Academic journal article Ethical Human Psychology and Psychiatry

Borderline Personality Disorder, Language, and Stigma

Academic journal article Ethical Human Psychology and Psychiatry

Borderline Personality Disorder, Language, and Stigma

Article excerpt

As many research studies show, a large portion of clinicians in the mental field hold pejorative attitudes toward those with borderline personality disorder. Oftentimes, these attitudes become manifest through the use of stigmatizing language to describe client behavior, such as "manipulative" and "attention seeking." In this article, combining personal experience with research, I explore how stigmatizing language and attitudes affect the relationship between client and clinician and how such language impacts recovery. I offer for consideration solutions that might be more conducive to recovery and lead to a better working relationship between client and clinician.

Keywords: borderline personality disorder; language; stigma; countertransference

Studies spanning the last three decades find that approximately half of mental health professionals have negative and pejorative attitudes toward those diagnosed with borderline personality disorder (BPD; Fallon, 2003; Lewis & Appleby, 1988; Servais & Saunders, 2007). In this article, using a combination of my own experience and an exploration of current literature and research, I examine the ways in which attitudes and the use of stigmatizing language come between client and clinician, undermining self- esteem in the former and making recovery that much harder. At the same time, I emphasize the importance of empathizing with these reactions and taking an honest look at the behaviors that elicit them.

I argue that as providers, changing our language changes our perceptions of our clients and can help shake loose the power struggle that often defines relationships between client and clinician in this instance. I offer alternatives that may be more helpful to all involved. I offer the argument, based on my experience of my own recovery and my travels through the mental health system, as well as empirical studies, particularly that of Fallon (2003), that one possible way to break free of the cycle we find ourselves in is to embrace the challenge of a posture of respect and the assumption of the best intentions of our clients despite the presenting behaviors.

I am in an interesting position because I am a recovered individual with the diagnosis of BPD wanting to treat people who struggle with it. I currently work as a peer counselor in a crisis intervention program, and even as I strive to help those experiencing similar struggles to my own, I encounter this same countertransference in myself.

I was in a gym talking to an acquaintance who was a therapist about going to school to become a psychologist. I mentioned that I wanted to have a practice composed of people struggling with BPD. "Well you can have mine," she snorted. I was flooded with a familiar feeling of shame, the sense that I was part of a group of people were inherently not like- able, not worthy, not worth helping.

The conversation continued. "Why would you want that population?" I froze. Did I dare tell the true reason? That I'd recovered and I wanted to help people like myself? I turned away a little bit and muttered under my breath, "I have some personal experience." I couldn't look at her. What I think is most a shame about this interaction is the way the interchange impacted our relationship. We were on our way to train together at an Aikido seminar, a nonviolent martial art, and her perceptions and my shame stood between us.

"You're just trying to get attention. Stop being manipulative." These were words that I heard frequently as a young child, and usually, they were accompanied by a slap, or worse, some other form of punishment. The words were a response to a request, or a response to crying when perhaps I fell or was feeling lonely. The words my mother used gave me the message that not only were my needs invalid but also that it was shameful and bad to have them. I was inconveniencing her, annoying her, and interfering with her daily activities.

I grew up desperate, a raw nerve: I would do anything to get my needs met. …

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