CW: self-harm, abuse
As a homage to mental health awareness week (14th- 20th May), I have decided to write on an often misunderstood and underrepresented psychological health condition close to my heart, or more accurately my spirit. Borderline Personality Disorder or BPD is characterised as a ‘behavioural disorder’, which is intrinsic to one’s selfhood, and because of its often abuse-induced origins, has been notoriously difficult to treat. It is not the expected actions or the very true fact that the condition is deeply ingrained that I take issue with, but the medical paradigm of dysfunction and negativity implied by the alliterative last acronym.
This pervasive perceptual context, reflective of the attitude towards many mental health issues, permits an entire trail of prejudice, extending to the defining symptoms of BPD. Common misconceptions are “attention-seeking, manipulative and over-emotional”. This comes from the high numbers of those with BPD who self-harm, especially during their already tumultuous teenage years, their expressing the need for special care or extra-vigilance and seeming not to be able to cope with the interpersonal and social challenges that everyone else can.
It is time to not only put the record straight, but to add some fucking colour.
Not as widely known as bipolar disorder and often mistaken for it, and less sensationalised than psychosis, it is certainly important that mental health institutions such as Mind, have started to take a more discerning and sensitive approach towards BPD. However, though far better than the derisive tone of Psychology Today, and very helpful to the individual in question’s immediate relief, this is still not sufficient in the long-term. It fails to tackle the wider idea of emotional instability as flinchingly unwanted, as if a burstable blister on an upright and immaculate society.
When Mariah Carey came out about her type 2 bipolar condition, it was incredible for two reasons: she talked in detail about a trivialised invisible struggle, and she was using the celebrity vector of social media to do good and actually boost the community’s mental health. For me, this wasn’t just to do with the amount of coverage the condition got – covered by every paper from The Express and Glamour to The New York Times, The Guardian and The Washington Post – but that she presented her illness in a shinier, A-list light. Mariah talked of her struggle, yes, but she also defended her behaviour.
It is time to not only put the record straight, but to add some fucking colour.
As opposed to glamorising mental health issues then, she used her high-profile to go some way in normalising a more holistic imagination of life: that striving, dips and complications are as natural to human experience as feeling the good points and incredible highs. Coming back to BPD, which is the mental health condition that I can speak most authoritatively about, I am compelled to take this to my signature radical yet logical, extreme. Not only does the regulation and administering of treatments, such as CBT, DBT (Dialectical Behavioural Therapy) and trauma therapy, for those suffering these corresponding mental health ‘disorders’, facilitate a return to a normal and happy routine, but also rich and extraordinary living. Many go on to become great role models and leaders.
Thus, its very emotional depth – BPD is so distinctly labyrinthine in its challenges and persistent by nature because of its visceral origins – is also what makes it beautiful, multifaceted life-skill.
Bolstered by my experience working with some excellent therapists, and continued exploration of the state through my MA studies and beyond as an inquisitive journalist, I will now extensively list some commonly experienced signifiers of Borderline Personality Disorder, but this time presenting the alternative lens of minutiae and admirable qualities alongside the common judgements and traditional shallower readings.
The points should address both the blind spots of the general public as well as those of some mental health professionals.
Heightened Sensitivity and Feeling Intensely
Mystification: this person is overly emotional and ridiculously sentimental.
Hidden truth: this person is highly empathetic. They also possess an unparalleled emotional intelligence that allows them to appreciate the intricacies of invisible worlds, including the unique depth of psychological bonds, which others cannot: ‘it has long been recognised that individuals with BPD seem to possess an uncanny sensitivity to other people’s subconscious mental content – thoughts, feelings and even physical sensations (…) In the first study that explicitly investigate this observation, Frank and Hoffman (1986) found that individuals with BPD showed a heightened sensitivity to nonverbal cues when compared with people without BPD’ (source).
Social and Relational Complication
Mystification: this person is being contentious, stubborn and difficult for the sake of it. Perhaps even for a power trip.
Hidden Truth: continuing on from the first point, upon feeling so intensely, this person is often fighting passionately for what they care about and is struggling to express the depth of it within socially acceptable boundaries.
For this reason, it is often equally as frustrating for someone with BPD to deal with a so-called ‘normal’ member of the community, who to them, seem callous and unfair. Being accused of tussling for control is then doubly insulting because there is such raw investment and love.
Additionally, an intelligent and compassionate understanding makes for a highly developed moral compass. The standard of which is too high for most people to appreciate, without further conversation.
Cutting oneself, fits, physical heaviness and epidermal blisters
Mystification: this person is being melodramatic, has induced it themselves or is playing the victim and faking it.
Hidden Truth: those with BPD naturally experience the world holistically. The psychological landscape is basically a physical one. I’ve had huge welts appear on my thighs when I am stressed, and my skin becomes super-sensitive so a laptop resting gently on my thighs can leave worrying, deep,red marks.
Those with BPD are so in touch with their emotions that it surpasses any physical pain or joy. In this regard, cutting oneself is not premeditated or irrational. The body is a physiological organism wherein the brain maintains both the body’s physical and emotional systems. Thus, when it undergoes near unbearable, seemingly real, pain, it reacts by wanting the individual to escape it. Cutting helps transfer what essentially feels as if a searing hot heat energy billowing inside, outwards to achieve calm. Whether someone sees the cuts or not is entirely incidental.
Similarly, an unprecedented build-up or sudden experience of unpleasant stimuli and social treatment can result in extreme contortions of the body for hours, including paralysis and exhaustion afterwards. The individual could be thrashing and screaming in pain.
Conversely, they can also experience periods of great elation that manifest in lightness of the body and enjoying activities so much that no physical pain is felt at all, even when it is happening. Also, any intensely pleasant thought can manifest corporeally, for example, I don’t know, a sex dream, where you wake up and it’s basically happened! That celebrity crush would have been sublimated and you can tick Reece Shearsmith off ‘the list’. Your skin can naturally look years younger – luminescent and blemish-free.
Finally: those with BPD generally experience life more vividly and fully than others.
Benefitting from external support
Mystification: this is indulgent behaviour and sheer neediness which must not be entertained.
Hidden Truth: those with BPD have either been physical, sexual or emotional trauma victims, or been raised in an environment of extreme neglect growing up. This creates a terrible emotional emptiness some have compared to the state of drug withdrawal. Most who are undergoing or have undergone therapy are doing really well despite this, and sometimes become even better at managing the very normal need for validation that most people are faced with because those with BPD have had to look inside.
If someone who has been diagnosed with this condition seems extra needy, remember they are in an exceptional circumstance and are probably going through a particularly demanding period.
Furthermore, to go back to the physical metaphor, it is important to remember that you would not withhold an insulin shot from a diabetic. One kind comment or compliment or special allowance can go a long way. This is topping up the confidence of someone who has a dangerously low self-esteem, and not inflating a swollen ego. Your actions can literally make the difference to their thriving or not.
On the flip side, a difficult upbringing that causes you to have to look outwards for legitimacy also instils an in-built compassion and empathy for others who are suffering as well as a natural desire to protect friends and the wider community. This sentiment is often unconditional and stays for life: They also seem to have a talent in involving and influencing others.
When acceptingly managing the condition, it then becomes quite possible to be positively powered by people.
Furthermore, this receptivity to the outer world makes a person with BPD incredibly discerning, possessing a sort of ESP. They can pick up on the mood of particular places and match activities to people and identify another’s personal strengths very quickly. This makes for some fun and fulfilling times.
Relationship with Psychosis
Mystification: you are unhinged and unpredictable.
Hidden Truth: You possess a trailblazing creativity just as many of those who are susceptible to psychosis do.
People experiment with psychotropic drugs to achieve the same insights into the social and human unconscious that someone who is prone to psychotic visions or symbolic thinking does. Many top creative industry professionals benefit from this state and are what is dubbed as traditionally ‘unstable’.
More qualities and part 2 of the article here
Sarah, who is a member of the UK Council for Psychotherapy (UKCP) and a trained supervisor under the Metanoia Institute has wonderfully endorsed this piece: ‘it hits the nail on the head – I couldn’t put it down.’ Her work has been published in books such as ‘Idols and Believers’ by Jocelyn Bain Hogg, and she has been featured in The Telegraph and Huffington Post.
Thanks also to my sister, who knows how infinitely she is my world.
Featured image CC BY-SA 2.0 Jon Fife
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