Stigma and Borderline Personality Disorder

 by Patty Fleener M.S.W.

The trouble about being a client with the diagnosis of borderline personality disorder (BPD) is anytime you speak up for yourself, take a stand in regards to your treatment, ask for a change, ask for another opinion, another case worker, another therapist or Dr., you are commonly accused as exhibiting "borderline" behavior. 

The stigma for people with BPD is so bad that when you initially step into your (Dr.'s, Therapist's, Caseworker's, Nurse Practitioner's) office, they are waiting for you to "step out of line." Their "guns are already drawn and they are ready to fire.

It doesn't much matter at what level of recovery you are existing at. That thing that counts is your diagnosis.

Many mental health professionals have a big stigma against borderlines because what their co-workers have said. Where did their co-workers get that information? From their co-workers.

I am sure that they can tell you some gruesome stories about "these borderlines" but what they are talking about are people who have the diagnosis of the BPD and they have it very severely and they also have other mental disorders along with it that the person telling the story did not mention because that part was never mentioned. 

Or perhaps they are judging you because of their past patients and what they forget is they are not dealing with a past patient, they are dealing with me, or you. It is as if they sit back and wait for that "borderline behavior" to pop out. So, if we have any level of intelligence (for some reason those of us with the BPD seem to have a higher than average level of intelligence from what I have noticed) and ask them to explain their treatment decisions, etc. they put that in their big bag of "expected borderline behavior."

Just recently I received two emails from mental health professionals that were extremely abusive to all BPD patients, and they were sent in the guise that they wanted to understand people with BPD better. I could not believe what I was reading. "Borderline patients are always manipulating staff and burn staff out and so many staff have left just do to the borderline behaviors."

Number one, this is clear splitting - black and white thinking. It is only the borderlines that are burning them out. I have been a social worker for almost 10 years and I can tell you I am burnt to a crisp but it is not due to one single population. If a mental health professional gets burned out, they are burned out on being a mental health professional with any population. That is burn out.

This sort of stigma in the mental health system is "contagious." When I was a social worker I would roll my eyes when someone mentioned BPD. Why? Because that is what all of my co-workers did. I was educated by my co-workers of how horrible borderlines were. Did I have my own experience with them? Nope. Did they? Nope. But if you rolled your eyes you were showing others that you were well educated about this population. You knew enough about this disorder to know that the borderlines were horrible people and hard to manage. When in real life, I knew nothing of this disorder. 

This stigma is not only false but is very dangerous for people with BPD in regards to treatment. When my husband told his psychiatrist his wife had the BPD, what did he do? He rolled his eyes. Seriously! Did he know much about the BPD? No, he kept borrowing our books. This is common! Most Drs. and psychiatrists don't have a clue about the BPD and thus have no idea how to treat it!

For those of us with the BPD and/or the Bipolar Disorder, we cannot express healthy anger because people become afraid it is rage/mania. I can understand their fears especially if they have been with us during these times. 

My work for borderline personality disorder in the "real world" off of the Internet includes a lot of letter writing. I am guessing that I am less effective with my mental health disorders known due to stigma.