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Borderline Personality Disorder Stigma...Why?

Posted May 26 2010 12:00am

In the past, I have written about the stigma of borderline personality disorder and some of the reason for it. However, Brain Blogger: Topics from multidimensional biopsychosocial perspectives , has one of the best articles, Psychiatry Discriminates Against People with Borderline Personality Disorder , that I have read and I want to share it with you.  I will later follow up with posts on abandonment, self-image and the brain. 

The stigma regarding Borderline Personality Disorder is probably the highest out of all mental illnesses combined.  While in college and in my career, my colleagues and I have often groaned when I find out one of my clients are diagnosed as such.  When I was diagnosed with it, I was quite scared because of the stigma which is clearly explained in Brain Blogger: Topics from multidimensional biopsychosocial perspectives .  As explained in the article, many professionals will not treat those individuals with borderline personality disorder.

However, I believe that there is hope.  For me, I have learned to manage my symptoms and understand them.  But, it has taken a very long-time and psychiatric hospitalizations and medication.  I continue to improve. My therapist is very committed to my becoming healthy and treats me as a person first and explains what behavior, thinking and emotions are common in people with borderline personality disorder.  I takes a huge commitment one the patient and professionals regarding borderline personality disorder.

Brain Blogger: Topics from multidimensional biopsychosocial perspectives , is a fantastic site and one that I follow one a consistent basis.  It addresses professional issues and psychological issues from many disciples in a way the someone not in the mental health permission can understand. Okay, I'll stop rambling and let you read the article. With permission the following is an article reprinted for this post:

Psychiatry Discriminates Against People with Borderline Personality Disorder
By Elise Stobbe


Borderline Personality Disorder (BPD) is characterized by a pattern of unstable relationships, a self-image that is always changing, and poor impulse control. The person suffering from BPD fears abandonment and will go to any lengths to prevent this, including threats of suicide. Self-harm is a characteristic.

There may be no other psychiatric diagnosis more laden with stereotypes and stigma than Borderline Personality Disorder. People who live with this label — the majority being female — often have problems accessing good mental health services. (1) Unlike the stigmatization that society puts on mental illness, the stigma associated with BPD often comes from mental health professionals and their patronizing attitudes.

Many psychiatrists will not treat BPD patients, or they may limit the number of BPD patients in their practice or drop them as ”treatment resistant.” Often attempts to treat borderlines fail, and some professionals blame the patient for not responding to treatment. (2) It is often undiagnosed, misdiagnosed, or treated inappropriately. According to Dr. Joel Dvoskin, former Commissioner of the New York State Office Of Mental Health,

“Why would psychiatry and psychology turn so viciously against people they call mentally disordered? Apparently the greatest sin a client can commit is poor response to treatment. What is apparently so wrong about these unfortunate souls is that they have yet to demonstrate the ability to get better in response to our treatment. Thus, they don’t make us feel very good. With a few notable exceptions, we have simply given up on helping people who desperately need us to do a better job of helping them.” (3)

Many mental health professionals discriminate against BPD patients because of what their co-workers have said about them. They watch other professional people “rolling their eyes” when someone mentions BPD. This is just evidence showing others that “everyone knows that people with BPD are horrible people and hard to manage”. (4)

Clients who come to services with a diagnosis of BPD “may already be disliked before they have even been seen. Clients in treatment are often embroiled in clinician attitudes which are derogatory or denying the legitimacy of their right to access resources. Studies have demonstrated clinicians having less empathy for people meeting diagnostic criteria for borderline personality disorder than other diagnostic groups and making more belittling comments.” (5)

Support services for consumers and families are woefully inadequate. The public is generally unaware of the disorder due to the lack of educational materials available from various mental health organizations. No celebrity has yet come forward to put a face on BPD, probably because BPD is the most stigmatized of all mental illnesses today. (6)

Recent research studies have demonstrated the effectiveness of individual cognitive behavioral therapy along with group psychoeducation and skills training that teach emotional regulation skills, distress tolerance, improved interpersonal relationship behaviors and awareness (mindfulness). This, combined with careful medication management, may allow the patient to achieve significant progress. (7)

Effective treatment can reduce symptoms and improve quality of life. There is also considerable short-term fluctuation in symptoms and distress, and the long-term outcome for many patients is often better than originally thought, even without treatment. (8) A fairly new psychosocial treatment termed dialectical behavior therapy (DBT) which was developed specifically to treat BPD is available. But without willing professionals, people with BPD are denied the help they need.


References


(1) Nehls, N. Issues Mental Health Nursing. “Border Personality Disorder: Gender Types, Stigma and Limited System of Care“. Abstract. Entrez PubMed.

(2) Bogod, Elizabeth. Mental Health Matters. “Borderline Personality Disorder Label Creates Stigma“.


(3) CAMI Journal on BPD, Vol 8 cited by TARA Association, “Understanding Borderline Personality Disorder“.


(4) Fleener, Patty, M.S.W. BPD Today. “Stigma and Borderline Personality Disorder“. (2002).


(5) Krawitz, Roy and Watson, Christine. Mental Health Commission Occasional Publications: No. 2. “Borderline Personality Disorder: Pathways to Effective Service Delivery and Clinical Treatment Options.” (October, 1999).


(6) Porr, Valerie. TARA Association. How Advocacy is Bringing Borderline Personality Disorder Into the Light“. (Nov. 2001).


(7) TARA Association, “Understanding Borderline Personality Disorder“.


(8) Livesley, W. John, M.D. The Canadian Journal of Psychiatry. Editorial: “Progress in the Treatment of Borderline Personality Disorder“. (July 2005).

So what is your experience with being diagnosed with borderline personality disorder or what have you known about the stigma surrounding this disorder?

Don't forget to check out Brain Blogger: Topics from multidimensional biopsychosocial perspectives .  You will be glad that you did. Follow it for a while to see the vast number of posts including funny research.  Thank you for Brain Blogger for giving me permission to post their article.

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