Borderline personality disorder is a highly stigmatized diagnosis. Although I do not identify with it and do not consent to this diagnostic assignment, it was given to me as a teenager. I experienced multiple levels of ongoing abuse, neglect, and self-harm. These experiences spilled over onto my psychiatric treatment. This diagnosis, along with a comorbid Bipolar Type 2 diagnosis were the drivers of many years of mistreatment that I had experienced from mental health professionals, peers and family members.
My prognosis was almost apocalyptic. My family was told to prepare to sustain me financially and emotionally for the rest of my life. They were told I would be in and out of hospitals, continually attempt suicide, and not be able to have meaningful interpersonal relationships with others. Independence, higher education, healthy friendships, romantic relationships, and family life were out of the question for me.
My subjectivity became reduced to that of a label with complete disregard to the trauma and abuse I was being subjected to everyday by my caregivers, peers and mental health professionals. My adolescence was spent being highly sedated but somehow powering through; there are years I still cannot remember. After finally forcefully and autonomously distancing myself from abusive family members, shedding the BPD and BD labels, and tapering off the cocktail of pills I had been on since I was 13, I finally found myself in trauma treatment.
For all those years, I had been denied humanizing and adequate mental health treatment. Due to these many mistreatments and constant dismissal of my experience within the psychiatric community, I now consider myself a recovered psychiatric and trauma survivor.
These experiences led me to aspire to a career in clinical psychology and to want to reform the mental health field. From the start of my higher education studies, I was aware that the road to get to where I wanted would be a constant uphill battle, both professionally and personally. Overall, I knew the experience would most likely be re-traumatizing and triggering in many ways, but I had hope that I would find allies, which I have.
For my graduate school interviews, I wore long sleeves to cover my scars and I steered away from any disclosure of my mental health history throughout the process. Although getting into graduate school definitely felt like a huge professional and personal accomplishment, I know that it is just a steppingstone into my ongoing fight for a truly worthy mental health system.
As clinical psychologists, we are trained to practice five principal ethical principles: benevolence and nonmaleficence, fidelity and responsibility, integrity, justice, and respect for people’s rights and dignity. Yet, through my doctoral training, I have heard many horrifying things about people with borderline personality disorder. The most common label is that “borderlines” are manipulative, needy, irrational, difficult, clingy liars and incapable of completing graduate school or even undergraduate. Another misconception is that people with self-harm scars must have borderline personality disorder.
Diagnoses are reductionist labels. Although for many people they provide an answer to their troubles, for many others they add to their troubles.
The first few years of my graduate training as a clinical psychologist were an unending nightmare. I was “outed” as a person with a borderline personality disorder by an angry classmate, whom I had trusted with this information. In the clinical psychology world, this can destroy your career. What happens, then, to a clinical psychologist-in-training who outs you as a person who has been given a highly stigmatized mental health diagnosis? Nothing.
After what I thought was a minor disagreement, a colleague who has dealt with mental illness themselves, and currently works with therapy clients, shared my mental health history and other personal information with other colleagues. Initially, I attempted to have an open discussion with this colleague. After several attempts at confronting this person, they became increasingly abusive. This colleague has since pushed me in the school building, consistently rolled their eyes when I speak in class, shut me out of conversations, and given me the silent treatment. Furthermore, they have isolated me and ruined my professional relationship with others in the program. In short, I am being bullied. I was “outed” without consent.
My colleague who disclosed is well-liked amongst our colleagues, and a hardworking individual with their own personal struggles. This does not excuse their actions or their inability to hold themselves accountable for the damage they have caused.
During the break after the previous semester ended, my stress grew over the impending start of the next semester and I decided to reach out to one of the psychologists who is available to speak to students about these sorts of issues related to school. I reached out to this school-appointed psychologist for support before the semester started; they told me to “suck it up,” and that there was not anything I could do but wait for this other person to get over whatever they needed to get over.
I had done that for many months, wanting to respect this person’s need to be angry and tolerating their continued abuse. Instead of offering a supportive and validating stance or resource, this psychologist basically offered support for the actions of the other person, which made me feel dismissed, disregarded, small, and even “crazy,” creating even more internal turmoil.
At this point, I had not said their name to anyone or spoken in detail about what had happened. I have tried to suck it up, but the hostile treatment continues, and even one of my clinical supervisors knew of my mental health history from others.
After six months, I finally got fed up and told my advisor what was happening. They advised taking meaningful action against this person. Only one other colleague knew, but they remained close with the other colleague and informed me of the continued disclosure of my personal information. I met with someone from the administration, but there was not much they could do due to lack of evidence, and I did not want to disclose further details regarding my mental health history, partly for fear of additional stigmatization.
I have enough going on as it is in the clinical psychology field. I am a Latinx woman with little U.S. connection and Spanish as a first language. In addition, I have scars, the result of violence, abuse, self-harm, and more. My scars can be seen and judged by anybody who pays close attention, which psychologists are trained to do.
For the last year and a half, I have felt powerless. Some colleagues have recognized the hostility, but besides offering moral support have not done anything proactive to help stop the bullying colleague or be an ally.
Some colleagues have expressed that they do not want to fall at odds or be shunned by others and basically end in the position I am in. But what worries me is not only myself, but our patients. They are being put in these positions as well, dehumanized by the very professionals charged with helping them.
The clinical psychology field seems to have an us (the healthy ones) versus them (the mentally ill) perspective. The field feeds and exists on the ideal that clinical psychology helps others heal, but in reality, they look suspiciously at those who have been able to heal, survived the system, and have a desire to do the same for others.
The field exists within the same authoritarian hierarchy as many other systems that perpetrate injustices. At one point, a PhD student who disclosed their given diagnosis was told that by sharing that information they had created a “burden” for their colleagues. They mentioned how their mentor and colleagues had joked about their given diagnosis and how they felt the need to disclose their given diagnosis in order to make them stop. In addition, a historic lack of all expressions of diversity, race, gender, cultures, economics, languages, sexual orientation, and psychological experiences permeates the field to the detriment of the patients.
These experiences brought me to this field, as I wondered how many others there are like me out there? How many others have experienced coercion, abuse, and have had their lived experiences of mental illness used as weapons against them by mental health professionals?
The ethical principles that rule clinical psychology are practiced as long as providers are the “sane/normal” ones and the patients are “crazy” and “incapable.” This has been further demonstrated by research on mental health provider stigma which may also take the form of prejudice and discrimination.
For the last few years, I have felt isolated, betrayed, powerless, and for the most part, defeated. I considered dropping out on multiple occasions. A quick Google search showed that there are not many clinical psychologists with lived experiences who are “out.” This made me wonder how many of us are living in the shadows, quietly listening to others in our field making deprecating comments about people like us and being marginalized and bullied.
Additionally, I wonder how “out” I actually am, how many people know, and how the labeling will ultimately affect my career. These thoughts kept me up at night and I debated many times whether or not to “officially” be out, and at least regain my narrative and speak out.
Within our field it seems that labels or given diagnoses place the person within a box, and context, circumstance, and the person’s personal experience are most often discredited and dismissed. One thing they could say if I “come out” is “Here she goes, the decompensated manipulative needy woman, needing attention,” as psychologists have previously said about individuals with a given diagnosis of borderline personality disorder.
These are the same beliefs that maintain the status quo and create systematic barriers for individuals with lived experiences to speak out, get help and recover. These are the same mechanisms that perpetuate abuse within our mental health system. The field needs to change, and clinical psychologists need to be held accountable for their role in keeping the status quo, and maintaining inequalities.
In my opinion, clinical psychologists need to be challenged from the minute training starts, any training. That can be a psychology class in high school, an undergrad pursuing a psychology major and so on.
Individuals with lived experience in mental illness should be at the forefront of this change and leading these conversations. We are the ones who have been through the system. Even if our perspectives of how the mental health system should be revolutionized digress, they matter. Instead, the field of clinical psychology, which often promotes healing and recovery, ironically keeps us marginalized as being “unable to recover.”
Moreover, from what I know, many schools do not ask that clinical psychologists attend therapy themselves and, for that reason, many have never been in the patient’s role. Is this not hypocritical and counterintuitive?
I am calling my field out for its hypocrisy and continued dismissal of minoritized voices. The field already exists within a Westernized, White, and developed bubble and it is time to put a stop to all of this. Simultaneously, I am calling out my colleagues and future clinical psychologists for their continued participation in these practices.
As it is, the clinical psychology field continues to promote and monetize the dehumanization of mentally ill people. When will the dehumanization of people with lived experiences in mental illness stop?
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.