
I got stuck with this label by a psychiatrist who was off the wall. He never looked at me the entire fifteen minutes I spent in his office for his wonderful evaluation. He asked me one question, “How are you doing today?” Since I’d just been told the day before that my sister had been murdered in New York City, I wasn’t doing well at all. When I told him I wasn’t well he asked why. When I told him the reason and that I felt like the entire world was coming down around me he finally looked up and literally screamed at me, “THAT’S STUPID!” At that point I realized that he was the one with issues, not me. This was the first time I’d ever dealt with psychiatry and it told me all I needed to know about the so-called profession.
The interesting thing is that the three other psychiatrists who dealt with me, and all the nursing staff that dealt with me in the hospital where I now work never accepted that I was BPD. They stated that it was pure rubbish, but in my records I’m still officially listed as a BPD. You can never get those records changed, no matter what you do. The only person who agreed with the label was my social worker, and she and I never saw eye to eye on anything!
What my experience taught me is that psychiatry is a sham and the system is staffed by people who have as many issues, if not more, than the people who are supposedly mad.
“What my experience taught me is that psychiatry is a sham and the system is staffed by people who have as many issues, if not more, than the people who are supposedly mad.”
A statement generally shared that 99% of the people who have ever known a psychiatrist (whether they have been a patient or not) according to my informal pool. I’ve just had this conversation with people at work and they have all expressed this opinion based on different experiences with different people.
I think it’s great that there’s a Borderline Personality Disorder for Dummies; not funny or sad! I just looked at it on Amazon and it looks like a great book. It’s almost impossible to get any clear, understandable information about what the disorder is, what the diagnostic criteria is, what might cause it, what the treatment is, or how to access treatment. The vast majority of the information available to the public about Borderline Personality Disorder is of the Glenn Close / Faye Dunaway variety. What’s incredibly sad is that it’s become such a throwaway, laughable term within the very institution that is supposed to be treating it, if not curing it. A personal example, a psychiatrist I saw for a very hellish, short term “treatment” in 2010 wrote “she appears to have borderline personality disorder” in my records, and that’s… it. No list of symptoms meeting diagnostic criteria, no treatment plan, and he also never said a word about it to me. Perhaps he had a good laugh with colleagues about it over drinks?
“No list of symptoms meeting diagnostic criteria, no treatment plan, and he also never said a word about it to me.”
Not that it’d be any better. I got my documents back from the hospital when they abused the hell out of me, physically and psychologically – that is what passes as treatment in these places so you can be happy you didn’t get any of that – the only comparison I know is rape. Anyway, the “symptoms” were basically a list of adjectives, all of them pejorative except maybe (?) for high intelligence (the guy who interviewed me had some hangup about that, maybe he felt stupid himself, I don’t know but he kept telling me that I’m narcissistic because I’m so smart and I feel smarter than everybody else and at some point I just laughed at him sarcastically because he would not listen to me – listed as another symptom). Doesn’t matter that 80% of symptoms were explainable by the fact that I was involuntarily committed and have no interest talking to them but had to to avoid being abused further (but I guess in their world I should be cooperative and kind and relaxed and god knows what).
Honestly, after my experience with psychiatry I feel that the only person who passes as normal is a white collar psychopath. Except that they have a label for him to. It’s catch 22 and you never get out.
B: It was only recently that I discovered that I had an axis II diagnosis of narcissism to go along with axis I bipolar that had morphed from manic depression from 1989. When I confronted the psychiatrist about this, he made the claim that the diagnosis was nonjudgemental.
Sure, there’s nothing judgmental in calling someone a narcissist. Nor was there anything judgmental in the list of insults they printed in my file and called “symptoms”. Their arrogance is astounding.
Yeah, dealing with this stuff would drive anyone crazy.
As one who attempted for years, unsuccessfully, to bring the Archetypal Feminine (and Masculine), as well as trauma, into the dialogue with colleagues around “BPD” I very much appreciate your getting to the heart of the matter here.
The continued cultural attack on both the mature Feminine and Masculine in every arena, including psychology, leads to absurd abuses, such as the obsessive Saturnine and Procrustean taxonomies of psychiatric labeling as well as the violation and persecution of the Feminine whose nature it is grow and flow outside of structures and strictures. The Feminine in each of us, and in the world, does not need containment, it longs for river beds, for form to support it in following its flow Instead we have dammed and damned the flow of the Feminine. Incidentally, resisting containment, control and imprisonment, like the notion of Histrionic Wandering Womb we’ve all been horrified by, resisting the command to accept what one is expected to accept, to feel what one is expected to feel, to behave the way one is expected to behave, are the core of “BPD” symptomatology under the surgical dismemberment of DSM psychiatric diagnosis. “BPD” is an attack on the Mature Archetypal Feminine (just as “ODD,” also a diagnosis run rampant, is an attack on the Mature Archetypal Masculine).
When the Mature Masculine is attacked in a culture a violent patriarchal structure managed by infantile men arises and this Lord of the Flies culture institutionalizes violent violation and control of the Feminine. Psychiatric diagnosis, the medical model in psychiatry, and STEM in general, are at the front lines in the siege on Psyche herself, on that face of the Feminine that longs for, invites and compels depth and penetration into the Shadow, because such depth perception will lead to cultural maturation and the end to the violent, violating infantile Police and Surveillance State, and the end of the cold-blooded goose-stepping Nanny State.
Locating the notion of trauma at the heart of “BPD” is a very healing act in itself, as trauma elicits compassion and moves to action in the service of those stuck in trauma. I also think that the emerging understanding of the role developmental trauma plays in all psychopathological processes is primally important in our field. I don’t think it’s important just because focusing on trauma will help us prevent and heal it, but because it will help us understand its inherence in our being an din the world, and will help us understand its purpose and function, which I think you, as authors, hint at, by suggesting that trauma shows us not only that we are not in control, but that something is is in control. Trauma leads to faith/pistis?
I greatly appreciate the authors’ willingness to transgress the boundaries in their illumination of what we call “BPD,” behavior that may earn them a diagnosis of Borderline if they were inclined to swim in the mainstream. ; )
Actually is it not that people of both gender having the same “symptoms” will anyway get a gender-specific label? It’s all sexist and one has to be blind not to see it.
All of this really gets absurd.
A person goes to a psychiatrist, and any possible underlying physical condition which may be the root cause is never investigated, or it’s ignored. A “diagnosis” is determined by a using a system checklist – ending in a diagnosis of a lifelong, incurable brain disease. Next come the mind-altering drugs. Brilliant, just brilliant.
Psychologists, social workers, and other “mental health professionals” insist they can do better… and the end result is very often a personality disorder diagnosis of some kind… which these professionals insist means long-term “treatment”…. talking, talking some more, talking until a person is blue in the face.
Talking is the key to overcoming trauma? Says who?
What if there are a multitude of ways to overcome trauma? It seems to me we have several millennium of human history to show that human beings are quite capable of reconnecting to themselves and communities, in a variety of ways after traumas – natural disasters, wars, plagues, death of young children, to name a few.
Sometimes it means *not talking* – especially, when a past experience has been talked about enough… sometimes, *once* gets the job done – with a close friend, counselor, member of the clergy.
If seeing a therapist works, great. But, IMO, there are no real “experts” out there. There are good listeners, people who truly care, good friends… but no “experts”.
There is a spiritual component to all of this, IMO… an inner Spirit that guides us. One that insists we are not only *okay* – we are much *more*… We are designed to heal, overcome, thrive… move through, beyond our temporal pain.. designed to learn how to more deeply love ourselves, and each other.
You are right. The only “good therapist” I know didn’t need her education to do her job – she’s been doing it since her teen years as people have always come to her to talk things out and hear advice and get understanding and empathy. It is not a profession, it is who she is and no amount of schooling can teach someone to be this way.
Each of us is our own expert of our own lives. We live and learn as we go along, and gain expertise about how we operate and about our own creative process, via our own experience. What became absurd to me was paying (or not) a stranger to tell me about myself, as if they were going to be neutral and inherently supportive. Of course, these diagnoses are often used as ways of saying “You bug me, there must be a name I can call you.” But it’s how we’ve been programmed in society, to not trust our own judgment, to not revel in making mistakes along the learning curve, to be ashamed to be human and flawed, etc.
I agree completely that we are guided by our inner being, our own light, which knows our limitless potential. Life stressors and trauma do interfere with our hearing this inner voice. Healing occurs when we hear our own guiding, supportive and validating voice over negative and limiting self-beliefs, as well as over the shaming or discouraging voices of others outside of ourselves.
When we connect with this inner light, we are free, not dependent on the opinion of others to reflect who we are, more often than not laden with judgment. Who we are is not something we can easily describe in language. It is a felt sense, a feeling of well-being. This occurs when we value our own voice over that of others. Of course, our own voice has to be kind with ourselves for us to feel good, which it often is not. When we learn self-kindness, we grow by leaps and bounds because we relax and feel our intrinsic value. Again, a felt sense of ‘worthiness.’
Live, learn, own, grow. Everyone has some kind of trauma or inner conflict to work out, and we each do it our own way, talk to someone we trust or not talk about it at all, work it out internally, ourselves. Many people heal this way, privately, simply through their own inner dialogue.
To whom on the planet does this NOT apply? Why do we need these ridiculous and pejorative names? That’s totally random and meaningless, other than to confuse people further terribly about their self-identity.
For me, the trauma is what guided me to that inner light so that I could 1) heal the negative effects of the trauma, and 2) use it as conscious guidance now. What else do we need to know?
Duane and Alex
Just to add emphasis to what the two of you stated so well here is something from Krishnamurti:
“You must know for yourself, directly, the truth of yourself and you cannot realize it through another, however great. There is no authority that can reveal it.
You yourself have to be the master and the pupil. The moment you acknowledge another as a master and yourself as a pupil, you are denying truth. There is no master, no pupil, in the search for truth.
…..there is no teacher, no pupil; there is no leader; there is no guru; there is no Master, no savior. You yourself are the teacher and the pupil; you are the master, you are the guru; you are the leader; you are everything.
If you are very clear, if you are inwardly a light unto yourself, you will never follow anyone.” ~~~~~~~~Krishnamurti
I love this quote, Stephen, because it basically advocates for radical self-responsibility, which, personally, I feel is key for the kind of healing that amounts to personal transformation, where the original trauma really can sink into the background, and be used as fuel for empathy, creativity, and truth. That’s how it worked in my case, at least.
When we experience repeated trauma, we can sink into crippling beliefs of being powerless to trauma. That’s an illusion, as we are all powerful and can transcend anything, if we only believed it. Our faith in ourselves is what opens the path to healing and integration.
To accomplish this, it is vital we believe in our ability and potential. Hard to do with some clinicians, who further embed that feeling of powerlessness. Not only clinicians, but a lot of people, whether or not they are part of any of this, will not let others grow, from their own insecurities. Effective support allows us to be powerful, that’s necessary, I strongly feel.
When we own all aspects of ourselves (teacher/student, leader/follower, etc.) then we are, in essence, retrieving our souls. When I finally experienced this after years of mind-bending healing work, my health, life, relationships, and environment changed completely. It is truly amazing–and seemingly miraculous–what occurs when we can integrate these dualities, and see ourselves as our own teacher, as well as our own student. This inner dialogue that we can create between these dual roles, is our light, and when we turn this on, we see things we never even imagined about ourselves and the world around us, that which supports us, rather than negates and sabotages. That’s expanded awareness, our collective goal.
In the self-healing work I learned to do, the idea was to see how we all have these internal dichotomies that separate us from our wholeness. For example, we are all masculine and feminine combined. The physical gender we project is not necessarily indicative of whether we are more masculine or feminine in how we operate. When I use these terms, I am not referring to culturally assigned roles or stereotypes, but more so about the universal principles of masculine/feminine energy–i.e., yin/yang. When integrated, there is wholeness, clarity, and inner guidance.
‘Shamanic’ work–where we own and integrate all aspects of ourselves–is not so mysterious, and can only occur when we drop judgment and replace it with authentic compassion and trust. Then we can become whole and free as we move forward in our evolution. Anyone who desires to do so can accomplish this. It’s no longer esoteric, like it used to be.
As indicated all over MIA, there are so many individual paths to integration. Still, I feel it’s a winning goal, and this quote you posted is a great vision of how this looks—we are ALL of it, each one of us, 100%.
Btw, I totally believe we are spiritual beings having a human experience. We are not our trauma, that is an experience we have, from which we can learn all about who we are and what we are here to accomplish in the world. Trauma is a highly effective teacher and guide. Post traumatic stress heals, no one is stuck with it, unless that is what they believe about themselves.
Great quotation, Stephen! Very “enlightening!” Thank you.
Many who transcend the trauma feel that the trauma gives their life meaning in a way that nothing else could. This takes nothing away from how horrible the trauma was in the person’s life. But they used it to grow and mature and transcend in a way that few people ever rarely do.
Well, that’s how I got the BPD label – I refused to talk to “professionals” because I saw no point in it (though I got coerced to it) so they labelled me with the “difficult bitch” diagnosis. Later I actually used it to persuade them to stop drugging me (there are no drugs approved for BPD as such) so it was even useful at some point. But in general it’s a great label for anyone whom you find annoying and does not display anything that could be called psychotic (although they tried this with me but then it magically disappeared from my file).
Well, you sometimes need labels for people who have done you harm. But “a” words and “b” words are honest and do not mascarade as medical disorders or imply that it’s something genetic/life long or that you know a reason for it.
Discover and Recover: I agree with most of what you’re saying and I’ve said — repeatedly in talks, publications and interviews — that psychotherapy can be lifesaving, helpful, supportive and, generally speaking, work wonders in some people’s lives. HOWEVER, unlike most of my colleagues, I do *not* believe it is somehow the best or ‘highest’ modality for everyone. Sometimes it is and sometimes it is not — it depends upon the individual asking for support and what his or her individual needs are. Sometimes, actually more often than not, it is a combination of things. Many years ago, when I was working for an inpatient facility, I had to have the humility to recognize that the nutritionist actually was able to have more rapid and dramatic impacts on clients than psychotherapy. Also, I have seen great results with people simply getting out into nature, perhaps enrolling in some program that restores trails or simply a hiking group.
I also would like to accent what you call a ‘spiritual’ dimension to the process. This is why I accent (following the Greeks, Jung and Laing) the notion of metanoia.
Finally, as Bob Whitaker points out, sometimes nothing is necessary. Incidents of spontaneous recovery were well documented until relatively recent years.
I’d like to go on, but I have to run…anyway, thanks for your comments. I am grateful for the comments.
Thank you for the blog post, and your comments.
And B, Alex, Stephen as well.
My pleasure. If you or anyone else wants to connect with me, I am most active on FB: https://www.facebook.com/drbrentpotter
Hope you have a great weekend.
And sometime Geographical Therapy is what is called for. That is leaving the country and getting away from your tormenters
Ohhh John I love this 🙂
I’d like to respond.
In my opinion, modern psychiatry is the least helpful and most dangerous profession, for the very reason that it is actual anti-science. Claiming to know empirically more than you actually know is anti-science to the core. So taking a disease approach and making the profession revolve almost entirely around psychotropic medication, practicing in ways that are often contraindicated or outright antithetical to available evidence – that ought to be criminal malpractice.
I know that there are a tiny minority of rebel psychiatrists out there. But I believe this to be a fair institutional criticism.
Next come the non-prescribing human service fields you mention – psychologists, social workers and others you mention. I am a social worker, and I agree fully with your criticism. There is no “one right way” toward healing. There are definitely wrong ways, namely ways that make claims to truth without any rational or empirical basis, ways that lie or distort the truth about medications, or “counseling” or anything else. Those are the wrong ways.
But what is the “right” way for a person experiencing distress? I believe the only “right” way is the way the individual chooses for themselves. However, I’d like to point out how psychologists and social workers fall into the trap of advocating process-oriented counseling or “talking talking talking” as you described. Because there is a somewhat humanizing reason why this mistake gets made….
This mistake gets made by my fellow social workers and similar professions because we are reacting against the prevailing attitudes set by Psychiatry that feelings, talking, processing, meaning-making or self-exploration don’t matter. Only taking the right drugs matters, according to them. The prevailing attitude by the most powerful forces in our broken mental health system are big pharma and big psychiatry, i.e. the APA, NIMH and the sadly enabling NAMI.
The key to my own healing and recovery was a counselor who created a safe-place for me to talk and process. Everyone is different, that’s true. But in a world where the prevailing narrative is one of “don’t talk to me about your feelings, don’t tell me about your past, just shutup and take this pill,” I feel like social workers and other non-psychiatry professions often feel a strong reaction to that. I know I do.
And that’s how we mess up…. it becomes easy to get tunnel vision. Talking is not always the answer. There is no “right” way other than what the individual identifies for themselves as helpful and needed. But in fairness I will tell you this, in working with folks I have found it amazing how many times people thank me and tell me they have never ever before had a safe place to simply tell there story in their own voice, and process the experiences of their life without judgement. I have ALSO worked with people who told me quite clearly, they had no need or desire to do anything of the sort. What was my response to them? To listen, to accept that they know best what they need, and then ASK them how I could be a positive part of their journey.
The same is true for the idea that there is a spiritual component to all of this. I have to ask the same question you did – says who? Personally, I think you are probably right. But many people do not interpret their lives that way. I respect that as well.
Basically, psychologists, social workers – all of us non-prescribing therapists – get it right when we see ourselves as servants rather than experts, and ASK the person we are serving what they need rather than TELL them what they need. That’s the key.
You make some very good points.
IMO, psychiatry is not ready for prime time. The brain is far too complex to arbitrarily attempt to drug someone to health. The attempt being made by shrinks is subjective guesswork:
“The average human brain has about 100 billion neurons (or nerve cells) and many more neuroglia (or glial cells) which serve to support and protect the neurons (although see the end of this page for more information on glial cells). Each neuron may be connected to up to 10,000 other neurons, passing signals to each other via as many as 1,000 trillion synaptic connections, equivalent by some estimates to a computer with a 1 trillion bit per second processor.” – From Memory and the Brain –
IMO, it’s also absurd to assume any profession has earned a monopoly on how the human psyche heals. We are (again) far too complex to make any preconceived notions about what single method may work; much less, assume that it is the only method that will.
I think you are saying the same thing.
Hey Andrew, I appreciate your comments and agree. It’s great to see folks, like you, who are (or have) worked in hospital / community mental health and similar settings step up and express your views on psychiatry.
I agree. And I appreciate your accent that, in fact, we do know wrong approaches to the various forms of distress that exist. Those in the so-called ‘helping professions’ have done great hard, at time, and often unknowingly. Fortunately, these are not the majority of people who get into the field. And we have enough data now to know that psychiatry is really not the way to go for a host of different reasons.
Also, on that note, I don’t identify myself with the ‘anti-psychiatry’ movement. I would consider myself more ‘critical psychiatry’. If someone does feel that he or she has benefited significantly from meds, then far be it for me to tell them otherwise. Moreover, I don’t believe anyone should be in the position of telling others what they should put into their body…this is tantamount, in a sense, to telling them what books they can read.
In any event, thanks for your comments. I am on FB, if you’d like to connect: https://www.facebook.com/drbrentpotter
I really liked your article, but this comment you made is something of a caricature of anti-psychiatry:
It’s fine if you don’t identify with anti-psychiatry, but let’s not lead people to believe that everyone who is anti-psychiatry is out to deny the experiences of others or to tell people what to do with their own bodies. That is simply incorrect.
I’d add that Dr’s should not be allowed to prescribe dangerous things, even if people want them. This is standard in other fields. For example, Vioxx was taken off the market – effective pain killer, slightly raised risk of heart failure and death. Other treatments were avaialable. Now apply that standard to Olanzapine or Clozapine, where does that take us?
Also, I have read of some communities where people with excessive alcohol intake were restricted in accessing it by the community because of the risk both to the drinker and the wider community (domestic violence, theft, bad behaviour in public). So restricting people’s access to psychoactive substancs is something universal to human culture.
I personally am always telling people what books to read, usually they ignore me. The question here is not what I or anyone else recommends, but rather what laws are in place and what are the prescribing habits of Drs.
” This is standard in other fields.”
If that was a standard in psychiatry there would be no drugs approved for mental illness.
Some people say it’s going to far to ban ECT or psych drugs because of the personal freedom of choice. I’d also not ban Prozac but I’d not allow it to be prescribed as medicine against “depression” just as alcohol is not prescribed for anxiety.
The “let me know how I can help you” line is one I’ve come to resent from mental health professionals. I usually get it when im open about my skepticism of drugs and therapy. I take it as a “what else do you expect me to do if not drugs or therapy?” response. I also dont like it because if I knew what would be helpful I wouldn’t be seeking help. My experience in social work school demonstrated social work professionals submit to p sychiatric domination for a bigger slice of insurance reimbursement mental health industry pie.
This is close to what I experienced as well. When I was “in the system” with the borderline diagnosis (after I didn’t respond to ECT for depression), it was expected that I would have a therapist and also a prescriber. Every social worker and psychologist I was in treatment with turned quickly to drugs as the solution. I had therapists tell me they wouldn’t continue to “see me” unless I was medicated. One psychologist I was in treatment with brought the psychiatrist (who she had referred me to, who I paid out of pocket for, and who had made clear that he would only treat me if I was seeing this DBT psychologist) to my session with her and told him, “Do something!” (i.e. drug her more). When this happened, some of what I was going through: my son was highly suicidal, my brother was dying, and my other brother had just admitted to molesting me as a child. But somehow the answer to what I was experiencing was more drugs.
Isn’t that label used anyway mostly to blame the victim and cover up the abuse? Like many other labels? It’s been done to me and I’ve seen that done to others (especially in domestic abuse, sexual abuse and mobbing situations). The abuser gets a pass because his/her victim is a crazy one nobody can handle hence it must have been the victim’s fault all along.
A few general thoughts on the topic:
1. I’ve been led to understand that “BPD” was supposed to be like “ADHD” – something you have since childhood and never get rid of. But somehow people get diagnosed with it even if they “just got it” and no one ever stops to think: “hey, maybe it’s the particular circumstances of the person at this moment in time that make him/her to behave this way”. This is the fault of all psychiatry but with BPD in particular – it’s not that you have a problem which you can’t find a solution for and you “go mad” in one way or the other – it’s that there’s something wrong with you intrinsically (and always has been and will be). And even if they are people whose problems have started in childhood it neither means that it will never stop nor that everyone who behaves in a similar way has had a childhood issue.
2. So-called therapists don’t want to work with so-called bordelines because what these people really want is a meaningful real and stable relationship. Which is against the “professional boundaries”. I remember reading once a therapist’s blog about how to get rid of the BPD after years of “successful” therapy. What stroke me was how clueless this guy was – he has just been a substitute relationship for hire for his clients and now he was surprised that when he wanted to end did (which was basically ending of a relationship) these people went back to being upset. IT sounded to me like this guy is cheating his clients of his time and money and seriously does not even realise that. That is my main complaint about the psychotherapy in general. Except for maybe few short interventions like if someone just wants to talk things out to someone not personally involved and “outside” of the situation or learn some simple coping skills (most of them are pretty intuitive anyway) it is just an equivalent of what prostitution is to love or worse. In fact all a “BPD” needs is a real long-term relationship with someone who actually gives a shit about them and they will be “cured” and the only problems are a) find that person (a problem more general for everyone) b) get through the phase of not trusting him/her and testing out the relationship without breaking it.
3. ““Well I am not taking any borderline clients.” The audience exploded with laughter.”
These people have no business calling themselves therapists.
Don’t we all need, ” a real long-term relationship with someone who actually gives a shit about them?”
Isn’t the lack of that, or it’s oppposite, why most people are so distressed they end up in services?
I have friends who have had this diagnosis. I’ve supported them and they to some small degree changed. They were not long term relationships, but they changed to some small degree. So yes, I agree, these people have no business calling themselves therapists.
Also, suppose he had said, “I am no longer taking any black clients.” No one would have laughed. Unless he said, “I refer them to ethnic minority therpists because I think they can be better served that way,” he would have been seen as racist. He is being derogatrorry and discriminatory about an arbitary grouping of distressed human beings who deserve support, understanding and sympathy.
B: In the boundaries training at the use agency where I work, nothing was said about discussing a critical critique of the helping professions. At a bare minimum, I always inform clients when I take them to appointments that they have a right to ask questions as well.
4. “unremitting, debilitating biological disorder characterized by lack of empathy, being unable to adapt or grow personally, fostering vicious relational cycles, clueless as to their toxic impact upon others, severe impairment in sense of identity, impoverished sense of self, instability in regards to goals/aspirations/values, intense and conflicted close relationships, mistrustful, being emotionally unstable, generally negative, nervous, tense, anxious, depressed, antagonistic, fearing rejection, depressive, disinhibited (impulsive/risk-taking), having transient psychotic episodes, and one or many forms of self-destructive behavior . . . chronic suicidality”
And how do these great specialist know that a person lacks empathy or does not grow personally or is clueless of something or what sense of self he/she has? Are they mind-readers? It’s funny how often psychiatrists talk about projection when they do it themselves. Also I love how these people define what is a “normal” level of trust or negativity or whatever other attitude to life and people one should have. Especially given the fact they always know exactly the social context of that person. Ad they never consider that it’s their attitudes that create the negativity and antagonism they perceive. Pathetic.
5. 75% females… well, that’s straight sexism isn’t it? The same as the ADHD diagnosis in boys. There are statistical (not individual) gender differences in human behaviour and stigmatising them is just one of the many tools of social control.
6. “When we mention trauma, we mean any sort of experience that renders a person helpless, unsafe or otherwise finding themselves in highly unpredictable circumstances. ”
The best definition of trauma I’ve ever seen. I’d only say that neglect is also traumatic, especially in early life – a kid seeking closeness and care and being rejected no matter what he/she does.
Agreed, B. Unfortunately, I can’t answer at length now, but it seems like we see eye-to-eye on most (if not all) points. If you’d like to connect, I am most active on FB: https://www.facebook.com/drbrentpotter
I am happy to keep the conversation going, if you’d like. Thanks again for your comments and I hope you have a great weekend!
B: A black male student once informed me that he was being scrutinized for BPD. Over the months of establishing a relationship with the man it seemed to me that as an intellectual, he was having trouble fitting into an anti-intellectual environment, and I continually emphasized to him that it was not he who was out of whack.
Best comment. It is obvious you have insight. I think one of the reasons these personality disorders became so strong, is that even people who did not give psychiatry validation, clung to some diagnosis simply because they did not like certain people.
We all don’t like certain people. Certain behaviours.
There are even behaviours and responses I don’t like in myself.
The “personality disorder” is one of the most bogus ones. I don’t think that the people I do not like are disordered. Maybe I am, for not liking them lol.
Excellent article. I’ve seen so much laziness and callousness amongst the community of psychiatric professionals. Sometimes it seems they simply lack the knowledge,curiosity or empathy to actually see someone through their problems. I’m wondering if BPD could actually be a misdiagnosis of Aspergers. These symptoms sure sound a lot like many of the symptoms a female with Aspergers might have….
Am I way off base here?
Martlisa: On this site, most contributors seem to have formed a consensus that psychiatric labels cause more harm than good. The boundaries of Autism diagnosis are somewhat fuzzy, but there seems to be some validity to the diagnosis, even though there is wide disagreement over the cause of autism.
chrisreed: Sorry to have used labels. I meant no disrespect. I am just trying to find answers so I can better help a loved one but perhaps I am out of place on this MIA site. How does one unsubscribe?
Hi Martlisa! I didn’t find your post disrespectful at all — people are at different places with use of diagnostic language (and as Chrisreed pointed out, autism seems to have more validity than most diagnoses). I honestly don’t think you’re out of place here, but I’ll email you about how to unsubscribe from notifications for this comment thread.
Wishing you the best in your quest for answers to help your loved one. Here’s a link to all articles referencing autism in our archives, maybe you can find something useful there: http://www.madinamerica.com/news-archives/all/autism-children-and-adolescents/
Re autism having more validity than most diagnoses. Really? Seems to me that a lot of people still think that “schizophrenia” has more validity than most diagnoses, and there begins the uphill battle. I would hesitate to even say that for autism knowing how harmful the “validity” has been for “schizophrenia.” Are there any biomarkers for autism?” Any blood tests? Can people grow out of it?
Rossa, good questions. It’s a slippery slope for sure… I hear you on the need to be careful.
“autism having more validity than most diagnoses”
Nope. There are many conditions which get a label of autism (or autistic features) including e.g. Rett syndrome. It is basically a bunch of symptoms bundled together and it is as meaningless as a diagnosis as all the DSM labels. Autism is just a “complex symptom” if you like just as “psychosis” is.
Having read your comments, I would be sorry to see you go and hope that you might reconsider. It’s true that many – though not all – of the people who comment here (myself included) have no use for psychiatric labels. I hope you do not interpret this to mean that anyone is minimizing or seeking to invalidate your struggles or those of your loved one.
I also hope you haven’t been given the impression that there is some sort of ideological purity test for participation here. There isn’t. Many folks just tend not to appreciate psychiatric labeling because they have borne them and found them oppressive. This is something to consider if you think there may be some benefit to your loved one getting diagnosed. But you clearly want what is best for them and you also have a healthy distrust for psychiatry. To me, you are most welcome.
Here’s a video I watched recently that might be of interest: https://www.youtube.com/watch?v=N2NTADxDuhA.
Even though autism definitely doesn’t belong in the DSM, folks I know on the autistic spectrum who have no love for psychiatry, have no problem with this label because they feel it explains their issues well. It is a relief for them to have an explanation for difficulties that most “normal” don’t have such as reading social cues.
Maybe the cause of both “conditions” is the same, early developmental trauma.
Hey martlisa! I really like you’re notion here and no, at least by my thinking, you’re not way off base. Here’s some information to provide some context:
BPD is considered the ‘mother’ / blueprint’ of all the other personality disorders which aka as Axis II disorders. There are three features to it: tenuous stability, adaptive inflexibility and fostering vicious cycles. People don’t hear about these, generally speaking, as it’s in the DSM above the little box with the brief-form of the criteria — clinicians usually go straight to the little box (it’s easier). Any one of these and one is on the ‘fast track’ to making an Axis II diagnosis.
So some of the items that you mention could fall under one or more of the three general features and thereby lead some clinicians to lean more towards the Axis II more so than an Axis I autistic spectrum disorder diagnosis. (Aspergers was axed in the last version of the DSM…which is an interesting topic for another time).
You’re question is also not off base, in my opinion, in that there is a certain sense in which some (not most or all) persons who have experienced developmental stress and/or trauma may withdraw. In fact, if you read Theodore Millon and some of the psychoanalytic literature, there are discussions of passive ‘borderlines’ and certain states in the ‘borderline’ spectrum that lie more on the ‘autistic’ side than an actively self-destructive or aggressive side.
Moreover, you’re onto something too in the sense that there has been a huge amount of discussion on what exactly ‘borderlines’ are on the ‘border’ of — depression, anxiety, psychosis, etc. or some combination therein…many clinicians have considered, especially historically, autism to be, in varying ways, on the ‘border’ of psychosis, without ever fully dissolving into a psychotic state.
I could go on — you raise a really good question — but think I’ll stop here. Thank you for your comment!
Thanks so much for your reply! I am at the beginning of my journey to find answers so I can best help a struggling loved one. We’ve avoided a diagnosis for many years precisely because we thought a label would hinder our loved one far more than it would help. Things have just gotten to the point that I’m willing to try the approach of getting a diagnosis so we can gain more insight and perhaps gain support. Thank you again for helping clarify! I realize I may be in the wrong place looking for answers. Do you know how I might unsubscribe?
I’m not sure what insight could a diagnosis possibly give you – all psych diagnosis are basically re-description of symptoms with zero information about what causes the emotional and cognitive state the person finds him/herself in. They are stigmatising and they don’t explain anything.
“tenuous stability, adaptive inflexibility and fostering vicious cycles” Oh, so that’s what BPD is. Wait what? Lol. Seriously, how is the average person off the street supposed to know what that means? How is that a helpful summary for someone like me?
There can be similar symptoms between almost all the different diagnoses, two people with the same diagnosis can be vastly different, and it’s completely possible that someone with Asperger’s could also have BPD. It’s also completely possible someone with Asperger’s could present as having BPD, and vice versa.
Whoops, I meant to add the whole thing is crazy! >8-P
I have found the concept / label of BPD to be helpful as to my problems getting along with people / getting through the day, to an extent. I was also able to get some books on DBT that were written for practitioners, which I also found somewhat helpful.
Something else to add is that I’ve seen people develop the symptoms of BPD from being mis-medicated.
Zyprexa (especially withdrawal) is great for this I believe – it makes you completely nuts.
That’s because these “diagnosis” are basically checklist of symptoms – you have 3 or 5 from 10 and you “have it”. That’s why all these “disorders” have such a high “co-morbidity” – a person simply fits more than one diagnosis.
It’s all bs to large extent and a misplaced attempt to put people into pre-defined drawers based on a very simplified and time and context-restricted observation of their behaviour and self-reported emotional states.
Perhaps the best summary is “it is complicated” and, as you say, “crazy.” :p Unless one has a burning desire to learn differential diagnosis, for some reason, it shouldn’t really be a concern. Concerning your original question, I don’t think you’re ‘off base’ — it’s an interesting question. Thanks for your comments 🙂
I was 13 when I was diagnosed as Bipolar. When my new psychiatrist argued that I didn’t fit the requirements, I was elated for half a second. Then he told me he thought I was Borderline instead. What’s really odd about all this is I’ve been so defined by the Bipolar label for so long that even I don’t know what to do now. It’s also not helpful to attempt to explain the new diagnosis with a joke about being “borderline psychotic”.
Hello acidpop5! Well, I am sincerely sorry to hear about your experience. Sadly, tragically, it is not uncommon these days.
If you’d like, I’d be happy to chat on FB: https://www.facebook.com/drbrentpotter
I promise that I really use that area to chat with like-minded people and not to spam or otherwise try to sell people things, etc.
If you’re interest, please send a request. If not, then I understand and wish you the best on your journey. Thanks, Brent
Brent and Jacqueline,
Great enlightening, validating post exposing one of many or all bogus psychiatric stigmas/degradation rituals. I appreciate the exposure that this insult stigma mainly applied to women to abuse and denigrate them all the more has to do with the victim’s trauma than any of the fraudulent eugenic theories of “mental illness” still perpetrated as if we still lived in fascist, Nazi Germany or Stalinist Russia!! What can one expect when their great mentor, Krapelin was the ultimate eugenicist predator himself?! Psychiatry can be really proud of this “accomplishment” and hopefully some day they will get their own “Nuremburg Trials” if not literally at least in terms of getting their proper place in history and public opinion once exposed as psychopathic enemies of mankind or intraspecies predators per Dr. Robert Hare, world authority on psychopaths. See great books, Without Conscience and Snakes in Suits. Of course, the term “psychopath” simply describes the traits of evil, vicious, abusive, traumatizing, sadistic people who prey on others with impunity with their phony charm, mirroring, lies, manipulation, smear campaigns and other nasty tricks like phony charm, the ability to mimic normal humans to hide their total lack of empathy, conscience, etc. Many of them are clearly described in the Bible and similar works. Though I’m not into labels, I think the perps doling out the labels should get a taste of their own “medicine.”
Though I realize there have been and remain some people within psychiatry who fight the main stream paradigm and try to really help people, they are in the great minority and can’t even begin to challenge the huge deadly psychiatry/Big Pharma/corrupt government hacks cartel that keeps the death trap of biological psychiatry churning.
Another useful book and web site is Political Ponerology for a great understanding of our global suffering.
You’re very welcome, Donna! I am thrilled that you enjoyed the brief article!
Wow, you really know your history! I think that a thorough understanding of history helps contextualize what (we’re told) are psychiatric diseases, the products of chemically imbalanced or otherwise malfunctioning neurochemical ‘machinery’. Psychiatry presents that these things are biological facts of nature, not unlike other natural forces (wind, gravity), but (of course) they’re not. They have a history and arrive to us in 2014 with a long story behind them. Usually such stories are really stories of power struggles — typically white guys trying to establish and maintain a hegemony of oppression.
Anyway, I think that psychology as a natural science and psychiatry have failed. They are just now waking up to that fact. I think you’ll find them receding into the background. There have been many failed quasi-science projects throughout history. I outline in the ‘bpd’ book the history of such happenings. Every successful paradigm sees itself as the highest achievement. Concerning hysteria / ‘bpd’, the doctors of the middle ages saw the wandering uterus as ridiculous and viewed their theories of women being in league with the devil as superior (etc.).
Thanks for the recommendation of Political Ponerology — I’ll check it out.
The upcoming release of the Torture Report from Congress will supposedly include material about collusion between psychiatrists and interrogators in the torture prisons the U.S. maintains (present tense) abroad. Of course, Big Pharma money buys a lot of ‘teflon,’ so expect to see these charges slide off the back of psychiatry like water. Unless we do something, that is, to highlight this matter and make it stick.
Every doctor who takes part in torture, interrogation, forced feeding of prisoners (like in Guantanamo Bay) is a criminal who should be sent straight to Hague. One would think after the Holocaust we have learnt something…
I am curious to see what the report has to say. I admit that I am slightly less than optimistic, as the APA seems to have been somewhat ambivalent on its stance with such things. I hope I am wrong that that someone there steps up to say something. You’re correct that it’s really up to us to, in our own ways, do something. If we don’t, who will?
Thanks again, Brent
You know, it’s funny… I spent so many years internalizing (or being defined by) my diagnosis of Bipolar 1, that I haven’t even bothered to look up the detailed analysis of my new diagnosis of Borderline. Of course, I should have know my new doctor would lean towards it the moment that he pointed out how loud my voice is…It seems to be the universal label for characteristics the observer finds unappealing in a woman. Oddly enough, I am no longer interested in being universally liked.
This is the abstract of a 2005 study:
Etiology of borderline personality disorder: disentangling the contributions of intercorrelated antecedents.
Bradley R1, Jenei J, Westen D.
A substantial body of research points to several variables relevant to the etiology of borderline personality disorder (BPD), notably childhood physical and sexual abuse, childhood family environment, and familial aggregation of both internalizing and externalizing disorders. However, these variables tend to be correlated, and few studies have examined them simultaneously. A national sample of randomly selected psychologists and psychiatrists described 524 adult patients with personality disorders. Family environment, parental psychopathology, and history of abuse all independently predicted BPD symptoms in multiple regression analyses. Sexual abuse contributed to the prediction of BPD symptoms over and above family environment, although family environmental factors such as instability partially mediated the effect. The results converge with recent studies using very different samples and methodologies.
This being the case, how is it enshrined in our mental health codes that family members can get a person involuntarily committed? In China, even, they have outlawed family being able to do this, as it was constantly abused by greedy and malicious relatives.
Are we in America so absolutely stupid that we think a relative can always be trusted to “do what is best” for an individual? My brother was my rapist and my mother colluded with him to keep me quiet. How would they ever be the ones to say if I’m sane or not?
If professionals in the psychiatric field don’t start acting ethically to restrain their coercion-minded fellows, they are to be despised.
Funny. I was watching a video about Star Wars on Youtube. I found out that a French psychiatrist named Eric Bui diagnosed Anakin Skywalker, who later becomes the iconic villain Darth Vader, as having Borderline Personality Disorder because he meets the criteria for the label (such a thing is also written on Wikipedia).
This is never something I’ve been labelled with (and hopefully never will be), and I’ve only ever spoken to one person who has been labelled as such and who was very traumatised due to a rather abusive familial environment.
Funnily enough, some people perceive it as “this disorder is a condition, the symptoms of which are..” rather than “we are calling these set of behaviours a condition and there are reasons why the person is behaving in such a manner” which are two very different ways of looking at it.
To medically label people who are already distressed as having personality disorders which will further add to negative (and likely untrue) perceptions in the eyes of people and their own family members (which will provide fodder for them to misuse these labels) is disgusting.
Perhaps if more people consider such labelling to be defamation rather than diagnosis and take legal action, such a thing would eventually stop. However, this is unlikely, as a large number of people who end up in psychiatry are powerless to begin with and probably can’t afford expensive lawyers, legal fees and hassles.
To evaluate a person’s behaviour and thoughts, why not just evaluate them for what they are, instead of stamping medical sounding labels on them? Or simply use more neutral sounding labels such as Category 1, Category 2 etc. rather than Borderline Personality Disorder which might simply end up turning into self fulfilling prophecies because the labelled will internalise them and people on the outside (family or others) will treat them and behave with them based on the label.
The argument for labelling is that “the benefits of such labelling and corresponding treatment received outweigh the residual stigma and other cons”. This is something for people who have never been through the cons to say.
There’s also an article about the whole Darth Vader fiasco titled “The Psychology of Darth Vader” : http://www.livescience.com/10679-psychology-darth-vader-revealed.html
Psychiatrist Eric Bui writes “I believe that psychotherapy would have helped Anakin and might have prevented him from turning to the dark side,” Bui said. “Using the dark side of the Force could be considered as similar to drug use: It feels really good when you use it, it alters your consciousness and you know you shouldn’t do it.”
One commenter on the article wrote a rather hilarious comment: “You mean to tell me that the fall of the Jedi Order, the destruction of Alderaan and a six-year galactic civil war all could have been avoided if this a**hole had just gotten some therapy?“.
What bugs me about this article, I can’t quite put my finger on it.
To me there seems something judgemental about talking about the “behaviours” of certain diagnosis. Almost an air that people in general accept it “BPD” as “certain behaviours”. Whether you call them “certain behaviours”, “symptoms” etc, you might as well stick with a label.
Then we can talk about the behaviours of everyone as not acceptable.
It seems to me this was hung on women because we are supposed to be a certain way?
Or people are supposed to be a certain way?
And no, I can’t accept that men are also diagnosed with this. THAT inclusion only happened after women became cognizant that it was hung on women.
Marsha linnehan is guilty of keeping “personality orders” alive.
They did drop the ones that men got diagnosed with.
Sorry, if anyone is part of working with “certain diagnosis”, I find it paternalizing. A sad state when you buy into any “diagnosis”, ESPECIALLY “personality disordered”
We might say that anyone that has difficulty in life has a personality disorder.
Agreed. Marsha Linehan didn’t do people who get this diagnosis (myself included) any favors. I went through DBT and as my functioning got worse and worse I felt a huge sense of failure. Looking back on it, there is a lot wrong with DBT. They work hand in hand with psychiatrists, and as you said they completely subscribe to the idea that patients have this thing called borderline personality disorder, and yet they tout nonjudgmental stance as a core principle of the treatment. When I entered DBT, it was drummed into me that my past was irrelevant, that recovery didn’t require any trauma therapy, that as long as I learned and used the skills I’d be golden. There was something incredibly invalidating about that. The entire time I was in DBT, I was traumatized repeatedly by psychiatrists and other “helping professionals”. I was treated like garbage every time I landed in the psych ward (which happened often because I took on the diagnosis), but I was supposed to be nonjudgmental about the abuse I was subjected to. There is so much wrong with DBT that I couldn’t see when I was still in it. Now it makes me angry every time I think about it.
The diagnosis is definitely given a lot more to women than men. Whenever this came up in the DBT group, the therapist would explain it by saying that men with borderline personality usually wind up in prison rather than in treatment. I feel like there’s an insult in there somewhere. Like they can’t admit to the bias so maybe deflect it by implying “just be glad you’re not in prison”?