Borderline Personality Disorder: Dismantling Stigma, Stereotypes and Outdated Beliefs
Borderline Personality Disorder: Dismantling Stigma, Stereotypes and Outdated Beliefs
By Jessica Bardenheier, MS, Licensed Resident in Counseling Addiction Therapist at Master Center for Addiction Medicine
Humanizing and normalizing the patient experience to feel safe, heard, and valued.
Borderline Personality Disorder is a controversial diagnosis in the clinical and medical world. The very language in its title implies a disease-centered undertone that can make understanding this illness complicated and stigmatizing. Traditionalists may align with the concept that BPD contains an organic pathology, aligning with the stigmatized and outdated reference to an “Axis II diagnosis.” This reference illustrates a stereotypical belief that BPD is somehow inherently pathological in nature and conveys a sense of intentionality in behaviors such as manipulation and patterns of self-seeking endeavors.
When looked at more closely, it becomes clear that the symptoms of Borderline Personality Disorder can parallel an unresolved trauma response gone awry. Unresolved trauma can render the otherwise adaptable central nervous system to become hijacked, shifting the manner in which needs become met. This realization can help the narrative move from, “what is wrong with me?” to “what happened to me?” which is considered to be more person-centered in nature. This means the condition is something that the individual experiences, rather than being representative of their entire identity or sense of self.
The disparities present between an organic mental illness and how an unresolved traumatic experience may present are noteworthy and should be considered when seeking treatment. Specialized treatment modalities are important so that greater results in treatment goals may be achieved. Dialectical Behavior Therapy (DBT) focuses on a cumulative model that ultimately incorporates an accessible means to skills that assist in managing painful emotions and decrease conflict in relationships. The first building block in DBT focuses on mindfulness which helps to identify the individual’s feelings, emotions, etc. in the present moment and allow them a means to accept them in the “here and now.” DBT methods of treatment target the concept of balancing opposites, which emphasizes the construct of dialectics. It eliminates the isolating extremes of the individual’s life to include relationships, impulses, thoughts, emotions, etc., and allows him/her the opportunity to achieve mental equilibrium, which enables increased awareness, insight, and growth. According to DBT principles, the core methods promote balance over “black-and-white” thinking. This reinforces that all-or-nothing patterns of thinking and behaving are not sustainable. As such, there is a “both-and rather” concept present in this counseling ideology, instead of an “either-or” perspective.
A person who has experienced a traumatic event and has perhaps not had the tools, resources, or ability to address said trauma, would understandably be experiencing suboptimal functioning, which in some cases can be pervasive. However, when an affected individual has internalized a traumatic event without any guidance for adaptive coping, understanding, or appropriate skill set, something unfortunate may occur. Rather than internalizing the event alone, there is the possibility for a new cognitive distortion to emerge: that the individual’s personality itself is disordered in nature, at its core. For patients with BPD, this can feel devastating. At the Master Center, we strive to humanize and normalize the patient’s experience so that they may feel safe, heard, and valued; not judged, shamed, or that there is something wrong with them. Part of our work as treatment providers at Master Center is to dismantle stigma, stereotypes, and outdated beliefs about mental health issues while increasing overall wellness.
