on labels: has borderline personality disorder become code for ‘crazy’?

I’ve discussed how I originally resisted the label of borderline personality disorder due to the horrendous things I’d read about it on the internet. On the other hand, being diagnosed with it allowed me to be introduced to dialectical behavior therapy (DBT), which has been immensely useful. It also led me to characterize one issue — identity disturbance, which I’ll write more about soon — that I’ve been dealing with years but have felt unable to accurately describe. In short, the diagnosis has proven really helpful.

At least, I think it has. I’m writing a post right now on a negative experience I had with my (now ex) therapist, who I’ll call Dr. Deville, that made me wonder. Before being labeled as having BPD, I’d had very nice relationships with the two therapists I’d been to. I was treated like a competent peer who needed to make some changes and was perfectly capable of understanding and doing so.  Dr. Deville, however, who is the one who diagnosed me with BPD, treated me like a child towards the end of our time together. I’ll go into more details in my post about her, but in short, she treated me like I was crazy and did not understand my actions and their consequences.

This was unsettling to me. I’m not crazy; in fact, I’m insightful and lucid. I know some folks with BPD might be in denial about how poorly they handle their emotions (and they’re not “crazy,” either!), but even when I’m in the throes of pain, I know what’s happening (and I’m starting to know what to do about it.) I’m competent. I’m an adult. I have a problem with how I react to things and process certain kinds of information, but I’m capable of learning skills the same way any other adult could learn to make a casserole or knit a scarf. I’m a whole, sane person. I’m also quite amiable, a hard worker, and genuine to a fault.

Dealing with Dr. Deville made quite an impression on me. I was thankful that John visited with me and agreed with my assessment of her. I started to worry about whether or not everyone I mentioned my BPD to would treat me like she had. Would everyone start handling me with kid gloves, like I might lash out at any moment? Would they start taking my thoughts and feelings less seriously?

In searching for a new therapist, several mentioned they didn’t have appointments available. I hadn’t mentioned BPD, only that I was looking for someone who did DBT, but I still worried: had they read between the lines? Were they deciding not to work with me because of my BPD? Finally, I mentioned to one therapist on the phone that I had some symptoms of BPD, but that I was afraid to even mention it because of the stigma attached to it. She sympathized, saying, “You’re right about the stigma, and I honestly would be careful who you mention that to. I personally hate that label; it’s only used to give psychologists an idea of what symptoms you’re facing, but honestly, everyone is on that spectrum somewhere. I like to think about those symptoms more in light of attachment theory and treat them that way, and get rid of the label.”

I cried when she said it, and even thanked her. I worried that was a weird thing to do, but actually, I’m sure she wasn’t surprised. It sounds like she knew exactly how hard it was in this society to carry a label that essentially told people to run away from you. I decided then and there that I wouldn’t use the label, either. I have the symptoms, but I’m not so many of the things that seem to spring to mind when people think about BPD.

I actually have continued to use the BPD label to search for resources, and I do think given a trustworthy therapist, it might be a good shorthand way to characterize my symptoms, but I won’t use it as a general descriptor for myself anymore. I’m not crazy. I’m not a psycho. I’m not borderline. I’m a human being.

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