Why You Don’t Want a ‘Diagnosis’ of ‘Borderline Personality Disorder’

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From Beam Consultancy: “Who the hell am I to say this? Well, I’ve worked in mental health services for over 25 years. The last 10 have been in services specifically for people who hurt themselves and want to die. The people I’ve worked with have almost always had a diagnosis of ‘Borderline Personality Disorder’ or ’emotionally unstable personality disorder’ as it used to be called in the UK. There was a time that I thought the diagnosis was useful and people just needed to understand it better, now I’m convinced that it does more harm than good.

Marsha Linehan is the creator of ‘Dialectical Behaviour Therapy.’ It is probably the most researched therapy for BPD and the only named therapy in the UK NICE guidelines for BPD. Linehan says:

‘I tell my patients if you end up in the Emergency Room for a medical disorder for god’s sakes do not tell them you meet criteria for “Borderline Personality Disorder.” Do not tell anybody. You’ll be treated differently and many, many mental health practitioners wont see someone who meets criteria for “Borderline Personality Disorder.”’

I’m trying to think of another diagnosis where one of the leading experts would advise people to keep their diagnosis secret in order to avoid mistreatment from health professionals. There can’t be many.

I was prompted to write this after I was doing some training and a clinician who worked with students in a university kept meeting people who were asking for a BPD diagnosis. They’d seen something on Tik Tok, had a google, and they were convinced they’d found a name for the discomfort, stress and pain they were experiencing. The pain is real, but this blog is an attempt to explain why you might not want to describe it as BPD.”

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10 COMMENTS

  1. “Borderline personality disorder” is basically a name assigned to people who had terrible childhoods with lots of trauma and abuse, and the damage to show for it. It is very true that many healthcare professionals have little patience for “borderline” patients. My former self was annoyed at my borderline patients until I changed my perspective to seeing them as very traumatized and needing a little bit of extra care and attention. As a whole these individuals were deeply hurt by forces outside of their control when they were still small and powerless. So I enjoy my interactions with them and don’t feel annoyed any more. I think if we expect to be annoyed with someone we will be predisposed and much more likely to be disrespectful to them (even if in tiny ways) and can create negative interactions through a self-fulfilling prophecy. However agreed that if you have this diagnosis you might not bring it up to others in a healthcare setting as they are pretty likely to use it against you.

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  2. It says more about the mental health system than it does about patients with a borderline diagnosis that they (the decision makers and power brokers of the mental health system) have created a label that leads to systemic neglect and abuse of those so labeled. The system itself is sick.

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  3. Most treatment providers I encountered would respond to a patient request to not be diagnosed with borderline with “Borderlines never want to accept their diagnosis but you won’t ever get well if you don’t accept it” and then go ahead and diagnose the patient with borderline.

    Maybe experts should stop trying to tell patients how to survive an abusive system and start working with their colleagues on changing the system.

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  4. A borderline diagnosis is part of a patient’s medical record. They very likely don’t have the luxury of “hiding” their dx if they utilize health care in the same system where they’ve received psychiatric treatment.
    All medical providers ask what medications a person is taking, want to know if they are seeing a mental health professional. Should we lie? Should we deny what’s in our records? That would certainly lead to more problems and more confirmation in the eyes of health care workers, since they seem to think that all borderlines are liars.

    I finally accepted that I’m on my own health care wise, including with the lasting iatrogenic harm caused by decades of psych polypharmacy.

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    • Yes, we should lie.
      I am a survivor and I will do what I have to, to survive.

      If one is diagnosed with cancer, after being cancer free for 5 years – you are cured.

      No such thing exists in the psychobabble world. The whole notion is garbage.
      It’s a dumping ground for the “ism’s” (sexism, racism, ageism).
      I have had enough!

      Sorry – I just encountered my first “ageism” where they look straight through you, as if you don’t exist. This has nothing to do with me, personally – it belongs to our culture. (prepaid motel reservations, but they never checked me in – they just kept my money)

      KateL – I wish you the best. We have a lot in common. U.S. physical health care is off limits to me, also. Just as well, last time I saw a primary – they wrote me up as dying (on zero evidence) and started denying me care (I asked for a diabetes check). I fired them. Don’t be ridiculous. Look at me. I’m not dying! This is now, many years later.

      Humans do what we have to survive..
      Speaking truth to those who unthinkably harm us is so – last century.

      Moderator – I wanted to support KateL, but I can not reveal my identity. Unspeakable things have happened to me. It’s up to you, of course – whether you accept this post.

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      • Thank you so much. I think you’re right. Why do we owe people the truth when they lie to us and show repeatedly that they believe we deserve the harm they inflict.
        As a 57 year old woman who got the diagnosis almost 20 years ago (immediately after ECT), I have also had enough.

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