Is Borderline Personality Disorder actually a thing?
Sometimes I feel like the DSM-IV invented an excuse for...just being a fucking child
I hear there has been a push in recent years, in our incredibly PC social environment, to rename1 Borderline Personality Disorder to “Emotional Intensity Disorder”. As someone who is emotionally intense, I don’t think this is very helpful. It does not sit well to have The Entire Way By Which I Interact With The World™ labeled as a pathology.
My last therapist told me that he thought I had some tendencies which could be labeled as borderline, based on some surveys that I took on an iPad. He then emailed me later that day to apologize, and to say that the term may not have been a very helpful label. I replied2 to say that I did think the label was rather useless, given that it doesn’t contain any pragmatic mental models for how to overcome the damn thing, and instead just sounds very grim:
Nobody calls a toddler mentally ill; they just need to grow up
Read any list of tendencies that are associated with BPD: fear of abandonment, intense mood swings, inappropriate outbursts of anger, rapid swings between idealization and devaluation of other people. Strip out all the stuff about suicidality, substance abuse, sexually impulsive behaviour, etc - and the rest all kind of just sounds like…being a badly raised toddler.
Sometimes I feel like the whole damn concept is ridiculous. The DSM-IV basically carved out an entire category of irresponsible, selfish, unaccountable behaviour, and then decided to throw the term “borderline” on it instead of “asshole”.
Let’s not crystallize bad behaviour into an identity
I’m still not convinced that the diagnostic concept carries any pragmatic value. More than anything else, descriptions of BPD simply state that you have difficulty regulating emotion, and that this causes undue amounts of distress and pain. This is about as useful as telling a depressed person that they may have a tendency to feel sad all the time: the response is generally 1) “Thanks for nothing, I already knew that”, and 2) “What the hell am I supposed to do now with this information”?
Most of all I dislike the concept because it allows you to take a set of behaviours that any moral or ethical tradition (Christianity, Buddhism etc) would simply call sinful, and legitimizes them into an identity.
Identity is one of the strongest possible drivers of behaviour, and I don’t need society or formal medical literature to give me any further identities which excuse shitty actions. I am already sufficiently capable of hurting people and then inventing post-hoc justifications. The mental models that I use to describe myself should change this - not excuse it.
#37
Though I’ve always thought the name made no sense - borderline between what and what, exactly?
I also responded with the meme at the top of this post. Not sure how it landed.