A Mad Pride Perspective on Borderline Personality Disorder
I have spent a lot of time trying to convince myself and others I do not have borderline personality disorder.
It’s true my fear of abandonment has been a driving force throughout my life. During high school, when I stayed up until the wee hours of the night studying, striving to earn straight A’s, everyone around me was shocked when they found out my end goal was not to get accepted into an Ivy League college. I stayed up late studying because I was terrified that my grades were the only good thing about me, and if I scored anything less than straight A’s, I would no longer be valued or liked by those around me.
You see, I’ve always been the weird, awkward girl. Growing up, I was that socially awkward kid with glasses, brace and bushy curly hair who would not stop talking about “Grey’s Anatomy” or the original stories I was writing. I didn’t have many friends and was even sometimes bullied. My parents, who were well-meaning and wanted me to be happy, tried to help me fit in. They urged me to wear make-up and contacts and to style my hair. They implored me to talk about subjects that other kids my age were interested in. I tried. Contacts and make-up were horribly uncomfortable; I never really succeeded in figuring out how to stick to “normal” topics of conversation.
But I was successful in one area. I was a hard worker, I received straight A’s, and for that my parents were proud of me. For that I received praise from my family, my teacher, and even my classmates. So high school became a nonstop tightrope walk during which I was constantly living on the edge of my seat, terrified of scoring anything less than 100 percent, of not participating in enough extracurricular activities and of not being the perfect student.
Sometimes, my own perfectionism, lack of sleep and terror of not being good enough got the best of me. There were times when I became so overwhelmed that I would have meltdowns, crying hysterically and even screaming and scratching myself in public. Of course, this embarrassed my parents and those around me. I was sent to therapist after therapist and was even put on medication to try to get my emotions under control. Nothing ever really worked.
So, on top of being weird and awkward, I was also emotionally unstable and a walking embarrassment to my family. I became so incredibly ashamed of who I was.
When I started dating my first serious boyfriend in college, that shame and embarrassment surged. I was absolutely convinced I did not deserve him. How could someone like him — handsome, funny, well-liked — love someone like me — awkward, weird, unattractive, emotional?
Although things had gotten better for me in college — I had finally found a group of friends who accepted me for who I was, and I started putting less pressure on myself academically— when I started dating my first boyfriend, the feeling of walking on a tightrope returned. I became convinced that if I did not keep up my good grades, maintain a certain weight, keep my room clean enough, put on make-up every day and maintain a calm, level-headed disposition the vast majority of the time, free from meltdowns or intense emotions, then he would leave. Because it felt impossible for me to maintain all of that, I began to hate myself. I felt like a failure. I started to have more meltdowns than ever and experience intense periods of suicidality.
I was eventually diagnosed with borderline personality disorder, a condition usually considered to stem from a pathological fear of abandonment. The diagnostic criteria for borderline personality disorder are five or more of the following symptoms:
- Frantic efforts to avoid real or imagined abandonment
- A pattern of unstable and intense interpersonal relationships
- An unstable self-image or sense of self
- Impulsivity in at least two areas that are potentially self-damaging (e.g. spending, sex, substance abuse, reckless driving, binge eating)
- Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior
- Affective instability due to a marked reactivity of mood
- Chronic feelings of emptiness
- Inappropriate, intense anger or difficulty controlling anger
- Transient, stress-related paranoid ideation or severe dissociative symptoms
I was told that I exhibited frantic efforts to avoid abandonment, an unstable self-image, recurrent suicidality and self-harm, emotional instability and inappropriate anger (this last “symptom” was in part due to my anger toward the mental health system).
The idea that not only was I weird, awkward, unattractive and overly emotional, but also had a disordered personality, only exacerbated my fear of not being good enough for those around me. Who could ever love a girl with a disordered personality?
I spent a long time trying to deny that I fit the criteria of borderline personality disorder. Wasn’t my fear of abandonment, to some extent, universal? After all, who can’t relate to the Cool Girl monologue in “Gone Girl”? Who can’t relate to the experience of wanting so desperately to be loved by another person, and being willing to do almost anything to receive that love, to feel deserving of that love? The line between our universal fear of abandonment and a “pathological” fear of abandonment — borderline personality disorder— felt all too subjective to me.
When that first serious boyfriend left me, in part due to his embarrassment of my meltdowns, I felt such intense self-hatred that I engaged in self-harm. Again came the pathologization of my reaction, the diagnosing of borderline personality disorder. But wasn’t my self-harm a natural reaction to that situation? I wondered. I thought back to my first hospitalization, where my roommate had been locked up due to saying she wanted to drive off a cliff after walking in on her husband kissing the babysitter. Don’t most people at least wish to do something drastic after being betrayed or abandoned by a loved one?
To me, those questions are important and valid. The work of scholars, researchers and survivors who ask these and other questions to challenge the validity of “personality disorders” in general no doubt serves an essential purpose in the field of critical psychiatry. But I’ve also begun to think: even if borderline personality disorder were a valid construct, does meeting the criteria for the diagnosis necessarily mean something is wrong with me? Does that necessarily mean my personality is disordered and I need to learn coping skills to recover? Could it possibly say more about society than it says about me?
Implicit in the diagnosis of borderline personality disorder is the assumption that healthy people do not need the love, acceptance or approval of other people — or at least not to the extreme that “borderlines” do. In response to my self-harm incident after my first break-up, a therapist said to me, “If you were healthier, you wouldn’t have reacted so destructively to being left. Most people in that situation know that they will be just fine on their own.”
We are constantly told we need to love ourselves first and foremost, before anyone else can. We need to feel comfortable and even thrive being alone; we need to love being single.
In our society, we are becoming more and more accepting of the aromantic community — people who do not experience romantic attraction. And that is absolutely wonderful to see. What if, similarly, there are some people who just prefer being in a romantic relationship? Who are not so comfortable or able to thrive on their own? What if there are people who do crave the acceptance, approval and love of another to feel truly fulfilled? Who gets to decide whether that’s pathological?
Wouldn’t it make sense for those people to feel the pain of abandonment more strongly, and to fear that abandonment more deeply?
Maybe it is true that during a break-up, most people know they will be just fine on their own, and therefore do not experience self-harm or suicidal thoughts as a reaction. But, as I have learned from the neurodiversity and Mad Pride paradigm, the fact that a trait is shared by the majority of people does not make it a healthier trait than one that is shared by a minority of people. Just like in the United States, white people are not healthier than people of color; straight people are not healthier than gay people; people who speak English as their native language are not healthier than those that speak French or Italian.
One therapist said something else of interest to me: “If you were healthier, you would have the confidence to know that you will easily find someone else.”
I began to wonder what that statement would mean for someone in a marginalized or oppressed group of people. There are so many traits and characteristics we are taught to fear and look down upon in others. There are so many people who cannot just “find someone else” easily. For some people, finding a friend who accepts them for who they are is difficult enough; to find someone who accepts them for who they are and shares a romantic connection may well seem next to impossible.
I thought about my friends in the Autistic community, who share many of my experiences being seen as weird, awkward and overly emotional. Most Autistic people spend their whole lives being told they need to act more normal and try to fit in. They are looked down upon, condescended to and even punished for their way of processing and responding to the world. Most of us have been teased and ridiculed throughout our whole lives and struggle to find people who aren’t prejudiced — who don’t see us as weird (or who like and respect our weirdness). To say that we should “have the confidence to know that we will easily find someone else” is unfair and frankly, unrealistic.
In fact, people with a variety of disabilities are often pitied and seen as inferior. Partners of disabled people are sometimes asked if they are “settling.” “You know you can be with someone ‘normal’ if you want to, right?” they might hear. Or, “Is it hard to take care of someone like that? I’m sure that must be a big burden on you. Are you sure you want to deal with that long term?” In this way, so many nondisabled and neurotypical people are conditioned to see disabled and neurodivergent people as burdens; neurodivergent and disabled people are conditioned to see themselves as inferior and not deserving of love.
I wondered if mental health professionals would make that same statement to a person of size. People labeled “overweight” and “obese” are taught to hate their bodies and view themselves with disgust; they are subjected to relentless and pervasive fatphobia and sizeism. I can count the number of people I know on my hand who are even open to the principles of the fat acceptance movement. How would it possibly be fair to tell a person of size that if they were mentally healthy, they would have the “confidence to know” how easily they will find someone who not only accepts them for who they are without fat-shaming them or encouraging them to lose weight, but who also shares a romantic connection with them?
For most of my life, I have been seen as weird, awkward, emotionally unstable, and unattractive. My parents felt embarrassed of me; my classmates made fun of me. When I started dating my first boyfriend, it was my first real experience of not being seen that way by someone so close to me. It is only natural that I would react so strongly, with such an intense degree of pain, to his departure. And it is only natural to continue being afraid that this type of abandonment will occur again.
I accept that I may fit the DSM’s criteria for borderline personality disorder. I am not trying to say that this does not come with challenges and obstacles. I acknowledge that I have things to work on. While I may not feel completely comfortable or fulfilled while I am single, there are times when I may need to accept being single temporarily. While I may feel intense amounts of pain after a break-up, I will need to learn how to deal with that pain in a way that does not make romantic partners feel pressured to stay with me in order to prevent my self-harm.
But I also believe it is important to acknowledge society’s role in the creation and construction of borderline personality disorder. As I described society’s treatment toward people in marginalized groups to one of my best friends, “First, they tell us we’re weird, disgusting, a burden and undeserving of love. Then, when we’re scared that it’s true — that no one will love us — we’re told that we’re crazy, and if we were sane, we’d be 100 percent confident that we won’t end up alone, or, alternatively, we wouldn’t think of ending up alone as a bad thing. Finally, because we’re truly crazy, we’re further marginalized, and told that we’re even more weird, disgusting, burdensome and unlovable. And the cycle continues.”
I would be lying if I said I was proud of myself for possibly meeting the criteria for borderline personality disorder — on the inside, I still feel far too much shame and fear over not being what mental health professionals consider normal or healthy. But I am also working toward a place of accepting myself and rejecting the message that anything is wrong with me (well, that something is more wrong with me than the average person!).
One thing is for certain. Ten or 20 years from now, if I do find myself in a stable, loving, committed relationship with someone who accepts me for who I am — and I know that’s a big “if” — I will not take it for granted. And I would not trade that for anything. I would not trade that to feel less pain after a break-up or less desire to be in a relationship. I would not trade that to be the cool, unattached, self-sufficient, composed, levelheaded woman idealized by Marsha Linehan, DBT, our society and the DSM. That would mean trading in my own personality for someone else’s. For better or for worse, I plan to remain myself.
This piece originally appeared on Mad in America.
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