Where did BPD stigma come from?

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In recent years, BPD has earned a very disagreeable stigma, so disagreeable that people who have a BPD diagnosis are refused treatment, being told they cannot get better or feared by professionals who might treat them. NPD too, hasn’t always been as demonized as it is right now. NPD and BPD have become almost interchangeable in the narc-abuse community. I don’t recall it being that way in 1996 when I got my BPD diagnosis, and I don’t remember ever being told I was hopeless or unredeemable or evil or anything like that. I was treated pretty much like any other psychiatric patient, and was given therapy and put on antidepressants. I was obliged to take a DBT class, which at the time I blew off. (DBT is like CBT but exclusive to Borderlines–and it does work. The fact it worked for me makes me think maybe I *did* have BPD but no longer do!)

BPD was always classified as a Cluster B disorder, ever since its introduction into the DSM in 1980 (it was recognized, however, for much longer than that, and popularized as a disorder in the 1960s because of the research of Otto Kernberg, a German psychologist who studied “the narcissistic and borderline personalities,” and other “disorders of the self.”).* All “Cluster B” means really is the person has a weak, fragmented or nonexistent sense of self. Not being able to access a “true self” means they become either cut off from or cannot regulate their emotions. One of the results of this is a lack of empathy (but BPDs are the most empathetic of all the B’s, and some have normal levels of empathy). In NPD, a strong false self takes the place of the true one, which is a very dissociative symptom. In BPD, there’s not a strong false self like with NPD, but there is a weak and unstable one, and the person isn’t ALWAYS showing that false self. Some BPDs act quite a bit like over-emotional or unstable narcissists (or narcissists in the midst of a breakdown due to loss of supply). Others act like covert narcissists or just act neurotic and insecure but are otherwise nice people. Some feel their emotions too much, including empathy. A few are antisocial. I’m not sure why BPD (and maybe NPD) isn’t classified as a dissociative disorder, because essentially the person is cut off from their “self” in some form or another and that is what dissociation means. I’m not sure what the mechanics are in ASPD (antisocial personality disorder) but they are very different from either Borderlines or narcissists because they aren’t dependent on others to boost their weak egos. They are psychopathic and just do what they want.

bpd_stigma_quote

So the Cluster B’s, including BPD, were already around, but until the mid-1990s, no one thought of them as anything but mental illnesses or for ASPD, a kind of “adult conduct disorder.” They were psychiatric labels and nothing more. The narc abuse community started in 1995 or so, and Sam Vaknin was pretty much the first one online who wrote about it. Of course, he has NPD but even so, he first called attention to the “evil”-ness of NPD/narcissism (actually it was M. Scott Peck but at the time he wrote “People of the Lie” in 1983, the term “malignant narcissism” wasn’t in vogue yet and there was no connection of “evil people” to people with NPD. There was also no Internet to spread Peck’s concepts like wildfire the way they could have been in 1995 and later. But over time, M. Scott Peck’s book has become one of the most popular in the narc-abuse community) After Vaknin established his online narcissistic abuse community and wrote his popular book “Malignant Self-Love,” more narc-abuse sites got established (many or most of them started by victims, who were understandably angry at the narcissists who had abused them). Soon “narcs are evil” became a sort of meme, and by association, so did all the Cluster B disorders earn a “evil” reputation.

There are benefits to this, of course. Victims are being more heard than ever before. People are paying attention and avoiding narcissistic abusers. But some people who carry a Cluster B label are being hurt too, especially Borderlines (or people–usually women–who were erroneously diagnosed with it). Some experts want to get rid of BPD and just re-label BPD as Complex PTSD (probably not a bad idea). There are MANY similarities. The vast majority of BPDs are not anything like malignant narcissists and are not sociopathic at all. Most just act extremely insecure, needy, and maybe “high maintenance.” They can be manipulative or act out to avoid rejection. They may collude with people with NPD, however. But it’s possible to find these same types of behaviors in many people with Complex PTSD. Are they actually the same thing?

Another reason for the BPD stigma could be the tendency for narcissists and borderlines to form partnerships or be attracted to each other. In such a pairing, the Borderline is almost always the abused or codependent partner. In several “couple killings,” one of the criminal partners, usually the female, has had a BPD diagnosis. But they may have been so brainwashed by their abusers they were coerced into colluding with them against others (a form of Stockholm Syndrome).

Finally, a number of high profile criminals and serial killers have labels of NPD or BPD. But they almost always also have a comorbid ASPD diagnosis. Media icons like Joan Crawford who were known to scapegoat their children also had a BPD diagnosis. In Crawford’s case, she was also diagnosed with HPD (Histrionic Personality Disorder). It wouldn’t surprise me at all if she had NPD (malignant) or ASPD as well, as her behavior was very sociopathic behind closed doors.

Why am I “defending” people with BPD if I don’t have it?  Several reasons:

  1.  I was diagnosed with it and carried that diagnosis for two decades.   I have personally experienced being rejected by therapists once they saw my “red letter” on paper.
  2. Just because my current therapist thinks I don’t have it doesn’t mean I don’t.  Or maybe I did have it and no longer do.  If I no longer have it, that means BPDs are not “hopeless.”
  3. Maybe BPD isn’t a valid diagnosis.
  4. Many people I have cared about who were slapped with “BPD” have been hurt by it.

These are just my rambling thoughts about this matter; I’d be interested in hearing your opinions.

* Timeline of BPD

14 thoughts on “Where did BPD stigma come from?”

  1. I believe there are many reasons for the bigotry and stigma toward this diagnoses, I’ll number a few. There is going to be a trigger warning in this for the last section.
    1. THE DSMS LABELS IN PEJORATIVE WAYS: Starting with the words that the DSM uses to describe the condition. If memory serves me correctly the DSM uses words like manipulative and deceitful (I no longer have a copy but I think those are words used to describe it) In fact, Paula Kaplan PhD one of the very few women to edit the DSM now is an advocate against the it saying it is hugely misogynist, unprofessional and a bunch of guess work. If you read the diagnostic description it is the last person on the planet you want to invite to your party because it sounds like a person that is going to make your life hell.

    2 BECAUSE CULTURE WANTS A SCAPEGOAT The human condition is to create an “other” that allows the larger society to feel superior. Every society has had those untouchables which is a form of social narcissism. This is done on so many levels– income, education, zipcode, race, ethnicity. The “other” is the reject of society like the leper in Christ’s day or the woman with the scarlet letter. Decades of film making and other media presenting the person with BPD as horrifying (think Glen Close killing the rabbit) is the stuff of nightmares

    3 BECAUSE WE CAN”T BURN PEOPLE AT THE STAKE ANYMORE: Yet, there is this violent hatred that wants expression in the dark part of “good people” This invented BPD person carries all sorts of shame, she is manifesting the crap done to her, acting out of the loveless vacuum her monster upbringing left her with and being deeply stigmatised as if she was the monster in that upbringing.

    4. BECAUSE OUR CULTURE IS A SET UP FOR IT BPD is associated with attachment disorders, something that is rare in Africa or other nations where babies are physically tied on to their mother for their first 3 years. This is changing with the “Lost” children. But, BPD is supposedly rare in countries were parenting involves a great deal of bonding. We put babies in cribs, in another room and often in daycare within their 1st 6 weeks, we drug mothers giving birth and immerse the process in all sorts of trauma so from the first moments of life that hormones that are supposed to produce bonding are wildly disrupted.

    5. BECAUSE THE MENTAL HEALTH PROFESSION IS ITSELF EXTREMELY BIGOTED. I did a small project in undergraduate school testing the attitudes towards people with a diagnoses in a random survey I distributed around campus. A number of students were psych techs from the nearby mental hospital. I asked students to do it anonymously except list their education and profession. My survey showed a surprising result. When I asked on a scale of 1-5 if people with a diagnoses were dangerous, if they could recover, if they could work, and have families those that worked in the nearby hospital were far, far more negative than students that worked elsewhere. I think if a large survey were done it would show the same results because some of the most bigoted individuals I’ve met are mental health professionals. If you had a diagnoses you didn’t dare share it with your colleagues.
    6 TRIGGER WARNING, SOME THERAPISTS ARE NARCS AND THEY GET A LOT OF MILEAGE OUT OF THE LABEL. 1. My ex, when working at the mental health center sometimes had the crises line direct the to our house at night. (rural areas used to do that) If some female pissed him off he’d begin to swear and be emotionally abusive to her. This happened repeatedly and when his boss called because the complaints came in at times he’d say within my earshot ” She was a borderline, you know how they all lie and are manipulative” AND HE ALWAYS GOT AWAY WITH IT… 14 years on one job and then another counselor position in which I heard the abuse on the phone and the woman was forced to apologize to my ex for “accusing him” falsely or stop getting services from the new clinic where he worked. She apologized, he came home gloating about that. it was at that point, I let his supervisors know what I’d heard. Without meeting me, he’d convinced them I was borderline so I was not believed…. Why did they not believe me? They were displaying their bigotry to that label.
    (trigger warning here)
    Additionally, he’d masturbate if someone female was talking about sexual abuse or assault (this is the man the doctors in town are coming to for medication advice. He was big time into drugging everyone. 2 At Christmas parties for the office, at various get togethers were spouses were included I’d hear smack talk about clients, sometimes by name with BPD talked about like they were subhuman. Before I married into the profession I thought these were nice sweet, loving people, 3. lastly, when I was being beaten up, literally fists hitting my face by Mr Mental health he frequently started a beating with “you #%#&@#*$ borderline b(@#th” Narcs can swear like nobodies business. Consequently, every time I heard that word I had became hyper-vigilant so my reaction to it is probably based on absolute trauma from the word. .

    I could go on and on how harmful this label is but I tell people that I worked with, saying you have BPD in a room full of therapists is like saying you run a brothel at a Baptist convention….

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    • That’s interesting about babies in Africa and other cultures where physical attachment and bonding is encouaged. I know some parents today practice something called “attachment parenting” in which the baby is constantly physically close to Mom, breastfeeding, “family beds,” etc. These childen probably won’t develop BPD or any other personality disorders (narcs probably wouldn’t practice such type of parenting). It does sound a little extreme, but it puts the child’s needs first. I remember in the ’70s, kids were encouraged to be independent at too early an age, and mothers not to “let” a baby tie them down. Now those children and babies are in their 40s and the chickens are coming home to roost. Slightly earlier than that, like you said, mothers were drugged during labor and childbirth, and separated from the child. In the late 50s/early 60s (when I was born), babies were encouraged to sleep in separate rooms and mothers were told by their doctors to let the babies “cry it out.” Those babies are now in their 50s, and the chickens are coming home to roost. You don’t spoil a baby by giving it too much love or physical holding; babies cannot be spoiled. But they learn trust and feel securely attached, and can grow into healthy, loving adults who do not have personality or attachment disorders.

      Your husband sounds like he was really evil. It gives me shivers that there are people like that working in the mental health field, with vulnerable people. As for the BPD label, I think it’s become one more way women become marginalized (because it’s given to women so often). and thought of as “less than human.” A “borderline bitch” can’t really be a human, can they? It’s the mental health professional version of “dirty whore.”

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      • Yes its marginalizing to women! Sorry I wrote such a long long post. It is one of those hot buttons in my life. and I’ve been isolated for a long time. My ex was evil, but came disguised as an angel of light. That book you mentioned “people of the lie by J Scott Peck” was really helpful in my life. I think evil can only hurt us when we don’t understand that is what we are dealing with. When we think it is a “relationship” it crushes. I think wherever there are vulnerable people there are narcs and we should be wise, I’m praying for the gift of discernment that I know it when I see it and that I respond the right way. Thank you for letting me share here I appreciate your blog I am finding some real healing in reading and responding!

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    • Agree to all points you list.

      “What ‘bad’ is to the ***goose***, ‘asd’ is to the ***gander***. (Yes, I’m an autist)

      That man sounds very-evil – as in he sounds like a (fictional) witch. I’m glad I’ve never been around him (not merely that he’s not going to prey on me. I tend to have ***very*** extreme reactions to ***hearing*** about women being abused.)

      Want to see me go***nuts***? Threaten a woman in my presence. The last time some wretch did that I was fully prepared to ***beat him to death*** if it took that for him to leave her alone. I did not wait for help, either.

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      • The irony is that evil comes disguised as light and that most people upon meeting him when think him kind and gentle. This is the brilliance of evil, the Oscar winning performances of a character that is actually the exact opposite of the dark evil selves. The fact they know to hide that self except to those victims that are vulnerable enough to land in their domain is evidence that they know their darkness and enjoy pulling it off. Their victim is left to look crazy and not be believed “because he’s so nice, he wouldn’t do that, she must be crazy” With a few hints that it is so from the abuser, they go undetected

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  2. BPD is an absolutely valid diagnosis, imho. My mother has BPD, but has refused medication her entire life. A good friend of mine with BPD also has had issues with prescription treatment. Why? Because it depresses all moods, allowing people to feel only one thing. And who wants to feel nothing? So yes medication is real. The fact that your current therapist has changed your diagnosis can mean a couple of things: 1) They truly are a better therapist than you have been seeing (because they’ve found a proper diagnosis or 2) they’re a worse therapist. As of now, there is no “cure” for BPD. Simply control of it.

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  3. And the stigma is definitely lifting I think. Btw, love the beginning picture. Mental illness shouldn’t be taboo and you shouldn’t be ashamed. Someone with heart disease isn’t ashamed. Someone, like me, with a neurological condition (chronic daily migraines) isn’t ashamed. Neither should you be.

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  4. Thank you so much for this informative post.
    Question, would you blame a child for acting out with emotions they have not yet had any help in understanding and furthermore have been shown no empathy for or enough empathy and mirroring to help them regulate those which are truly overwhelming and often even preverbal (eg imagine as a baby being flooded with a toxic substance which the mother ingested and suffering all kinds of reactions which are then encoded at a cellular level and not consciously accessible to awareness which can then replay?)
    Why then demonise borderlines?
    It beggars belief.
    As adults we do have a responsibility to try and understand what happened to us, why we act out as we do, so as not to damage other human beings. But UNTIL the borderline is shown empathy and understanding by a therapist sensitive to see below the push pull acting out dynamics of a tortured soul for whom trusting others spelt psychic obliteration or murder nothing can change.
    In recovery it is essential we find therapists who have done enough work with primitive and primal emotions that they can hold and mirror for us through the rages which may actually be a form of psychic insulation or protection.
    It is thorny work. But I do feel its charlatanism for a therapist to charge a patient and then unconsciously abuse that patient by abandoning them all over again due to the fact they do not have the level of expertise to deal with what should be understood by them in the first place.
    Attention seeking? You betcha. A child needs the right kind of attention and mirroring to grow without developing the myriad holes and empty spaces that develop when a healthy ego is not enabled to mature with adequate boundaries it requires for psychological health.

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    • You have spoken the truth here. A rejecting, cold therapist would NEVER work for me. I wrote more about this in another reply to you. I may write a new post about it.

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  6. Hi, I have recently learned that I was diagnosed with emotional unstable PD in 2010 but it wasn’t disclosed to me. I have tried to research the disorder and it has left me terrified and if I wasn’t pregnant I think I may have considered ending my life. I have read that BPD sufferers are manipulative, violent liars, that it cannot be cured, that they make terrible mothers. Even though I feel very vulnerable at the moment deep down I know that isn’t me. My main issue is that in times of intense stress I am unable to control my emotions and can be self destructive and ‘out of control’ I don’t lie and I often wish I was able to be manipulative as oppose to letting my emotions leave me completely open to hurt! Reading this has helped me immensely and given me hope in what has been a dark few months. Thank you.

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    • BPD has a terrible stigma attached to it (being included in the Cluster B group of personality disorders), but there’s a growing community of those who think it’s really not distinguishable from complex PTSD.
      I’ve heard the term Emotionally Unstable PD as a possible replacement for BPD but personally I don’t like it. It makes you sound like a lunatic.

      I don’t think most borderlines are as manipulative as they’re made out to be. Some are, but I don’t think there’s any conscious desire to hurt or manipulate anyone. The problem is, their emotions can go so out of control the person forgets to think about the needs of others or in their emotional turmoil, can unintentionally hurt someone. But borderlines, from what I have seen, have normal amounts of empathy when not triggered. Lying? I don’t think most BPDs lie more than the average person. They’re not narcissists.
      I’m sorry you’ve been having a hard time with your emotions lately. Sometimes the darkest moments come before the dawn.
      I’m glad my post helped you.

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