The Scarlet Label: Close Encounters With ‘Borderline Personality Disorder’ (Part 2)

Jacqueline Simon Gunn, PsyDBrent Potter, PhD
123
3748

Editorial note: This case example is fictionalized. The individual described below is not an actual person, and any resemblance between this fictional person and any actual person is coincidental. This is a co-authored paper and the authors sometimes use ‘I’ instead of ‘we’ for clarity and continuity reasons.

A referral came via e-mail: She was a 31-year-old Caucasian female who reported, “I need to leave my boyfriend of seven years, but I don’t know how to.” The psychiatric history check-box was clicked for “significant” and the past reported diagnosis was ‘Borderline Personality Disorder.’ I called her and we set up a time.

Sophia arrived roughly 10 minutes early for her appointment time and was quite polite. She took her seat, thanked me for my time and asked what she should tell me. “Whatever you’d like,” I responded.

Over the years, I’ve heard countless horrific stories of abuse, neglect, trauma and most every form of torment that one human can inflict upon another. The sting of such stories never lessens. I’ve often marveled at the mind’s capacity to focus a sustained attention upon new ways to perpetuate and promote anguish. Sophia’s story is tragically similar in regards to the abuse she suffered. Her life, by her convincing account, was really an endless series of disappointments and traumas, of every imaginable variety, layered on top of one another.

Her childhood experience sensitized her to the pain of other living things, both animals and humans. She volunteered at an animal shelter, but she had to leave to find gainful employment. Sophia set her sights on psychology and decided she should get her own therapy along the way. She was caught, much like her mother, in an abusive relationship which she could neither tolerate nor leave. Unlike her mother, there wasn’t any physical abuse, but she described her partner as controlling, rageful, demeaning.

She was perplexed; she could leave the relationship at any time — she saw no real threat or danger in leaving. As a matter of fact, she desperately wanted to, but couldn’t for some unknown reason. In this relationship she acknowledged her own rage, cynicism and derision directed towards him, but it was present prior to him and also outside of romantic relationships.

Relationships were intolerable, yet completely needed. Sophia couldn’t afford most therapists, but seemed to make a sincere go of it, paying what she could and engaging in the best way she knew how. The diagnosis of ‘Borderline Personality Disorder’ seemed to be the only consistency between the various therapists she saw over the years. She took a break from therapy after, apparently, a therapist told her that her stories were too disturbing. The therapist discontinued the work after roughly four sessions and Sofia took with her another layer of rejection.

Something in her wouldn’t give up. She had faith. I am not sure if it was faith in herself, faith in the process or if she was simply inspired to take the proverbial leap of faith again. Perhaps it was some combination therein, but she called and showed up.

“Am I borderline?” — A lot of clients ask me this. One doesn’t have to be a psychology student or a professional to know that this is the psychiatric label demarcating an especially disturbed, even dangerous, person. “I don’t know,” I responded. “I don’t really use psychiatric labels that often. Is the diagnosis helpful to you or has it been helpful in some way?” The answer came easily, quickly: “No, I understand what it means. I’ve read all about it. They really accent it in school. Even though I don’t find it helpful or useful, there’s still something wrong. I don’t like the way I feel. I don’t like who I am with people sometimes, friend and family too. I don’t like not being able to leave this relationship and not knowing why. I am broken.”

And here we stand at a crossroads. The ‘standard-normal’ mental health professional would know, as this client did, what the label ‘borderline personality disorder’ means. Generally speaking, it refers to a relationally and emotionally unstable woman. (Despite research to the contrary, the DSM continues to list women as being predominantly the ones suffering from this affliction). As a ‘personality disorder,’ the condition, by definition, is chronic and unremitting. Most insurance will not cover it nor any other personality (i.e. Axis II) disorder.

The standard protocol when faced with ‘borderline personality’ is to refer the person for a psychiatric evaluation and to Dialectical Behavioral Therapy (DBT), a manualized psychoeducational program specifically designed to treat this ‘condition.’ For some, this may be helpful. While I remain critical of psychiatric labels and psychiatry as a whole, I would never want to tell someone, who may find these things helpful, that they’re wrong. I don’t see myself as someone who tells others what to do. I lay out the possibilities as I see them and partner with people, meeting them where they’re ‘at,’ to accomplish the things they want to accomplish.

I’ve had some clients come to me after completing a DBT program or two, usually grateful for some of the skills they’ve learned, but wanting something more. They usually say that DBT offers some practical and useful tools, but that life is about more than utilizing such things. Moreover, there tends to be a lingering sense of something yet to be accomplished. This may be something like, “I am broken,” or perhaps a desire to become centered, well and successful (as the individual defines those things for his- or herself). Most people, said differently, do not want to simply lead a reduced-symptom life, facing a perpetual recovery from some purported psychiatric disease.

A medical-model, pathologized view is one way to understand varieties of psychological distress. It pretends that it’s the only view, hence it tends to be taken as fact by most people emerging from psychology and related programs for the last few decades. Yet, the force and even hegemony of a perspective does not make it a fact. Said differently, most people (not just students and professionals) assume that behaviors, thoughts and affects are the result of electrical-chemical activity of the brain organ. An abnormality in the smooth everyday functioning of the brain organ is, then, what explains ‘abnormal,’ — potentially a disease. These abnormalities/diseases are considered to be like cancer or diabetes — no further thought is needed. Actions and aberrations of the brain organ are, much like wind, gravity, rain, an act of Nature. They just happen.

But what if the assumptions of the medical-model approach are incorrect? Again, because a series of hypotheses and propositions are popular or continually assertively put out there, that doesn’t necessarily mean they’re correct. In our book Borderline Personality Disorder: New Perspectives on a Stigmatizing and Overused Diagnosis (Praeger, November, 2014), we demonstrate that ‘borderline personality disorder’ is a cultural-historical construction typically foisted upon women with a history of developmental stress and/or trauma. This is the case for every purported psychiatric disease outlined in the Diagnostic & Statistical Manual of Mental Disorders (DSM). These supposed psychiatric diseases did not somehow simply land here, in 2014, out of the blue. Not only do the various diagnoses outlined in the DSM each have their own narrative history, but so too does the DSM itself.

In any event, we consider the following when addressing so-called ‘borderline personality disorder’ or any distressing state of mind. In no particular order:

  1. Varieties of psychological distress are the logical outcome of early developmental stress and/or trauma; they are not diseases. Moreover, no psychiatric nor any other label is necessary if one simply sticks to the person’s experience descriptively.
  2. All people are capable of growth. There is a clear and sustained focus upon pathology in psychology and related fields. While this is understandable to the degree that psychology and related fields need to focus on what’s problematic, this view has become stubborn and rigid. It is not always the case that it is wise to focus on the pathological. More often than not, it is more beneficial to focus on the growth capacities of the whole person. Also, from the perspective of metanoia, everything that is distressing is the person’s attempt to achieve wholeness. That is, distress is often on its way, so to speak, to something further, more complete, whole. In this way, our approach is reminiscent of Karen Horney’s recognition of the problematic, but (more importantly) the person’s abilities to learn, adapt, grow and integrate.
  3. There is no cookie-cutter, one-size-fits-all approach to growth processes. What ‘works’ best is usually a combination of different approaches tailored to one’s unique circumstances and history. For this reason, we provide a Wellness and Recovery Resources directory in the text.
  4. Despite the type of modality sought, a hierarchical relationship is not only not necessary, but can be harmful. It is usually wise to work in a collaborative partnership — to wrestle, together, with the questions.

Applying this collaborative approach to Sofia, we were able to negotiate together between the spaces between the (ascribed) ‘borderline personality disorder’ and the (self-reported) “I am broken.” Sophia decided to stop understanding herself as being ‘borderline.’ She cast aside the label. We talked about the “I am broken,” and differentiated it relative to different people and contexts. Now, roughly a year later, she reports, “I am no longer broken with my family and friends. I am no longer broken with my coworkers and at school. I am still with him, but am understanding that more, too, and am less attached, somehow.” Sophia still talks to me once in a while, but has successfully found where she feels most at home and serene — in Nature. She has also significantly adjusted her diet after doing some research. She recognizes that there is no ‘cure’ to be found, since there is no disease. It is a matter of finding what ‘works’ in finding one’s rhythm with life.

After Thought…

As I was writing the brief section on pathologizing and growth, it struck me that most people consider psychotherapy, psychoanalysis, recovery, wellness, etc., resources only within the context of suffering. These are, of course, perfectly great resources to utilize in contending with distress. But this, too, I suspect, is falling in line with the pathologizing model. It is equally true that these (or other) resources can be harnessed to further one’s desires in life. Not every resource has to be utilized relative to pathology. Perhaps one is simply interested in psychological life or how to be more successful in this or that venture. Sometimes an individual wants to know how to be a better person to his or her friends, family, and other relationships. Others are interested in dreams or discovering different combinations of approaches that work for themselves and maybe for others. People who have suffered often come to the point of feeling satisfied with their growth and want to somehow express it. I have seen many artists, poets, activists, recovery sponsors/mentors, peer bridgers, therapists, psychoanalysts, etc., emerge from their own metanoia with a burning curiosity to know more, to take things to the next level, whatever that may be for them.

* * * * *

123 COMMENTS

  1. Call them what you will, the broken will never really be fixed. Our progressive recovery shrinks have now implemented a subculture in which they label themselves and set their own “objectives”, oppressing themselves so efficiently that they barely need psychiatric treatment at all. Broken, not borderline. Successful by their own standards. I have a piece of writing I did called Broken that explores trauma. But it is far too mad for Mad in America, which now has so many shrinks on board that its condition will soon be upgraded to Mildly Dysphoric in America.

  2. Before my break years ago, and before the years it took to finally accept my diagnosis of schizophrenia/schizoaffective I had some encounters with floridly borderline women. They tore me to pieces, like a wildcat would if you tried to hold it.
    Radiant and
    Immediate
    one
    moment and
    Razor sharp
    Bloodletting
    Fury
    the next.

    In my mind once I stumbled across the label “borderline” I was eager to have a label to shove that intensity away. Years later, after my own onset, which lacks borders in similar and
    Dissimilar
    Ways.

    I see how much these women taught me now, years later, about
    Echoing
    Unimaginable
    Pain
    Now
    An
    Old
    Friend.

    I discovered DBT through one of these women. It saved my life.

    We need to get rid of the toxic vocabulary that the DSM is based on. It’s not useful to anyone but
    Big Pharma
    Patent Holders
    And
    Stock Hoarders.

    These skinless
    Burning
    Women
    Lit
    My
    Way
    To sanity.

    I think it’s time the crushing
    Stigma
    Was removed
    From
    Our
    Caryatid
    Sisters.

  3. I also appreciated this article. In many, many powerful ways I’ve been denied my own self, and my trauma has been defined “not trauma,” or even “delusions, lies.” It makes me wonder if it’s possible to have my trauma recognized and heal from it, something I never considered before.

    • I am very happy you enjoyed the article, Cataract. I appreciate too reading your comment. I suspect that one of the things that made this book appealing to the publishers is that it is unlike any other book on the topic out there. It is so in that we (1) focus on trauma — not biology — as the source of distress, which is consistent with the current research and (2) our unwavering belief in people’s growth potential. Despite what psychiatry and countless other professionals say on the topic, *is it always possible to grow, learn and to be happy, centered, and well (as the individual defines that for him- or herself). It is possibl to recognize trauma and to heal from it! Thanks again for your comment.

  4. Sharon,

    In response to your question:

    “Is this how you people want your account of Borderline? Fictionalized. Sanitized. From a doctor, who knows it from the outside in, who references clients and not people?”

    I have to admit that one clear advantage to “this account of Borderline” is the safe space created by the internet—

    Trauma does not explain the need to inflict pain. Trauma does not explain a display of entitlement to reduce another person to subhuman status– nor is the pervasive attitude of one’s superiority a right of passage for a victim of abuse. These traits are indeed exhibited by *some* people whose graphic recounting of their abuse histories is often the first sign that the *listener* is being scrutinized for his/her potential to satisfy their predatory cravings.

    It is quite the challenge to approach any discussion of healing with someone bent on making you pay for their irreparable damage– though this does not discount the truth of the inherent human potential to heal, it does pose significant risks to therapist or friend who dares suggest that everyone does actually possess this human potential— or that creating more bad karma by demeaning others is a vicious no win cycle sure to increase suffering– and it does appear that the heightening of suffering is the goal– with the limits set by the *victim* who is settling a score—

    I suppose the meat of any true account of *borderline* is in the wondering why anyone would submit to being eviscerated by a vengeance seeking trauma victim– I mean willingly submit– as in grant permission to be strapped into the roller coaster seat for the virtually senseless experience of *sharing the pain* — on terms that appear masochistic — at best.

    Having said all this tucked safely behind the security of my computer screen, I have to say that the this post is probably the best way to give *us people* our account of *borderline*–

    The title of Bob Whitaker’s first book, “Mad in America” evoked compassion from many people and inspired a desire to find more humane solutions for those who were branded with psychiatric labels– so I doubt that the webzine was given the same title with the intent of driving its readers to madness ??

    • Hello Sinead,

      While your comment is directed @ Sharon, I hope it is ok if I comment here. I’ve been reading your post over and over — you’ve covered a lot of ground in a very concise way. A lot of it hits a nerve with me in the best possible way.

      A lot of people, typically who endorse a professional / survivor (peer, etc.) binary, assume that the ‘professional’ does not have his or her own story. The “doctor, who knows it from the outside in, who references clients and not people” makes a few assumptions and, as you point out, this is made especially easy to write from behind a remote computer screen.

      More interesting, at least to me, are your comments on the (attempted) pain-producing maneuvers and concordant double-bind the friend, therapist (or anyone else in the vicinity, really) finds him- or herself in. You clearly have a sense of these dynamics, which are pretty slippery and quiet, but concretely present for those experiencing them. We take a run at this in our book. This and a few other things I simply haven’t addressed in the MIA posts thus far. I can’t get to everything, except for in book form and even then, there are still things left unmentioned.

      Anyway, I won’t go on and on. I guess I am saying that I appreciate what you had to say here and hope you write more. Thanks!

    • “It is quite the challenge to approach any discussion of healing with someone bent on making you pay for their irreparable damage”. Not sure what you want to say by that… It is only understandable that people who have been abused have a of of rage in them. But there are also people who use their real or made up abuse stories to use other people’s sympathy – that’s quite a different animal you’re dealing with here. The borderline label is the same bs diagnosis as ll the DSM labels – throws many different people with many different reasons for a particular behavioural pattern (like they can even start talking about a personality type) in one bucket and makes sweeping statements about them.

      • Hey B, I’ve got a lot going on today, so I have to run soon. Briefly, though, I agree with you. We outline in the book many of the things you’re saying. Axis II diagnoses, which are based upon ‘BPD’, are so all-encompassing that its one of those ‘this is either everything or nothing’ categories. Thanks for your comment!

      • B,
        Though I have a working theory of *trauma memory* that explains for me why someone offering comfort or reassurance to a victim of severe abuse could be perceived as a target, whipping post, meaning that even beyond the defense, that it “only natural for a victim of abuse to have a lot of rage”, the truth of the dignity and respect worthiness of each of our lives, dictates that all forms of abuse directed at others is fundamentally wrong–. I denounce it– never excuse it.

        I agree that the labels and DSM diagnosis are waste baskets — but they are also shields for psych clinicians who need to project their inadequacies on to an acceptable scapegoat– or need to extricate themselves from the vortex of human experience —

        The increase in the number of diagnoses indicates the ever increasing sense of weakness and inadequacy of psychiatry–. imo, of course.

        • “dictates that all forms of abuse directed at others is fundamentally wrong”
          Not all bad things are created equal. Having a fundamentalist approach to anything is hardly ever a good thing and understanding someone’s perspective is not the same as condoning it.

          • My approach is humanistic– rational thinking, awareness of the value of every living being– human stuff.

            “Understanding someone’s perspective..” on why she is cutting herself?–

            IF one does not confront the *wrong doing*, one is essentially condoning it–

    • I don’t relate to most of this post. It is easy to asset that a person receiving services assumes the provider has no trauma history of his or her own. It is even easier to assert that the person with the trauma history has no experience as a provider or clinician who would “be strapped in the roller coaster seat”. Some people use the therapist as a target to “settle the score” and some don’t. I find the whole idea of a graphic accounting of the abuse history as an assessment tool to determine if the listener is an appropriate target for “predatory cravings” to be offensive, not to me personally (as I am one of the angriest, most predatory trauma survivors out there, at least in the realm of individuals publicly sharing and involved in these kinds of discussions), but as a generalization of trauma survivors as a group. In my previous experience as a clinician, I did not find this to be the case at all.

      And, I can agree with you, Sinead, that Mildly Dysphoric in America is giving *you people” what you want. It seems I have really offended you with a few words of criticism; and, I am not sure why, nor do I care to guess. But the predator in me is purring.

      • Sharon,

        No offense taken. I appreciate your response as it has supplied me with many points to ponder today. The first being that I am in total agreement with Brent and Jacqueline regarding their view that the DSM diagnosis, BPD is nothing but trouble.

        I subscribe to a perspective that explains every documented symptom of mental, emotional, spiritual duress– whether or not is has made it into the DSM V, as a function of an individual’s unique reaction to *trauma*.

        I define traumatic experience in terms that reflect an individual’s perceived threat to her survival– an experience that set into motion our innately human biological survival mechanisms– that turn us into instinct- driven animals and turn off all of our higher executive, cerebral functions– which automatically means that the *memory* of the event(s) will likely be *miscoded*.

        Creating a narrative to satisfy our innate biological drive for equilibrium, the story we believe explains the terrifying angst.– This is not to say that no one can accurately recount a traumatic event he has survived– but natural variances in comfort, safety seeking needs- or, rather individual differences in pain tolerance thresholds , tend to influence the degree to which the unbearable stuff is perceived and recorded. I will not go into this much further, as I firmly believe that there is no benefit to challenging or directly altering anyone’s perception of their trauma– or trying to figure out what really happened– or even if the whole thing is confabulation. WE are the stories we tell ourselves and others about our lives.

        ALL of us trauma survivors? Most likely, yes, imo– but there are some fascinating differences in the way we live our *stories* that are, after all, our life rafts.

        There are help seekers and help devourers amongst us– infinitely different and deadly in certain combinations.

        WHY was there ever a need to pin a label on a sub-set of trauma survivors?

        Or specifically (not trying to avoid the discussion)-

        How did the diagnosis * Borderline Personality Disorder * become the best label to attach to a hook, IF you are trolling for Sharks? I think because it is a compilation of unnatural, alien behaviors that draw blood– (emphasis on the blood letting)– It means nothing, and everything– depending on where you sit.

        On locked wards announcing the presence of *a borderline* is like sounding a red alert.
        The staff knows the drill:
        Secure your personal boundaries!
        Sweep the unit for sharps !
        Check the med cabinet !( Do we have enough Benzos?? )
        AND– don’t bother thinking you can make a difference with THIS one–

        That was enough of a hook for me– I could NOT resist this mystery.

        20 years later, and 180 degrees from my original *clinical* perceptions and practice, I do still see a point in differentiating trauma survivors– just as I understand the value of litmus tests–.I have noted a few that define territory and mobilize the force within me.

        Someone who – on first, or early encounter, insists on just putting out there, the story that lets you know who you are dealing with?? Combo of shock and awe style narrative that is so heartbreaking and terrifying that you fear for your survival?

        Put away the popcorn and grab your haz mat suit!

        Someone who broadcasts that you are the only one who understands him/her-? only one who really cares ?– only decent human being on the planet?
        THE only one she trusts??

        Wipe that self satisfied smile off your face and locate your high school goalie Lacrosse gear- PRONTO!

        YES! It can be done– you can ride (his/her) wave to shore, unwitting passenger on * her personal* surf board — don’t look down and if you do, don’t mind the SPIKES–

        YES ! transformation is possible– but it is not a clinically driven *positive patient outcome*- it is a mutual death defying trap, where you cannot escape until you have seen your own demons from h*ll.

        Having survived the initiation, no doubt you will create the narrative– the all clear, I’m safe story– and you will become hyper vigilant and adept at devising and using *trauma survivor differentiating litmus tests*

        AND though you may choose to NEVER refer to BPD in any way shape or form– YOU will be sensitized to the red alert—when you hear it.

        So, Sharon– did you know that breeders of German Shepherd dogs have to be vigilant over the litters of pups for signs of Wolf traits ? The *litmus test* is determining whether a puppy laps or sucks milk poured into a bowl. The *suckers* have too much wolf in them — which means they are unsafe — not okay to sell or have as a pet.– BUT, there are many who claim that is hogwash– it is all in the nurture– STILL– breeders are expected to conduct this safety litmus test–

        No two predatory, vengeance seeking trauma survivors are the same– which is why, I believe the force fields (BPD stigmatization) have gone up–they were created by and for therapists–

        who don’t want to be labeled *bad therapists*–

        because they could not resist the urge to bail-

        at the first sight of their own blood.

        Best,
        Sinead

    • Oh, I forgot to mention something, Sinead: I am still reading and re-reading your post. It’s very interesting, at least to me. I hope you’re doing some writing out there somewhere. The field really needs your voice. If you or anyone else wants to connect, I am on Facebook: https://www.facebook.com/drbrentpotter

      I am there more than here chatting with quite a few people about such topics. Anyway, thanks again and I hope you’re having a great day!

    • Sinead,

      I really appreciated the sensitive acuity with which you broached an immensely loaded topic. Personally, I can’t think of ANY diagnosis or label more difficult to hold in open conversation than that of “borderline personality disorder”. As Judith Herman so aptly wrote, borderline personality disorder, in many ways, has become “a sophisticated insult”. The fact that certain sequelae of experiences can lead to a collection of symptoms that, when clustered together, lead to an entirely subjective diagnoses isn’t what’s loaded. Where it gets loaded is with is everything that goes along with the cultural, societal, medical perception of someone labelled “borderline”.

      When I read your paragraph – “Trauma does not explain the need to inflict pain. Trauma does not explain a display of entitlement to reduce another person to subhuman status– nor is the pervasive attitude of one’s superiority a right of passage for a victim of abuse… graphic recounting of their abuse histories is often the first sign that the *listener* is being scrutinized for his/her potential to satisfy their predatory cravings.” – I felt chilled. I thought of my own experiences with and around this label.

      It’s so rare to find a piece of writing that brings together the challenges of navigating trauma (one’s own or another) AND YET simultaneously speaks to the pain that renders it seemingly impossible to stay with such pain. Of the need for both listener and sufferer to, somehow, find ability to remain present as required for healing to occur. To recognize the human in the other… and the humanity and humaneness of oneself.

      I’m going to save your post, and reread it many, many times over… Wow. My own words aren’t doing justice to what I’m trying to write… Thank you. Great work.

      MB

      • I also appreciated Sinead’s comment. A turning point in my life was when some people helped me realize that no matter what you’ve been through, it’s never okay to be abusive to others. (Not that I still don’t have moments I’m not proud of, but don’t most people?) The “you people” phrase was not lost on me either. I guess I just became a “you people.”

  5. With all due respect, I honestly do not think you understand BPD at all. And I fear that you really won’t unless you live with someone who suffers with it, because only then will you realize that, though their stories are emotional and powerfully persuasive (amazingly so), they make things up.

    You say that, “Over the years, I’ve heard countless horrific stories of abuse, neglect, trauma and most every form of torment that one human can inflict upon another. The sting of such stories never lessens. I’ve often marveled at the mind’s capacity to focus a sustained attention upon new ways to perpetuate and promote anguish. Sophia’s story is tragically similar in regards to the abuse she suffered. Her life, by her convincing account, was really an endless series of disappointments and traumas, of every imaginable variety, layered on top of one another.”

    What you don’t understand is that people with BPD turn ordinary events into trauma and drama. Until you realize that, you will be doing the patient no good, and you will potentially be assisting with the slandering of the “split” person they are telling you did these terrible things. Whether you like labels or not, its called a “distortion campaign” when it gets hot and heavy, or just a way for them to externalize the bad feelings they have about themselves and gain sympathy when it hasn’t reached a crisis. People who suffer from this do deserve sympathy, but not from the stories they tell. I actually lived with someone who had this for seven years and I know the truth and I know what was said after I ended things, and the two had very little in common.

    • “I actually lived with someone who had this for seven years and I know the truth and I know what was said after I ended things, and the two had very little in common.”
      Yeah because that never happens otherwise. People whose relationships fall apart (in a bad way) usually have quite different narratives about what, when, where and why. You don’t need to label someone a BPD for that.
      BPD is a lovely label for anyone from pathological liar to a victim of neglect and abuse. Making blanket statements about people who are labelled as such (often as a result of the actions of abuser: nothing better to get your daughter/wife declared dangerously crazy and have her every word be disbelieved and treated as hysterical drama queen) is harmful. You can’t say anything if you don’t know a person well and for a long time and know exactly what happened to them.

      • Actually I have, Zippy321 and so I know first-hand of the things of which you speak. And I have seen, for the most part, positive outcomes (personally, professionally) in my engagements with emotionally chaotic people. Living with someone who is emotionally chaotic, as you describe it, it truly painful and traumatic. But that doesn’t mean that there isn’t hope and the possibility for growth. Our character doesn’t show itself under pleasant circumstances, but when it’s under fire, as it were.

        I am sincerely sorry to hear that you lived with someone who was destructive for such a long time. I can empathize and sincerely hope that you’re recovered from the experience or, at least, are not in similar circumstances now.

        Emotionally chaotic / destructive people are wounded people. This heightens the demand for compassion and hope, not lessens it. And we have to manage our own way too. It is true too, sadly, that some people are just unwilling, incapable and/or confused about wellness and, no matter what, will remain chaotic, destructive, negative, hateful, angry, etc.

        I appreciate your comment — thank you!

        • I certainly agree, Brent. My point was that borderline personality disorder cannot be understood, in my opinion, unless we confront the fact that much of the purported tragedy is inflated beyond rational thought. That is part of BPD – a symptom, if you will. Sure, sometimes the tragedy is exactly as claims, but often inflated beyond rational thought? Absolutely.

          It seemed your article simply took the patient’s tragic stories (see the quote from your article I cited above) at face value. Maybe you were just being tactful by not saying that, but I think it must be confronted and that it plays a much bigger role than most are willing to admit.

          • You make it sound as if every person given this disgusting label are all alike, all one and the same. And, you sound as if you’re making your experience the yardstick by which to judge all things. I disagree with both things.

            You try getting traumatized, especially as a child, and then see what you have to say about all of this.

      • Hello again, B! Thanks for your comment. I agree with most all of what you’re saying. The label ‘BPD’ it too broad, in my opinion, and can basically be translated to ‘crazy woman’ as determined by the (predominantly male) view making that judgement. It is important that labels be tossed out and replaced with a relational understanding of someone. Thanks for your comment.

    • Dear Zippy, I thank you for this response (and taking the time to engage in this important dialogue). I think you will be pleasantly surprised by the content of our book. This clinical narrative is less about the complex relational dynamics you are describing and more about seeing all people as having the possibility for growth and change – finding ways to live better. This is something I have seen over and over in my clinical work (even with severe trauma) and that’s why I believe it to be true.
      ‘Thought distortion’ happens all the time – amongst all different people – no diagnosis necessary – as B points out. But I hear your frustration. When you are in a close relationship with someone who is distressed and whose emotions feel chaotic it is very difficult. I know this both personally and professionally, so I am not naive to your point. And I am sorry for what you’ve gone through. I am hoping our new book will help friends and family members, as well as people suffering and mental health providers.
      Best wishes,
      Jacqueline

      • Jacqueline, thought distortion may well happen to a lot of folks with a variety of problems, but let’s understand clearly that those who suffer from BPD have that problem. Until we face that uncomfortable truth, how can you go about trying to help them properly? I just don’t see it.

        All – much appreciated, but no need for sympathy. I’ve made my peace with what happened and hope the best for her. I just would like an honest discussion about the condition and that requires facing truths that are unpleasant to hear (although liberating for others).

        • Hi Zippy, I agree and we do provide experiential narratives that show what it’s like for a clinician to navigate these types of distortions – which in my opinion is one of the greatest challenges of the work. We also show how we use a growth model to help people identify and integrate trauma(s) and feelings and hopefully relate better to themselves and others in their lives. I don’t deny the difficulties (it’s challenging), but I also believe that people can be helped – and I really despise the diagnosis – all diagnoses are stigmatizing – but BPD is one the worst.
          Thank you again for the discussion.
          Jacqueline

        • Zippy,

          OK, I’ll bite.

          What sort of *proper* help would you suggest for someone who confabulates to beat the band?

          One thing I believe has a ring of *truth* universally, is this:

          People lie when they are afraid–the alarm set off by fear, is internal- and quiet.

          Unbearable anxiety is frightening–IT demands an explanation — a story to explain what someone or something is doing or has done TO us — to explain this angst/fear FOR us.

          The explanation is a STORY–
          that ;
          we tell ourselves and each other:
          A *believable story*–
          not necessarily a factual one.

          The TRUTH is ,-
          -all that matters is the quelling of the unbearable angst–

          because–
          First and foremost, we all need to feel safe in our own skin– we strive for this– by whatever means necessary?– sure,sometimes.

          You have described a characteristic , confabulation- It can be an indication of a protracted state of fear–

          The TRUTH that this may have been the internal hell experienced by your ex, is the best place to start for an honest discussion about *her condition*

          Can you face that truth??

          • You say: “The explanation is a STORY that we tell ourselves and each other: A *believable story*– not necessarily a factual one.
            The TRUTH is ,–all that matters is the quelling of the unbearable angst–”

            Sinead, I recognize that. In fact, my understanding of that actually flowed from my ex’s diagnosis, and I never would have understood it without that diagnosis.

            But what happens when when the story a person tells does not reflect reality (beyond the person’s internal reality)? What happens when that story is then told to other people – friends or neighbors, or to the police, or to children’s services? What happens when the person whose internal story does not reflect reality but they are telling people it is true? Real consequences flow.

          • “One thing I believe has a ring of *truth* universally, is this:
            People lie when they are afraid–the alarm set off by fear, is internal- and quiet.”
            Not only. And not always. Generalisations always are dangerous ;P.

        • “those who suffer from BPD have that problem”
          Oh, so every person diagnosed with BPD is a pathological liar? Or a professional story teller?
          that’s the problem with the whole diagnosis angle – you make sweeping generalisations about a bunch of people with a sticker over their foreheads just based on a 3 word phrase that is a label.

      • Nothing in my statements suggests people who suffer from BPD do not deserve compassion. Quite the opposite. Recognizing that people who suffer from BPD sometimes cause harm by fabricating and inflating stories is just recognizing reality. Denying it because their condition (aptly described by Sinead above) is the cause helps no one. It’s better to face it and gain a greater understanding of the problem by so doing.

          • I respectfully disagree. Suggesting that the fabrication and inflation of stories is not linked to BPD itself is simply a denial of reality, and sets you further back from really understanding the problem.

          • Typical response from someone hurt by someone with the borderline label. Emotional abuse can occur and be explained without reducing it to “well, it was because she was borderline.” This is as reductive as reducing someone’s violent outburst to “well, he was psychotic.”

          • Melodee, I recommend that you read Sinead’s comment above, which I will summarize here as I think it remarkably captures the reason why confabulation is tied to BPD:

            “People lie when they are afraid. The alarm set off by fear is internal, and quiet. Unbearable anxiety is frightening. It demands an explanation — a story to explain what someone or something is doing or has done to us — to explain this angst and fear to us. The explanation is a story we tell ourselves and each other. A believable story – not necessarily a factual one. The truth is all that matters is the quelling of the unbearable angst – because – first and foremost, we all need to feel safe in our own skin – we strive for this. By whatever means necessary? Sure, sometimes. Confabulation can be an indication of a protracted state of fear.”

            We can have empathy for the person who suffers this – my God, I was with my ex for seven years and I tried and do have empathy. At the same time, and without being contradictory, we can (in fact, we must) recognize this if that person who is suffering bears false witness against others that has to be confronted.

          • Zippy321 writes;

            “At the same time, and without being contradictory, we can (in fact, we must) recognize this if that person who is suffering bears false witness against others that has to be confronted.”

            Have to agree with that. The events that can follow from bearing false witness can be disastrous for others.

          • Exactly. People lie all the time and especially in relationships when something goes wrong. Talk to a randomly chosen divorce lawyer. What about all these “borderlines” who were really abused and do tell the true and nobody will ever believe them since they are “crazy”? I happen to know a lot of stories where people were traumatised in one way or the other, had a mental breakdown and then were re-traumatised and labelled while the abuser walked (or not only walked but got all the sympathy for having to deal with a nut case). It can work both ways and sticking labels on people’s foreheads doesn’t help. You have to know the whole story before you can make any judgement on someone and the so-called professionals are usually the least informed to do that because they usually hear only one story and too many of them anyway hear what they want.
            “Suggesting that the fabrication and inflation of stories is not linked to BPD itself is simply a denial of reality, and sets you further back from really understanding the problem.”
            And suicide is linked to depression. That’s circular thinking – it is part of the definition so surely it’s linked to it. Except that it’s neither sufficient nor necessary so you’ll have a lot of people labelled BPD who are honest folks and a lot of “normals” who are pathological liers. And BPD “diagnosis” usually does not involve a full blown investigation to define who’s telling the truth.

          • I find the dichotomy of lies/truth seriously flawed. There are a number of points in between. Misrepresentations, half truths, mistakes, all having different uses to a skilled deceiver.

            I know that in the public sector one method of getting around the code of conduct/ethics where as a public officer one has a duty to tell the truth and be honest, is to pay an outside contractor to tell you the lies you need to ensure the required outcome.

            For example setting a savage dog on a person injured in the workplace, and in a wheelchair, to see if they are ‘faking’ the injuries would be unethical. So, contract the work out to someone who is not bound by the code of ethics.

            These type of skilled liars would never be deemed as suffering from BPD, and in fact are rewarded for such behaviours.

            I wonder if it is a lack of skill in deception that results in the successful application of the label?

          • “Misrepresentations, half truths, mistakes, all having different uses to a skilled deceiver.”
            I’ll file all those under lies. In fact they are usually much more effective than straight lies and can be easily explained away if the person gets caught. In fact many people labelled with BPD get it because someone well versed in the above mentioned techniques have gaslighted not only them but also the so-called professional.

            It reminds me of the still quite recent Zimmerman case: the guy was clearly an abuser but if you have taken the account of any of his many escapades with the law one by one he was always able to explain himself quite well (and if you happen to have heared tapes from his calls to 911 he was the calm guy with a believable story, not like his hysterical, potentially BPD wife, GF etc.). Only when you take the whole pattern and collaborate all the witnesses and use some Ockham’s razor it is clear that he’s the one to blame. How often did you see so-called professionals do a thorough investigation of patient’s life and relationship to determine who’s really crazy?

          • “I’ll file all those under lies. In fact they are usually much more effective than straight lies and can be easily explained away if the person gets caught. In fact many people labelled with BPD get it because someone well versed in the above mentioned techniques have gaslighted not only them but also the so-called professional.”

            Certainly misrepresentations and half truths are much more effective than straight out lies B. Tell the lie with plausible deniability, and if caught out, put it down to a mistake, and don’t do anything to rectify the ‘mistake’. That’s the integrity test for misrepresentations for me. If the person makes an effort to rectify the mistake, then it truly was a mistake, if not they were deliberately lying to achieve a particular outcome.

            Personally I look forward to the day when these interviews with psychiatrists and mental health professionals are recorded so that the information they are provided with, and the opinions they formed from that information can be checked. I know from my experience their are a lot of these people very skilled in the art of fraud who are manipulating outcomes, and with no accountability, no chance of them ever being caught.

            Can’t see them being in a hurry to do that though until the loopholes have been identified and can be exploited. Needs to look fair, but not actually be fair lol

        • Zippy, If some people who suffer from BPD “sometimes cause harm by fabricating and inflating stores,” then so very well do those close to them who have no diagnosis. It’s becoming quite obvious that you equate your personal opinions about and experiences with your ex, one single person, with every single person in the world who has the BPD diagnosis.

  6. I am sorry you are feeling defensive. I only know the situation with my ex-spouse. For years my heart went out to her as she told me of the terrible wrongs done to her over the years, as if tragedy were metal and she a magnet. I sympathized and tried to help. When it all became too much and I left, I witnessed her saying things about me remarkably similar and I knew that her statements were simply false. Knowing that they were false, I do now doubt the veracity of the things she said about others.

    I am sure some people are wrongfully accused of making things up. That does not mean that the opposite is not true, as is often the case with people who suffer from BPD.

    • I replied above, Zippy321 and will also say here: You have absolutely nothing to apologize for. Like you, I know first-hand and have been impacted by the things of that you talk about. I have no way to convincingly convey this over a thread, but I’ll ask that you take it on faith. It is traumatic and, as I mentioned above, some people choose to remain addicted or attached to misery rather than otherwise. I am sorry to hear that you had to endure this and hope things have improved significantly for you.

        • Zippy, you wrote:

          I am sorry you are feeling defensive. I only know the situation with my ex-spouse.

          Question 1: Do you often tell other people how they feel?

          Question 2: If you only know the situation with your ex-spouse, then why are you so intent on making blanket statements about all people who have been given a particular arbitrary label?

          Question(s) 3: What did you actually read as “defensive” in B’s comment? (You didn’t say.) And do you know B well enough to make an assumption like that?

          Related question: Just out of curiosity, did your ex identify with the “borderline” label, or did you “diagnose” her after the relationship ended?

          • Just reading between the lines, but I assume he actually loved her. It is devastating to love someone and watch them not only destroy themselves, but also to punish you for wanting to love them. It usually means you stuck around for quite a while knowing that you were going to be hurt, but you weren’t willing to give up on the other person until your relationship became one long, string of abuses. It is generalization, but we all generalize our pain in an attempt to protect ourselves.

          • That was my sense as well. I was not trying to minimize anyone’s pain. It’s only human to generalize, as you said, but the “borderline” label is dehumanizing and it doesn’t add anything to the conversation.

          • Most people on this board say they don’t like to “label” people as borderline, but I would point out that there can be a positive side of the diagnosis. (I would not call it a label at all, as that term itself is negative.) I was with my ex trying to help as best I could for years, but there was no comprehensible explanation for what she suffered from that I knew. I had few tools. I think a lot of family members and loved ones of such people feel that way, but much more so when there is no explanation. Finally learning what she suffered from was a revelation, and the diagnosis actually gave me more empathy and real peronal relief. There was a name for what I found incomprehensible and I was not alone in caring for someone with these problems! In fact, if that diagnosis came to light earlier, rather than after we split up, it’s possible I could have done more.

            Fine, don’t label people with these problems, but do diagnose them. The diagnosis is of a very real problem. Pretending its not makes things worse in my opinion.

          • “I would point out that there can be a positive side of the diagnosis”
            Positive for whom? It reminds me of all these people who find it helpful to drug their relatives up to their nostrils or lock them up in a psych ward. Yeah, it’s helpful to put the blame on someone else and rid yourself of responsibility but calling it medical diagnosis/treatment is another matter.

            The problem with medicalization of human distress is that it is a double edge sword (where both edges bring destruction): one one hand it allows real abusers and bad folks to hide behind “it’s not my fault, my mental illness/childhood trauma made me do it” on the other hand it allows blaming the victim for the understandable even if extreme reaction to his/her circumstances. Treating people as individuals in a certain social and historical context (in relation to their personal histories) and not as labels is much more useful since these labels are not explanatory but at best descriptive (of behaviour: the whole mambo-jambo about how a certain person is inside his/her head is a lot of untestable, unscientific bs).

            You can have two people with superficially similar behaviours having different reasons, personal histories, emotionality, empathy etc. etc. Label tells you nothing, at best it tells you that there are certain patters of behaviour in human populations in reaction to certain social influences. You can get that same ideas from reading fictional literature and interacting with people, you don’t need psychology for that. In the end it is down to whom you can accept in your life and whom you have to cut ties with in order to stay true to yourself and maintain meaningful relationship with others in the same time.

            Treating these rough descriptions of human behavioural patterns as medical diagnosis is harmful and counter-productive just as it is harmful and counterproductive to call homosexuality or transsexuality a mental illness. People are who they are and some things they are born with, some things get imprinted in their early development and some they acquire during their lifetime. Some can change some don’t. There’s nothing medical about it.

    • “I am sure some people are wrongfully accused of making things up.” Well thanks for that at least. 😛
      There is a movie available on Youtube called The Trouble with Evan. Very demonstrative of what’s truly going on in the life of a “troubled” person (in this case a child.) How I wish I had had a “Trouble with Evan” camera of my own. The camera catches the unbelievably abusive reality of his publicly-appearing sweet, loving family. And the kicker is neither his father or mother have a sliver of realization of how abusive they’re constantly being. They have just decided Evan is crazy, bad, evil. If there had been no camera, Evan’s horrific abuse would have remained his own personal mental disorder.

    • I think that some people are traumatized that it leaves everyone that comes into their life suspect for further abuse. That outrage and anger becomes a comforting constant in the chaos, and the one thing we can always depend on. The sad thing is that it envelopes all of their relationships because that is the one response they can fully relate emotionally to. So they pick fights and create situations that are resigned to end in further trauma for both parties.

      • @acidpop5,
        From my persepective, your explanation here– is a rationalization of the pattern of dehumanizing others, that is at the heart of [some] trauma/abuse victim’s failed relationships–. It sounds compassionate, and on the surface it is, but looking deeper you have to note that most of the failures to achieve or sustain a value creative lifestyle come down to these *excuses* for mistreatment of others. In cases where the catalyst for the abusive behavior IS the care another is trying to demonstrate, you have to note that this is *unnatural*- *alien* to that which we call human. Stop here–

        WHY would anyone want to create and propagate a *reason* for this irrational behavior ? Doing so only condones the *right of passage* of an abuse victim to take hostages anywhere, anytime–

        Whether the connection with a person who “is suspecting everyone close to him/her as a potential perpetrator” is based on friendship, intimacy or a therapeutic/treatment contract- ; whichever relationship applies, it is nothing short of a lack of respect and lack of mercy to suggest the person has a *reason* to – hurt the ones she loves!

        First priority, in my practice, is REALITY TESTING– the methods for laying this foundation vary – need to vary as everyone is uniquely an individual, BUT-all rapport building- , all motivational interviews- , all the gathering of info that describes the person’s strengths, wishes, fears– is key to broaching issues related to the basic humanistic principles and values that one relies on as a guide for relating to others–

        Dehumanizing others is the M.O. of some trauma survivors– I call it a litmus test for mobilizing the force within to confront, divert and redirect these tendencies they have that hideously negate the value and worth of another person.

        DBT seems to be effective in directing the focus internally– a tool for calibrating oneself in order to more accurately perceive others, perhaps– And DBT is a not threatening to the *wounded self*– does not judge, criticize or admonish–. I see DBT as a great scaffolding base from which to get down to the business of assisting and supporting the development of a more realistic *self*– with human, rather than animal skills for survival–

        I just wanted to point out that while it is true that these patterns of lashing out and causing injury to others or to self do reflect a *reaction* to prior abuse– they are occurring in a context where only *internal angst* exists with no external evidence for the fear–. This is what I call *maladaptive survival syndrome*– or rather the language I use – not finding anything relevant in PTSD–

        • Dehumanizing others is the M.O. of some trauma survivors

          It’s also the M.O. of some “mental health” professionals.

          And who is saying that abuse of any kind should be tolerated by anyone? Saying that there is a reason for a person’s actions is not the same as saying that there is justification or that those actions.

          • My point is that *reason* does not figure into rauma reactive behavior– not as a cause or as an explanation.

            I think this is important because the whole *off wiring* of neuro nets in a trauma victim/survivor really has to be addressed, for IT is the reason– and only the only explanation–

          • But, then if you say there IS a *reason*– why shouldn’t the abuse be tolerated?
            You have railed against the use of the term , the diagnosis, BPD — but then you employ the thinking of psychiatry when you refer to a behavior as having a *reason*– a symptom of a disorder is expected to exist so long as the disorder does– the symptom is given credence via the naming of the disorder–
            Reasoning applied to these scenarios points to a *maladaptive* behavior that should be the focus– NOT an explanation for hurting another person.

          • I think you’ve misunderstood me, Sinead. To me, there is no excuse for abusing another person. I was using the word “reason” in the sense of “cause” or “intelligibility,” not “rationality.” That is, a person’s behavior is intelligible within the context of their life experiences. There is nothing *unnatural* or *alien* about it, as you suggested in your reply to acidpop5, whose comment, far from rationalizing predatory behavior, was simply (to my reading) putting it in context. Your reply to her comment was dehumanizing (see *unnatural* and *alien*) and therefore unacceptable, imo. That’s why I found it so ironic that you went on to say that “the M.O. of some trauma survivors” is to dehumanize others.

          • “To me, there is no excuse for abusing another person. (…) rationalizing predatory behavior”
            First of all that is kind of philosophical, moral and to an extent a legal question: how much does intent and motivations matter? And more widely: how much are we responsible for our actions (is there free will etc.)? I think the most practical answer for most people is: intent and motivations matter to some degree. If I kill someone because of an accident I’ll be “less guilty” than if I kill someone intentionally. Same if I kill someone in an emotional argument vs in cold blood – they are not morally or even legally equal. Which of course complicated things because people can fake intentions and motivations to avoid punishment.

            So it’s not so much excusing abuse or predatory behaviour than rather to figure out why a person is doing this and if they are aware or in control of their behaviour and its consequences to others. No label can do that – that is not easy in criminal cases with witnesses and evidence and all – it’s far more difficult in personal lives of people who get caught up in toxic relationships. It’s practically impossible for the so-called experts who form their bs opinions after minutes at best few hours of interview, usually with one person and usually with their own prejudices.

          • “But, then if you say there IS a *reason*– why shouldn’t the abuse be tolerated?”
            The fact that behaviours have “reasons” (or rather causes) does not implicate whatever moral judgement you apply to the behaviour itself or to the person. All behaviours have “reasons”.

        • And it largely is. There are points in your life when you consciously choose to love a person because you’re stronger than they are, and they need you, and you do rationalize because it gets you through the worst parts. It is never okay to cause trauma or be abusive to those around you. I made the decision as a well informed and capable adult. In the end, I began to fear that the role I played in his life was causing him more harm than good, and I was forced to walkway. He never forgive me.
          You seem determined to read a lot of psychological confusion into my decision, and it is your right to do so, but you don’t go into a situation where a person is trying to withdraw from years of heroin use and don’t expect top get hurt. What you do do is learn to rationalize and compartmentalize because ur allows you to focus on that person and separate from their situation. There are probably better ways, but having not seen him in fifteen years, and to suddenly find myself in the middle of that, I played it by ear.

          • @acidpop5,

            I am lost– if your above post is a response to me– or to @uprising;’s response to me about my response to you? I have not been addressing anyone’s personal relationship decisions– at least not knowingly– and I have no argument against seeking to know another’s heart and mind thru processing encounters and conflicts with him/her–

            I thought we were discussing BPD– as it effects the lives of those given the diagnosis and those who relate to the diagnosis and not the person–

            In any case, I appreciate all that you have shared here. It is difficult to have fully meaningful dialog on these forums, but it is possible to learn a great deal and to imagine this sharing is expanding our capability to understand one another.

        • I’m sorry to tell you Sinead but you’ve got no idea what you’re talking about:
          1. “whichever relationship applies, it is nothing short of a lack of respect and lack of mercy to suggest the person has a *reason* to – hurt the ones she loves!”
          Every behaviour has a reason. It may be revenge, it may be fear, it may be pleasure (like the one that comes with being a puppet master). There are reasons, which does not mean they’re equal justifications.

          2. “Dehumanizing others is the M.O. of some trauma survivors” Dehumanising others is a natural tendency of all human beings operating in a group think mode. It’s in fact a very human and evolutionarily reasonable tendency (which doesn’t immediately mean it’s justifiable).

          3. “a tool for calibrating oneself in order to more accurately perceive others, perhaps– And DBT is a not threatening to the *wounded self*– does not judge, criticize or admonish–. I see DBT as a great scaffolding base from which to get down to the business of assisting and supporting the development of a more realistic *self*– with human, rather than animal skills for survival–”
          Sorry but I file all the “wounded self” and “calibrating self for better perceiving others” and “development of a more realistic *self*” under psychobabble. Like you or anyone knows how and what a person thinks and perceives self and others. Or how is her/his internal perception of self structured. This is super arrogant. You don’t need to tell me what my image of self is and if it is animal or human or developed or childish or what not. This is the most disgusting and harmful part of the whole BPD label – the pretense that you know anything about the person that he/she does not know/understand and that you can help mold this person into a more mature or human being. Sorry but sounds like some Freudian bs to me.

          4. “This is what I call *maladaptive survival syndrome*– or rather the language I use – not finding anything relevant in PTSD”
          Of course, if you’re operating within the BPD and PTSD label framework you can’t possibly find any link. It’s not like what people filed under PTSD (and let’s take only vets as an example) and BPD are a bunch of different “misbehaviours” for different reasons and with at best partially overlapping “symptoms”, right? There are people coming from war who were traumatised by seeing their comrades or civilians blown to pieces, there are ones with traumatic brain injuries and they are ones who simply got addicted to the thrill of danger. And you have a mix of them all. They all have problems to adjust to “normalcy” and they all have additional hurdles (situation at home) and they all get one label. I wonder why “treatment” of PTSD is such a disaster (and I’m not only talking drugs here). It’s the same with BPD. Bunch of people who display a bunch of behaviours from some checklist who may have little if anything to do with one another characterised by some pull it out of my a** description of how their psyches are structured (your “wounded inner child” and other bs) and one wonders why BPD cannot be effectively “treated”. You don’t treat disorders, you treat people and only if they are sick. PTSD is no sickness, neither is BPD. Traumas are real, highs and lows of extreme experiences of abuse are real, effects of chronic stress are real and individual responses to them, maladaptive or not are real. Labels don’t help you in helping people heal – they make you blind and stupid and a cog in a mindless machine.

          • Gee whiz. B.– might you consider asking for more detail– or adding your own ideas instead of saying I have no idea of what I am talking about?

            1)” Every behaviour has a reason. ”
            I disagree–. I would say that every behavior has a *goal*.
            I define *reason* differently than you do–.

            2) “Dehumanizing others is the M.O. of some trauma survivors” Dehumanising others is a natural tendency of all human beings operating in a group think mode. It’s in fact a very human and evolutionarily reasonable tendency (which doesn’t immediately mean it’s justifiable).
            I disagree that it either human or evolutionarily *reasonable* to disregard the inherent dignity and value of another’s life. I believe such transgression from human/reason should be acknowledged and addressed– THIS is how we develop *character*
            FWIW- BPD is an Axis II diagnosis- categorized as a personality disorder– the label marks the diagnosed as having deficiency in character development– alerting *mental health professionals* to the inherent obstacles to *treatment*–ALL of which I find unreasonable and harmful–

            3) “Sorry but I file all the “wounded self” and “calibrating self for better perceiving others” and “development of a more realistic *self*” under psychobabble.”
            The interventions I use would be best categorized as sensory modalities and body work. The effects are astounding– briefly, they help a person feel *grounded* and *empowered*– they serve as a means of teaching a person what they can do to overcome the feeling of powerless — or the sense of being broken. It may sound like psychobabble, but then I am not talking about concepts as *therapeutic* tools– It is the experience of control that provides the realistic view of *self*.

            4.)4. “This is what I call *maladaptive survival syndrome*– or rather the language I use – not finding anything relevant in PTSD”
            Of course, if you’re operating within the BPD and PTSD label framework you can’t possibly find any link.”

            What I mean to express is that the very mechanism that is creating havoc in the emotional and behavioral responses of traumatized people IS actually the basic human survival mechanism– It is maladaptive when there is no REAL threat–. The combination of physiological stress and chaotic emotional responses to *others and the environment* creates a less than happy, productive lifestyle–

            “You don’t treat disorders, you treat people and only if they are sick. PTSD is no sickness, neither is BPD. Traumas are real, highs and lows of extreme experiences of abuse are real, effects of chronic stress are real and individual responses to them, maladaptive or not are real. Labels don’t help you in helping people heal”

            I completely agree– !!

            As a mental health professional, I see people who are seeking help with managing their emotional/behavioral issues, in the context of the person feeling *something is wrong* with them– and I encounter people who are coerced into *treatment* because significant others have determined that something is wrong with them. Prior psychiatric treatment is most often a huge barrier to developing a *therapeutic* relationship. The labels– and the psych drugs– are the barriers.

            I believe that like, Bipolar Disorder, Borderline Personality Disorder, has been created by psychiatry. Both are iatrogenic — imo. Both are more an example of the adverse effects of psych drugs– AND the medicalizing of non-medical issues– replete with damaging labels that negate the person’s actual circumstances and needs.

            I also believe that mental health professionals can be helpful– when the focus is the person-.

            My practice is not based on psychobabble — it is grounded in a humanistic philosophy and informed by a life long process of discovering human potential for growth and healing–

          • 1) “I would say that every behavior has a *goal*.”
            Define “reason” and “goal” then. Reason in my understanding does not imply intent or conscious action on the part of the individual, goal does.

            2) “I disagree that it either human or evolutionarily *reasonable* to disregard the inherent dignity and value of another’s life.”
            I meant reasonable in as an evolutionary strategy (intra group altruism and inter group competition theory). I don’t use human in moral sense, I use it in biological or psychological terms. “Othering” or dehumanising is a perfectly normal human behaviour even if you don’t like it or think it’s a net negative. You have to understand the reasons why people behave in certain ways in order to persuade them to consciously change this behaviour. I have a feeling (correct em if I’m wrong) that your absolutist approach prevents that. If we acknowledge that certain instincts are understandable and even reasonable from the evolutionary standpoint and a normal part of human nature we are in fact better able to control them. Kind of like the mindfulness approach to dealing with extreme emotions.

            “the label marks the diagnosed as having deficiency in character development (…) which I find unreasonable and harmful”
            Agreed.

            3) “It may sound like psychobabble, but then I am not talking about concepts as *therapeutic* tools”
            OK. I just get a bit annoyed when I hear these terms thrown around because they implicate the bs models of how a bordeline this or antisocial that is structured internally which are untestable, unscientific and generally harmful idiocy. As long as you’re using them as a useful metaphor I’m fine with that. Whatever a person self-representation is and any kind of change to it that helps this person heal is their own personal matter and I don’t judge either way.

            4) “mechanism that is creating havoc in the emotional and behavioral responses of traumatized people IS actually the basic human survival mechanism– It is maladaptive when there is no REAL threat–”
            I generally agree, however: there are people who do actively seek dangerous situations or when exposed to them get “addicted” to the thrill. I believe that this is a common between some vets and some people who tend to get into toxic and chaotic relationships with others. I simply don’t think that the borderlines or PTSD people are homogenoius populations and I can see at least two psychologically plausible explanations for certain behaviours in both groups that are not group-specific but rather personality and experience-type specific. That is why I find all the existing labels not only inadequate but also harmful. They make many assumptions (how often in a woman in a toxic relationship labelled with PTSD and a male vet with BPD?), are stigmatising and have no explanatory or even therapeutic value.

            5) “in the context of the person feeling *something is wrong* with them”
            Well, I’d say: there’s never anything wrong with them. Or even if it is usually in the category of “life’s not fair”. I think many “mental illnesses” have to do with social pressure put on the individual to conform and excel in very narrow frames of what is considered normal, valued and acceptable. If you don’t fit “there’s something wrong with you”. I think people should not be looking for what is wrong with them but rather why they don’t fit to the current social model. You have to identify the conflict and the unmet need. Only then can the person either learn to live with the conflict or do something to resolve it (if that’s possible at all. So one can reverse this question and ask “what is wrong with everybody else?” and see how that works.

  7. “And then I felt sad because I realized that once people are broken in certain ways, they can’t ever be fixed, and this is something nobody ever tells you when you are young and it never fails to surprise you as you grow older as you see the people in your life break one by one. You wonder when your turn is going to be, or if it’s already happened.”
    ― Douglas Coupland, Life After God

    You know, I don’t think I’ve ever met a person who wasn’t broken regardless of their psychiatric status. My experience has been that it’s part of the human condition. Trying to assess the weight of that destruction is a lot like trying to judge the clarity of another person’s mourning. The simple fact is, it doesn’t matter if people have suffered through far worse, when it’s the worst moment in YOUR life it is still the WORST POINT. Also, the only perspective of a disorder from a psychiatrist is going to be neat, sanitized and emotionless. The reality is, they can spend twenty years in that therapy room with people like us, and they’ll never define a disorder the way we do. Of course, you also have to remember that eye witness statistics report that 86% of eye witness accounts are false. I have a theory that psychiatry is a lot like eye witness accounts. Truth simply isn’t absolute. I mean, I was diagnosed as Bipolar 1 when I was 13. I am not 37 and being told that I am Borderline. No matter what you call it, the effect on my life has still been devastating. I am the product of the totality of my experiences and most of the experiences were pretty traumatic. Being broken is what allowed me to survive. To me, that’s what being crazy is… It’s your mind’s last ditch effort to save itself from an unreasonable and unrelenting situation.

    • Hey acidpop5, I like a lot of what you have to say here. I am definitely noticing a ‘us’ vs. ‘them’ current in yours and other comments both here and in other groups. I am always a little wary of binary thinking but maybe that’s just me. I often find that truth lies usually in complexity and varying shades. I suspect that one reason people resort to binary, literalistic, moralistic thinking (much like a lot of psychiatry) is that it provides the illusion of a safe haven, of sorts, from the complexity and unknown qualities of life.

      In any event, more importantly, I really appreciate the things you have to say about brokenness. In a lot of recent interviews and in a different upcoming book, I talk a lot about trauma and truth. Trauma (brokenness) isn’t a ‘thing’; it’s a lot of different kinds of things manifesting, often, in a variety of different ways. One kind is the kind inherent in life. Trauma is interwoven into the fabric of being human. No matter how resourced, intelligent, etc. etc. one is, he or she will still be subject to illness, loss, grief, jilted love, heartbreak, etc. It is, as you say, part of the human condition. I hope all us can move away from the illusion of normalcy. There is simply no such thing.

      Also, your definition of insanity is very similar to R.D. Laing’s and Wilfred Bion’s, which is really interesting. ‘Insanity’ as a strategy of survival. Thanks for your comment and quote.

      • My use of the us vs. them paradigm is less a result of binary thinking, and more accumulated observation. For example: I have an unreasonable fear of the dark and closets. My world can be completely shaken by my inability to escape a small space with people in it. However, give me a situation of absolute chaos, a situation where all the logical people fall apart, and I am suddenly calm and decisive. Chaos is my natural element. and I don’t think that the rational mind can fully grasp the reality of that. While studying law, I had the privilege of listening to a series of very logical prosecutors explain the motivations of the mentally ill, and it took me a while to realize they weren’t being purposely obtuse. My theory is that the rational mind looks for the simplest series of connections, the same way an uninjured brain uses the most direct paths to access information or communicate with the rest of the body. However, people, particularly children, who experience brain trauma will slowly adapt to create new less simplistic paths to the same information to compensate for the damaged portions of the brain.

        I also agree entirely with your view that trauma is more the totality of experiences than a single moment when your world fell apart. One of the most interesting experiences I had with trauma was due to some unconscious but strategic disassociation. I lived most of my adult life with only a basic outline of my experiences, no emotional connections and only scattered actual memories. I was completely willfully ignorant of this fact, until my sister died suddenly and I experienced a handful of glimpses at my past. I spent the eight years prior to that in front of an audience. I was outgoing and social. Even though the events I remembered had happened fifteen years before or more, just experiencing those memories had a lasting impact on my personality that was immediate that I struggled to identify with my own emotional responses. In a matter of a year, the outgoing girl disappeared. I began having panic attacks, simple and social phobias, and anxiety. I stopped leaving the house. The best explanation I have is that my mind had stored the memories and the trauma. It was like I was experiencing it for the first time.

  8. Hmmmm

    A scenario. As a result of a family conflict my wife’s family began subjecting me to verbal abuse and a serious threat to harm me. After three weeks of this abuse I told my wife I would have to leave (in laws lived next door). I was laying on the couch when I said this to her. She then came running at me with a large carving knife and attempted to plunge it into my chest. I managed to lift my foot and deflect the blow. She then started screaming at me to stab her.

    Now, apparently my saying that I was going to leave was controlling behaviour (domestic violence). So, two days later my wife spiked my drink with benzodiazepines, knocked me out, put a knife into my pocket and called Mental Health Services and presented me as being a danger to others. I was detained under the Mental Health Act and examined by a psychiatrist who found nothing wrong with me.

    Now, in order to detain me the Community Nurse had to fabricate the required evidence to detain me, and then when I attempted to obtain the documents to demonstrate the unlawful detention, the FOI officer at the hospital and my wife engaged in an agreement to deceive me and my legal representative so that the drink spiking would remain hidden. When this criminal act looked like being exposed, they then tried to have me sign documents to release the FOI officer from the criminal act.

    My wife organised another man to move into our home, and I was evicted and have been homeless for three years now. Still trying to have someone look at the offenses that occurred but apparently me wishing to leave justified all that has happened to me.

    I think next time I will leave without expressing my intentions.

    • Oh, I thought I would add that whilst believing that you have been drugged without your knowledge may be a symptom of delusional disorder, I actually have the documents from the hospital to prove it.

      It’s been interesting trying to have something done about these offenses and watching the authorities find new and creative ways of covering up and simply ignoring documented facts because well, can’t have public officers being held accountable now can we lol.

      • I guess my point about this ‘borderline’ diagnosis is that I find it easy to look back and think about the scars from cutting, the morbid obesity, stories of abuse and torture by her brother, large amount of psychiatric drugs, the sleeping with another man before even separating from her husband, the kleptomania, etc etc as symptoms of being a ‘borderline’. But am I simply attempting to applying the label to suit my own needs?

        • boans,
          I think you answered your own question-
          a *label*,easy answer, suits your needs.

          A lot more difficult if you needed to make sense of it?

          Harder still– what if you needed to find the value in this experience?

          Labels can be tricky– they are not fool proof-

          Wouldn’t be prudent to never examine the contents of can or package, or to always trust that the contents match the label–

          Labels and slogans can halt the thinking process–

          Buyer beware 🙂

          • Oh I think I’ve found value in the experience. I am contemplating going to work for divorce lawyers and assist with acrimonious breakdowns. I didn’t realise that the State is providing a service that with a phone call will dismantle a persons life. As my wife put it “you just need to know what to tell them”.

            I’m being assaulted with a knife, drugged without my knowledge, locked in a mental institution, and she is appointed a ‘domestic violence officer’ when I complain about it.

            The DVO was great when her new boyfriend was in town and she wanted me evicted from our home. A phone call and I had a gun at my head.

            So I figure I can use what I know about the corruption of our State services and make a few bucks out of others pain 🙂

  9. “Borderline Personality Disorder” is a simple human paternal facial skin surface lipid pheromone deficiency, easily remedied. Cure it with 150 to 250mg of healthy adult male facial skin surface lipid paternal pheromone by mouth 1 time. There is nothing “borderline”, nothing “personality, and it is not a disorder. It represents an ecological adaptation which matches populations to available resources. The biological mechanism is “broken” in that simple air pollution, notably ozone, O3, irritates the chemoreceptive surfaces (microvillar “brush border” cells that line about half of the entire upper respiratory system in human beings) and disrupts pheromone reception. Simply providing a sufficient tiny quantity of the pheromone alleviates all symptoms without sequellae, instantly.
    I wonder if the discovery of vitamin C to cure scurvy had as much resistance as put up by these psychobabbling incompetents are doing today?

  10. @uprising

    Thank you for engaging in this discussion and clarifying your statement about the dehumanizing behaviors of mental health professionals–as you see that description pertaining to me.

    I think I can add some more clarity responding to this statement you made:

    ” I was using the word “reason” in the sense of “cause” or “intelligibility,” not “rationality.”

    My argument is that when the “reason” or “cause” is stated as the effect of the abuse history of the person who is lashing out– the conclusion has to be that the person’s behavior, like the abuse they suffered, is “not within their control”- This thinking is the foundation for calling the behavior a symptom of BPD– The thinking that BPD is unremitting– and all of the rhetoric that supports the dismal prognosis and horrible stigma of the diagnosis is actually supported by the belief that the original abuse damaged the person beyond repair– because you cannot change the past- or mind over matter a disease/disorder.

    My reason for starting with denouncing the *wrongful attacks on significant others* is to focus on a humanistic, rather than diagnostic view of the person. Refusing to accept that their abusive behavior makes sense in any context sometimes serves to redirect the person to their own abuse history, where their self concept was eviscerated and their sense of worth obliterated. The scene in “Good Will Hunting” when Robin Williams repeatedly tells Matt Damon- “It wasn’t your fault”– does not make Matt Damon jump for joy– It is a hard sell, but it is the crucial first block of truth in a foundation for building a healthy self concept.

    Identifying the reason or explaining what I believe to be the reason for the behaviors I call, unnatural, alien- or stating the problem as I see it, allows for focus on repairing and reconstructing the *part* of the person that is malfunctioning– and yes, that damage resulted from abuse, but it is within the person’s capability to repair.

    My goal- more like a quest, has been to assist and support people thru healing and change– there is no set formula, but there are some basics that are required. I believe that the rapport building phase is crucial and that telling the truth is key to this phase–

    I have shared in the suffering of many people who had alienated everyone they actually needed. And as the only one whose door remained open to them, I ran the gauntlet they constructed. Their goal being to prove that I was no better than those who had rejected them, and or/ they were not worth the trouble–.

    To demonstrate that I was not tolerating abuse, I did not claim to understand why I had become the new target [in the context of their abuse history]. I did struggle to rise to the occasion and remain fully human, which I found depends on telling the truth and sticking to it– and sustaining engagement, no matter what.

    These behaviors do not yield to *talk therapy*, and are usually worsened by psychotropic drugs– . What is needed is the experience of awakening to their inner resources for mediating the discomfort they are most always suffering. This is vital. However that happens [DBT, alternative/complimentary therapies], the next phase is like watching a work of art in progress– or witnessing birth– that is to say, it is life affirming.

    No pain- no gain.

    • “Their goal being to prove that I was no better than those who had rejected them, and or/ they were not worth the trouble–.”
      Well, if one has been abused and/or betrayed by people close to him/her, no wonder that the bar for trusting someone jumps to impossible heights and the first thing the person wants to do is to “test out” if the potential friend/partner etc. is worth the effort and emotional investment. I’d call that rational. And it’s no wonder that the “testing” process is likely going to be too much for the other side.
      Forming real relationships requires vulnerability and that is very hard for anyone and even more so for a person who has been subject to horrific and often repeated betrayal. Not mentioning the effect of growing up or being involved in abusive relationships for prolonged periods of time ca be disastrous for one’s emotional controls and may drive the need for “drama” to sustain it. If you read some accounts of vets coming from war and explaining why they can’t adjust to the normalcy of the civilian life and abuse victims who have troubles to form stable “normal” relationships they are often very similar and the survival mechanisms that work well in extreme situations are ultimately destructive not only when that situation lasts too long but also when the person is expect to “switch” to normalcy.

  11. This isn’t a comment to anyone in particular: I think it’s great that there can be a discussion on something as controversial / ‘combustible’ as the diagnosis of ‘Borderline Personality Disorder’ without the conversation degrading into an argument. Actually, this has been a pretty thought-provoking discussion.

  12. Speaking, again, as someone who has been given this label, among other labels, it pains me to see this disorder painted as some kind of “interpersonal” deficiency, as a label given to people who lie, manipulate, deceive. It is the black hole of psychiatric diagnoses. If you’re a woman, and you’re in the system long enough, this label will be applied to you (or at least, its “traits”). It is often about punishment. I have seen people vilify those with this label who would never do the same for someone labeled with depression, or schizophrenia, or PTSD. And considering up to 40% of people in-patient right now have this label, then we are vilifying those who are most in need of a psychiatric survivor intervention.

    Thank you for embedding this label into the trauma-informed narrative. Even “borderlines,” are people first, last, and in the middle. And they are usually people who have suffered from great trauma.

    And yes, I work in mental health and have worked with people with this label. My compassion still does not waver. If yours does, get out of mental health care.

    • Hey Melodee, without knowing it, you summarize our book very succinctly. Totally and completely agree on all accounts. I am glad you’re holding the line, as it were, AND working in the field from that perspective.

      We need to ditch all psychiatric labels and let psychiatry receded to the archives of other failed quasi-scientific projects, like phrenology.

      Thank you for your comment.

    • BPD is given primarily to:
      – women (guys more often get the anti-social personality disorder)
      – people who are annoying, refuse treatment or mouth off staff
      It’s basically “I don’t know and don’t want to deal with you so I’ll label you hopeless case”.
      Many of these people are also abused by the staff themselves and giving them a “pathological liar” label is a perfect excuse in any lawsuit.
      BPD is usually a great think to label a victim when you’re an abuser.

      • That is correct, B. It is all of those things, plus a part of a social-historical narrative of women going back more than 4,000 years. What is called ‘BPD’ doesn’t simply show up in the DSM-III, it is the logical outcome of a line of thought about women.

        Also, as an interesting fact, all of the Axis II diagnosis are variations on BPD. It is the ‘blueprint’, if you will, of all personality disorders. Also, as you point out, it continues to be primarily attributed to women, despite research demonstrating that (of course) men can be distressed in similar ways.

        Thanks for your comment!

      • I suspect that contempt or considering a person “lesser” is a key element. My closest brush to a Borderline label was as a teenager when a counselor had me do a personality test. Because I was mature for my age he ran my answers twice, both as a youth and an adult. The adult results described me pretty accurately (gifted, sensitive, traumatized by abuse) and offered a diagnosis of chronic depression and I think PTSD. But the youth results painted an ugly picture of someone I didn’t recognize at all — a pathological liar with delusions of grandeur and BPD.

        The obvious implication was that no mere child could actually be as I was, so I must have been lying and manipulating. Luckily, my counselor saw no more merit in that assessment than I did and the insult didn’t stick. I’m grateful for that experience because it planted seeds of doubt about the validity of diagnostic categories — maybe that’s why it was so easy to make the leap once I finally encountered people questioning or rejecting them.

        • That’s an interesting experience you’re describing.
          When I was being interviewed at the hospital (and got a BPD sticker) I had a feeling that one of the so-called doctors was some how hung up on my perceived “high intelligence”. I don’t know what he was at really but it felt as if he had some problem himself – he constantly tried to push me to say that I think I am so much smarter than everyone else (and presumably a narcissistic b*tch for that reason) which was extremely frustrating – no matter what I said was twisted to suit this idea. Later I read all that in my documents (among other “symptoms” aka insults): “intelligence above the average level, (…), narcissism” and other adjectives along these lines. I don’t know what his problem was but I remember at the end of the interview I really wanted to punch him in the face (even more than normally after talking to a member of this lovely profession). I was also accused of having no empathy more than once by the so-called professionals which caused a major LOL in my best friend (she told me I was the most empathic person she knows and that these people were idiots).
          That is exactly why these labels are so harmful and dangerous – they take some subjective measures aka symptoms one may really display, at least in the particular context and time, and then try to fit the whole person into some frame of how you’re supposed to be as a “borderline”

  13. The “borderline” label seems like yet another example of psychiatry blaming and pathologizing the victim. This is from http://www.thesystemisbrokenblog.org/2014/11/16/abuse-victims-called-mentally-ill/:

    While some abusers have long psychiatric histories, or attempt to use a psychiatric label to justify their actions, many seem to effectively avoid labeling altogether. It seems like victims’ behaviors are more frequently pathologized, while abusers are simply spoken of as evil monsters. The problem is, many people who have suffered within the confines of the mental health system would actually rather be considered “evil” than “mentally ill.” Being “mentally ill” can often induce more fear in others than being a violent criminal, as we see criminals’ actions as wrong but not inherently irrational, while many consider “the mentally ill” to be prone to completely random, unexplained acts of violence, instigated by little more than faulty brain chemistry. The fact that many studies proclaim that there is no psychiatric label which, without consideration of other factors, is associated with a significant increase in violent behavior, is widely ignored. As abusers are seen as “bad,” yet rational, they can be looked at as more redeemable than their seemingly unstable victims…We must move towards a culture in which people can experience a wide variety of lasting effects from abuse or any other adversity without being pejoratively labeled, and where such individuals will never have to suffer without justice, safety or liberty on the basis of a presumed “mental illness.” We have an absolute responsibility to protect, support and find justice for those who have been harmed. When any given profession interferes with these noble goals, whether or not it is considered a “healing” profession, it must be stripped of both coercive power and assumed legitimacy.

  14. I was once diagnosed with bpd as I was suffering from psych drug withdrawal. That had never been a diagnosis for me before this. I had anxiety, depression, and I was in flux between two poles for a while, but I had never been diagnosed with a personality disorder, I’d never had any social or relationship issues like this. I was diagnosed because I didn’t feel myself and had a lot of chaos in my head that scared me, and I wasn’t sure why; not because anyone complained about or objected to my behavior. But this psychiatrist diagnosed me as such was because I feared being abandoned while sick and disabled, I had a lot of anxiety about that. I don’t think that’s an unreasonable fear, because this happens to a lot of people.

    As I healed and recovered, I got clear on what this psychiatrist was all about, and I let him know that I would not be continuing with him. He did everything in his power to not get me to abandon him, including having the gall to inform me that if I left him, I would just take my borderline personality with me into any relationship.

    I have a very healthy relationship life, always have. Strangely, he never perceived this about me. No matter what I said and how I said it, he would only hear the conversation is in own head. Whatever he brought into this was his issue, clearly. So who has “fear of abandonment” issues?

    What a crock this all this. I think it’s obvious that established mental health care practice these days is a rabbit hole to which there is no bottom, thanks to toxic relationships such as I describe above–a mere recreation of that from which we are attempting to heal. From all the stories I’ve heard, I am so not alone in this.

    I can no longer tolerate discussions such as these–reading this conversation made me nauseous. All this does for me now is to bring back horrible memories of dealing with ‘mentally ill’ (or whatever you want to call it) clinicians, and I seriously want to focus on moving forward, rather than remembering how these toxic projections and mind games made me feel crazy. That’s where I am now. I can certainly appreciate the value these discussions have for others.

    It’s been an interesting couple of years interacting with this website and I’ve learned a great deal, especially from the incredibly courageous sharing of truth from mental health system survivors. These are the voices to which I give my uncompromised respect when it comes to life wisdom. Thanks to these voices, I was able to validate my experience fully, and that’s what I needed for closure to all of this. I’m eternally grateful to all of you.

    We have, indeed, suffered needlessly at the hands of tragically misguided practices and gratefully, that part of the journey does have an end. My sincere and heartfelt wish is for each and every person who desires to end their suffering to find their way as quickly as possible. It is such a personal and subjective journey. Don’t let anyone discourage or distract you from finding peace.

    Very best wishes to all.

  15. I was curious on the anti psychiatry movement’s feelings on DBT. On one hand the DBT framework seems essentially anti psychiatry to some degree since it advocates psychotherapy rather than medication and also encourages not placing BPD patients in the hospital if they are “suicidal.”

    I found this helpful, particularly the critique of giving DBT to people. I was diagnosed as “almost BPD” and given DBT therapy. I feel that in the end this did more harm than good, because the DBT seemed to work well and it was the only thing that remotely addressed the repeated child rape that I suffered (it never fixed my symptoms more half way), I concluded that I must have been BPD. I feel that the DBT world and the psychotherapeutic profession did me an immense disservice by never informing me that the symptoms I was suffering were the result of trauma. I really wanted to get to the root of my problem but I was given no road map or clues and I was allowed to take the shame on myself and blame my genetics/biology.

    I didn’t want to discuss my child rape out of humiliation but a few years later eventually the trauma blew up again when my abuser was about to abuse another child and the abusive DBT expert (but this is another story) I was seeing at that point refused to discuss my child abuse, a close friend I tried to open up with told me, “It wasn’t abuse because you didn’t know at the time.” At that point I both suffered intense PTSD and flashbacks and I finally had to confront the trauma at the root of those symptoms and start putting together the pieces of what was at the root of my mental health difficulties. I feel that the DBT world and the psychotherapeutic profession did me an immense disservice by never talking about trauma, not to mention leaving another child at risk of this happening to them.

    Oh did I mention that while this was going on my DBT expert therapist decided to “drop me” as a patient after having an erection in front of me? On one hand this was a blessing in disguise since I got away from him (I never would have seen him or been abused by him if I hadn’t thought that as a DBT expert he had the keys to what was at the root of my problem).

    • “BPD” is, of course, just another label for behavior that psychiatrists/psychologists decided needs to be “treated.” It is never true that you can “have” or “not have” “BPD” in the same sense that you have or don’t have an ulcer or pancreatitis or a ruptured spleen.

      That being said, the vast, overwhelming majority of people I’ve known (and I’ve known a lot, as I work with a traumatized population) diagnosed as “Borderline Personality Disorder” had significant childhood trauma histories. From what I understand of DBT, it focuses a lot on developing emotional management skills, to which I have no real objection. But if people are receiving DBT for “BPD” and no one is discussing the likely traumatization that underlies this “condition,” I agree, they are doing their clients a huge disservice.

      Bottom line, I regard “BPD” as a description of a common set of coping measures used by people whose parents or other caretakers were usually inconsistently abusive or neglectful when they were very young children. I find that describing and treating these “symptoms” as a rational set of coping techniques adopted by a powerless child in a very confusing and scary situation provides many potential avenues for resolution, whereas viewing it as a “mental disorder” that somehow resides in the client reinforces the idea that 1) your reaction to being traumatized was WRONG, and 2) you should get over it and to the extent you haven’t, you’re the problem.

      I find the labels themselves more problematic than the proposed “treatments.” If you’re honest with people from the start in a compassionate way, almost any situation or “condition” can be improved upon, but it never helps to label and blame the victim of abuse.

      —- Steve

      • “That being said, the vast, overwhelming majority of people I’ve known (and I’ve known a lot, as I work with a traumatized population) diagnosed as “Borderline Personality Disorder” had significant childhood trauma histories. From what I understand of DBT, it focuses a lot on developing emotional management skills, to which I have no real objection. But if people are receiving DBT for “BPD” and no one is discussing the likely traumatization that underlies this “condition,” I agree, they are doing their clients a huge disservice.”

        Yes and also the creators/proponents of DBT are not addressing trauma, they are saying that it is biosocial in origin.

    • Oh, and CREEP OUT about the therapist getting a hard on in front of you! At least he had the decency to realize he was unable to help, though again it sounded like you were blamed instead of him admitting he had boundary problems that kept him from being a good therapist.

      —- Steve

      • “Oh, and CREEP OUT about the therapist getting a hard on in front of you! ”

        What do you mean ?

        “At least he had the decency to realize he was unable to help, though again it sounded like you were blamed instead of him admitting he had boundary problems that kept him from being a good therapist.”

        It’s too bad he didn’t realize that at the beginning before he tortured me. The man is still out there torturing women.

    • I’m so sorry you went through that. Trauma, particularly sexual trauma, is so often the root of emotional distress that sends people to seek help. You can’t expect a child who has been raped repeatedly to not suffer injuries to their sense of self, to their ability to trust and feel a basic sense of safety. That’d be like dunking a book repeatedly in a pot of soup and expect the pages to remain flat, readable. Books should not be subjected to dunking, and dunked books sustain water damage. Why people cannot see that it’s the trauma that’s the source of the damage is beyond me. It’s still your book, still your story to write. Just know you aren’t alone. There’s a whole library of smeared and ruffled pages out here.

      • Thanks! This experience was heartbreaking for me. It was like going to the doctor because you have a cut on your foot that requires stitches and instead of treating the cut (or not treating it) he comes over and breaks your leg and other leg (that is fine). Imagine what that does to your ability to trust ?