STIGMATIZATION OF BORDERLINE P.D.
Medicalization of Mental Disorders OnlineJuly 22, 1996
Borderline personality disorder is mental disorder as defined by the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Like all personality disorders, it tends to be an intrinsic style of coping and dealing with the world in a manner that is not all that beneficial either for the person who has it, or those who interact with that person. And when I say "not all that beneficial," I really mean "it ain't working."
An example of this could be a person's relationships with others in their life. In borderline personality disorder (BPD), the individual goes back and forth in an emotional state, hating and loving the person depending upon their feelings of dependency (or not) on another. These emotional swings can often be intense, and therefore the person with BPD might feel a need to let out some of these emotions. However, here's where the quandry begins... If you tell someone you hate them, they aren't likely to like you very much and a person with BPD, because of their dependency needs, fears that person leaving them. So they cannot (or have not found adequate ways in which to) express themselves emotionally.
So often someone with BPD will turn their intense emotions as much inward as possible. This can result in self-harm behavior and suicidal attempts, as is often the case when anybody is feeling very angry and depressed about themselves at the same time. Sometimes, for some people with this disorder, some of the emotions do get out, and they let people know they've harmed themselves or need attention or the like.
Now the problem arises when mental health professionals put down individuals with this type of disorder, explaining away every behavior and interaction with another human being with, "Oh, her? She's borderline." Yeah, like that says it all. As I've talked about here before, this demeans the individual not only because it describes them merely in terms of their disorder ("Oh, he's schizophrenic." You wouldn't say the same thing to someone with cancer, "Oh, he's cancerous!") It's mean and unthinking to talk in terms like this, and rather patronizing to boot.
But what's worse with people with BPD is that many mental health professionals act as though the person with this disorder is a child. Or irresponsible. Or that their emotions are somehow "fake" and not as felt as "real" emotions. While this could be the case in some people with BPD, I'd argue this could be the case in some people in the general population, regardless of whether they have BPD or not. To dismiss or pretend to explain away a person's feelings with such a label is doing a disservice not only to the person who has the disorder, but more importantly the validity of their emotions and feelings. If we start denying people their feelings, what's next?
If you're a mental health professional and you see yourself in the above, please stop and consider this next time you're amongst your colleagues discussing cases. I have sat in hundreds of case conferences and staff meetings where live human beings were reduced to nothing more than their disorder and everything was explained in that one or two words. It's dehumanzing and it can stop with you. If you're a client in treatment now, ask your therapist why he or she might use that term to talk about you and see where it leads to in a discussion. I'm sure it'll be interesting, regardless of your or their views.
As more and more health-oriented sites come online, I'm beginning to see a lot more of what I call the "medicalization" of mental disorders. I visited a new Web site last week and found an article on depression where they stated time and time again that it is a fact that depression is caused purely by biological conditions and only medication is the real treatment. I thought, "What a crock of horseshit," and promptly wrote them some e-mail telling them so.
They promptly wrote back, and, in part, said:
"Thank you for your thoughtful and extensive comments on our www site. As you recognized from our site, we take a very medical and biological approach to the topic of mental illness. I will indeed review the site to make our focus more clear."
Hmmm, that's interesting. Any objective reading of the entire literature across disciplines clearly shows that a) we don't know what causes mental disorders like depression and b) we do know that it appears that a number of equally important factors are a part of almost every mental disorder, such as biological, psychological, and environmental.
My point? Watch out for these sites as they come online and carefully review their material and what they're saying with what the rest of the mental health profession is saying. Just because you read it online by someone with some fancy degrees after their name doesn't make it true.
I'm planning some sort of redesign of the home page soon. It's getting boring and losing whatever originality it once (if ever!) had.
Also, check out the latest edition of the mental health magazine we publish over at Psych Central every other month, Perspectives. It's our best one yet!
And, if you're a Prodigy member, check out my weekly mental health chats there in the Health n' Fitness area in the Psych Central room, Sunday nights, 9-10:00pm EST (-5:00 GMT).
If you want the whole shi-bang of over 3,650 separate resources that have to do with psychiatry and mental health online, then you might want to visit Psych Central. It's the largest and most comprehensive site of its kind in the world and we're looking to build upon it in the upcoming years, acting as a super guide to mental health online. If you didn't find what you needed here, look there next!
That's it for this time... As always, keep in good mental health!
Last reviewed: By John M. Grohol, Psy.D. on 27 Jan 2007
Published on PsychCentral.com. All rights reserved.