Borderline Personality Disorder – is it the ‘hysteria’ of the 21st century? If you remember, the word ‘hysteria’ was coined in Egypt about 2000 years BCE. Hysteria is a mental disorder only attributable to women, on account of our ‘wandering wombs’. The belief used to be that women’s mental health was adversely affected by their wombs – which (it was asserted) moved freely around their bodies, and a woman’s mood depended on where in her body her womb had decided to scuttle off to. As a ‘genuine’ diagnosis, Hysteria was only removed from the DSM in 1980.
I find Borderline Personality Disorder problematic for a number of reasons; it’s applied to women more than to men. In fact, over 75% of people to whom the label is affixed are women. I’m also aware that the women who are told that they have ‘borderline’ have histories of trauma – usually child sexual abuse, and often the trauma of being raised by a narcissist. In many cases, these woman have experienced both – child sexual abuse, and a narcissistic parent. I have a huge problem with normality being pathologised – it’s normal to react to trauma in certain ways, but to decide that these normal reactions are somehow indicative of a ‘personality disorder’ speaks to the patriarchal nature of psychiatry. It also reveals that there is a lack of desire to understand trauma and women’s trauma in particular.
Let’s take a look at the essential elements of ‘Borderline Personality Disorder’, shall we? The following is an indication of the statements that are put to people (usually women) to ‘test’ them for this ‘diagnosis’.
Source: Help Guide
Let’s unpack these symptoms, shall we?
I often feel ’empty’ –
Do you know who else often feels ’empty’? Trauma victims. Many of us with histories of abuse, who live with PTS feel ’empty’ until we have managed to learn to process our trauma and then we feel less ’empty’. It’s not a disorder. It’s a reaction.
My emotions shift very quickly, and I often experience extreme sadness, anger, and anxiety –
This is typical of those of us who have anxiety. The ability to regulate our emotions can be difficult – not least because this regulation has been stunted by the effects of childhood trauma/s. It’s also a sign of the neurobiological effects of maltreatment.
I’m constantly afraid that the people I care about will abandon me, or leave me –
People who have insecure attachment – those who have narcissistic mothers, who have experienced abuse or neglect in their early childhoods – are often afraid that the people they care about will abandon, or leave them. It’s a completely normal reaction.
I would describe most of my romantic relationships as intense, but unstable –
Here’s the thing – women who have been abused as children are often preyed upon by abusive men (that’s a whole other blog post). Abusive men are known to love bomb the objects of their affections, and to gaslight them. This results in intense, but unstable romantic relationships. Way to victim blame, DSM!
The way I feel about the people in my life can dramatically change from one moment to the next – and I don’t always understand why –
Those of us who were unlucky enough to grow up with abusive and / or narcissistic parents soon learnt that our thoughts and emotions did not belong to us: We were told what to think, and how to feel, and had to express thoughts and feelings that aligned with those of our abusive parent/s’. Our feelings were often ignored and / or invalidated. We learnt to adjust the presentation of our emotions very quickly. This coping mechanism, which helped us to survive, does not simply fall away when we become adults. Blaming a survivor for the behaviours they had to adopt in order to survive is a whole other level of victim blaming.
I often do things that I know are dangerous or unhealthy, such as driving recklessly, having unsafe sex, binge drinking, using drugs, or going on spending sprees –
These behaviours are all common to women who were sexually abused as children. When everything is dangerous, nothing is dangerous. Unsafe sex is an unhealthy behaviour that is a ‘classic’ indicator of child sexual abuse. All addictive behaviours have their roots in trauma (refer to the excellent, and accessible writings of Gabor Maté for more on this). Depression is also diagnosed by ascertaining whether or not the person is engaging in ‘risky behaviour’. Depression is bad enough – people don’t need to be told they also have a personality disorder.
I’ve attempted to hurt myself, engaged in self-harm behaviours such as cutting, or threatened suicide –
Every woman I know who has a history of child sexual abuse has been driven to externalising their trauma and their overwhelming feelings of helplessness in the form of self-harm. Many have also been driven to attempt suicide. This is a normal reaction to very abnormal circumstances.
When I’m feeling insecure in a relationship, I tend to lash out or make impulsive gestures to keep the other person close –
Again, this is an effect of insecure attachment. The fear of abandonment can be very intense for those of us who were not loved as children; who were neglected, abused, or both.
Women who are ‘tested’ for Borderline Personality Disorder also report being asked if they had difficulty knowing what they thought, or believed; or taking on the opinions of those around them. This, apparently, is a symptom of Borderline Personality Disorder. Do you know what it’s actually a symptom of? Trauma (let me know when you spot the pattern here). Women who are raised in abuse (including narcissistic abuse) learn, very quickly, and from a very young age, what they are ‘allowed’ to think. They learn that what they think and feel is not important. They learn that it is unsafe to express an opinion, or behave in a way that is authentic to them, but not aligned with what their parent/s tell this is expected/accepted.
Choosing to pathologise the normality of women like me – who were horribly abused, and / or neglected – is helpful to no-one except the psychiatrists who make coin out of labelling women with a non-existent disorder. It helps only those who wish to tell women that their – entirely reasonable – reactions are problematic; and persuading women that there is something wrong with them because they react in completely normal ways to completely abnormal events.
I’d like to see this ‘diagnosis’ addressed, seen for what it is, and removed from the DSM and the diagnostic lexicon.