Why we must start trying to help “Cluster B” people instead of stigmatizing them.

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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.

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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

Guest Post #5: Why Does Mental Illness Stigma Exist?

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In The Asylum, Unknown artist.

Matthew Malin, owner and creator of the blog  Confessions, has written a wonderful guest post describing the history of mental illness stigma, going all the way back to Roman times.    Not only is the subject matter fascinating, but the unique historical perspective shows how the stigma is rooted in two things that seem almost diametrically opposed: mental illness as a medical problem centered in the body; and ancient superstitions, such as demonic possession.   Even today, there are those who regard mental illness as either a primarily medical problem (leading to doctors over-relying on drug therapy) or a spiritual problem. While there may be both medical and spiritual elements involved in mental illness,  both views have led to stigmatization.

If you have a chance, please visit the Confessions blog.   Matthew’s articles are all about living with depression and anxiety, all written from an intimate, Christian perspective:

In the Spring of 2015 an incredible passion for those suffering from Mental Illness was born within the heart of Matty Malin. Through his own struggles with Depression and anxiety, a fire was ignited within his heart. That desire was to create a place of honesty, transparency, and love. We, the broken, have grown far too weary of the masquerade playing out before our eyes in society. We’re tired of hiding behind “I’m fine”. Here you will find unabashed clarity into the soul of man. You will also discover the love of God despite the ugly, sometimes violent, heart of man.

We fully believe that man is sinful and in need of a Savior. Jesus, the perfect son of God, stepped into our world, lived a sinless life, and was murdered voluntarily on the cross for our sins. He took on the wrath of God for us so that we might have access to a relationship with God that will one day result in spending eternity with him. We obtain salvation through faith in His work and by the grace of His loving hand.

We firmly believe that no man can go too far for the love and hope of Christ. Mental Illness can provide some of the darkest days of life. It is here that we need hope and it is here that we can find it in Christ.

WHY DOES MENTAL ILLNESS STIGMA EXIST?
By Matthew Malin

As someone who has dealt with the debilitating effects of Depression and anxiety for a period of 4, almost 5 years, I believe that I’ve stumbled across something much more paralyzing: Mental Health Stigma. The more aware I become of my own struggles and the more honest I am with myself and others, the more I find a growing discomfort with the topic of Mental Health. Why is this? What is it about Mental Health that sends general fear and inquietude through someone who is tasked with aiding the mentally ill?

A timeline of mental illness stigma.

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Cutting the Stone by Heironymous Bosch, ca. 1494

I believe that history is ultimately to blame in this arena as well as a shallow thought process towards the issue. The Greek Era (500-100 BC) brought forth our first record of Mental Health treatment. Hippocrates was of the mind that a build up of bodily fluids was to blame. In his words, he said, “It is some kind of black bile that is making you depressed.” Their treatments revolved around the physical removal of whatever fluid was ailing the individual.

The Roman people (100BC-600 AD) did nothing to treat the issue at its core either. Instead, they were of the mind that depression/mental health issues were caused by organic malfunctions. Diet and exercise were prescribed to deal with the issue. Yet another example of a culture misunderstanding the true nature of Mental Health.

During the Middle Ages (600-1100 AD), a holy war was being waged on Satan and any form of mental issue was prescribed to be due to demonic activity. The medication for such issues became obvious: Exorcism or any other kind of holy activity. It is believed that the stigma of such illnesses became obviously prevalent and prejudiced during this time.

This recap ultimately brings us to our day and age. If you take a good hard look at the process of treating/dealing with Mental Illness today, you will see a common thread amongst diagnosis and treatment. The 1950’s brought about the thought that medical treatment was the only way to deal with the issue. This solution can be easily traced back to the Greek Era and their thought processes. Others will still claim that diet and exercise will best help those suffering from mental illnesses. There are those as well who righteously claim that mental illness is of the devil and must be rid of by God.

The meaning of mental illness.

All of these prescriptions are lazy, surface level suggestions that completely forsake the underlying notion of what it means to be mentally ill.

It is within the opinion of the author that, when it is appropriate, medicinal, organic, and religious means be used to treat mental illnesses. It is not, however, appropriate to cast off those with mental illnesses by simply telling one to deal with their issues by such means.

What is meant is this: Non-suffering individuals should not settle for surface level treatments when the real issue must be dealt with by more personal means. There is more to those who are mentally ill than meets the eye.

Medicine, religion, and organic based treatments are incredibly valuable but there is one treatment that is oft ignored: the support of a caring soul.

Our culture is neck deep in instant gratification. Social media, advancements in technology, and a general lack of education have only worsened the stigma that already existed towards those with mental illness. It is within the opinion of the author that our society has lost all care and respect for the people around them. Why? We’re far too caught up in ourselves.

What needs to be done.

It is a sad, unfortunate truth that this stigma will truly never go away. Some people will never care but all hope has not been lost. While arrogance can hardly be cured, ignorance can be educated. This kind of teaching cannot take place within a classroom. This is the kind of schooling that happens through our parenting, our social lives, and our social media ones. What I’m advocating for is change, but not from the outside world.

Change has to come from within if we ever want to make a difference. This requires those with any kind of mental illness to step up and speak out. It requires a willingness to open up about the issues, the difficulties, and the failures that come along with mental health. This change begins with us.

I recognize what I’m asking. I’ve not been very shy about my struggles but I recognize that it may come a little harder for others. Whether social stigma has silenced your voice or your own perceived stigma has, it can be an incredibly difficult thing to open up about. Let me reassure you of this: Your mental illness does not define who you are. Yes, it limits you. Yes, it makes life a little more difficult. I guarantee you though that it does not take away your worth as a human being.

You have been fearfully and wonderfully made by the God of the Universe and He loves you. You were made in His image! No person can ever take that away from you. No amount of vicious vocabulary or audacious action can strip you of your worth as a human being. Don’t allow yourself to tell you that you have no worth and therefore cannot speak out. Don’t allow other people to tell you that either. You have inherent worth, you are loved, and you are capable of standing against this.

Decide today that you will no longer stay quiet in this battle. You have a voice, let it be heard.

Be the change you wish to see in this world.

God bless you,

Matthew Malin
Author and Founder of Confessions:

https://confessions92.wordpress.com/

Borderlines: incurable demons or trauma victims?

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The symptoms of Complex PTSD are almost identical to those of BPD.

Something has come to my attention during the time I’ve been blogging, which I think is important enough to merit another post about it.

Borderline Personality Disorder (BPD, DSM code 301.83) is classified by the Diagnostic and Statistical Manual of Mental Disorders as a Cluster B (emotional/dramatic/erratic) personality disorder having many similarities to character disorders like Narcissistic Personality Disorder (NPD) and Antisocial Personality Disorder (ASPD). Both NPD and ASPD are characterized by a lack of empathy, entitled behavior, and disregard for the rights or feelings of others. It’s also true that some Borderlines act out in ways harmful to themselves and others. Hence, “Cluster B” has become a pejorative category and some ACONs (adult children of narcissists) and others have demonized people with BPD as being amoral, immoral, and almost inhuman, nearly or as bad as as people with NPD or ASPD. Some even go so far as to lump all borderlines in with the “narcs” and barely make a distinction between them. In their minds, if you’re a Borderline, you’re no better than a “narc” and that’s all there is to it. You’re a bad person and to be avoided.

To make matters even worse, many mental health professionals refuse to treat people with BPD, believing them to be troublemakers, incurable, or both. I remember one therapist I saw years ago for an intake session and seemed to connect well with, called me a few days later after he received my psychiatric records, and told me he couldn’t take me on as a patient. “I don’t work with borderlines,” he said.

It’s true that there are some similarities between the Cluster B disorders, and both BPD and NPD/ASPD have roots in childhood abuse or neglect. But the similarities don’t run very deep. What I mean by that is while both a borderline and a narcissist cn be manipulative or abusive to others, the reasons are very different. There’s also the matter of intention. Borderlines, if they act out against others, aren’t usually aware they’re being abusive and/or manipulative. If their bad behavior is brought to their attention, they normally become very upset and feel terrible about it (unless they have a comorbid NPD or ASPD diagnosis). They act out because of overpowering emotions that they haven’t learned how to control. In contrast, a narcissist or person with ASPD acts out because they can. If their behavior is brought to their attention, they’re likely to become angry and rage against the accusation, make excuses, blame-shift it onto someone else, or deny it.  Unlike most borderlines, they don’t feel remorse, guilt or shame for hurting others.

In addition, many borderlines are much more harmful to themselves than to other people. If they do act out against others, most are as frightened by their own outbursts as others are and sometimes more so. In a nutshell, people with BPD know they have a problem and wish they could be different. Untreated BPD makes a Borderline’s life miserable, while people with NPD or ASPD are usually not bothered by their disorder. That’s why, even though Borderlines can act “crazier” than narcissists, they can get better and are much more responsive to therapy or behavioral treatments such as DBT or CBT.

But we’re still caught in a gray zone, neither here or there.   The stigma against borderlines (in my observation) has grown worse, and most narcissistic abuse sites pretty much regard people with BPD  as the “female or over-emotional version of NPD.”  (actually, Covert/Fragile NPD or Histrionic Personality Disorder would come closer).   If we’re narcissistic abuse victims suffering from complex PTSD, it takes a great deal of courage to admit you also have a BPD diagnosis.  It took me a few months to come out about it on this blog. Fortunately,  I haven’t received too much (or really, any) flack about it.

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Click to enlarge graph.

The good news is, a number of BPD bloggers are helping to reduce the negative stigma that we’re “bad seeds” with an untreatable disorder just because we’re OMG “Cluster B.” Think about this: have you ever noticed that there aren’t too many people with NPD (or ASPD) blogging about their challenges and insecurities, or fighting to reduce the stigma against their disorder? If they blog about their narcissism or psychopathy, it’s usually to brag about how NPD/psychopathy makes them superior or allows them to have control over others and be successful in the world. That’s because they don’t think they have a problem (They just cause others to have problems). Most Borderlines know they have a problem and struggle with it constantly, since it makes them feel so crazy and lowers their quality of life. I can only think of ONE blogger with NPD who was unhappy with his disorder and successfully treated for it (or so he says). That man probably had low-spectrum and probably covert NPD; a person with malignant or high spectrum grandiose-type NPD will never have enough insight or willingness to admit that THEY are the ones with a problem. In contrast, I can think of about 20 bloggers with BPD who are in treatment or therapy or have even been healed! I’m sure there’s many more that I don’t even know about.

BPD also seems to co-occur a lot with complex PTSD or PTSD. Most BPD bloggers I can think of also have complex PTSD or are in treatment for it. The symptoms of BPD and Complex PTSD are almost the same. The DSM does not recognize Complex PTSD as a diagnosis; it only recognizes PTSD, which is not caused by chronic trauma over a long period of time (such as having been abused as a child), but by one traumatic incident (such as fighting in a war or being raped). Therapeutic treatments for complex PTSD and BPD are also almost the same (for that matter, NPD and other personality disorders are treated almost the same way). Both BPD and Complex PTSD have a higher cure rate than NPD. Since Complex PTSD isn’t recognized as a valid diagnosis, I think a lot of people (especially women) who might have been diagnosed with complex PTSD if it was recognized get slapped with the “Borderline” label instead. Although I accept my BPD diagnosis (and have even become a little attached to it), I wonder if I might never have been diagnosed with it at all had Complex PTSD been recognized by the psychiatric profession. I think in some cases, BPD may not really be accurate, or could even be the same thing as C-PTSD due to their many similarities. At least one blogger (BPD Transformation, who used to comment here but stopped for some reason), doesn’t even think BPD is a valid diagnosis and shouldn’t exist at all.

Further reading:

Are BPD and Complex PTSD the Same Disorder?

Is BPD a Real Disorder or Should it Be Eliminated as a Diagnosis?

BPD Awareness: end the stigma

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Borderline Personality Disorder is a serious mental disorder with its roots in childhood abuse (usually narcissistic or sexual abuse) and as you can see in one of the memes below, it shares much in common with Complex PTSD and may in fact be a variation of the same disorder.

But BPD is terribly stigmatized, with its sufferers being called everything from evil to incurable.  Many mental health professionals refuse to work with Borderlines because of this stigma.  They’re afraid of us!  While some more aggressive borderlines can certainly do bad things to others and be manipulative, for people with BPD, their actions are caused by an inability to control or regulate their emotions, so they act out instead of thinking before they act. Many Borderlines are more destructive to themselves than to others.  They can seem self-centered and narcissistic not because they lack empathy (many borderlines, in fact have an excess of empathy) but because they get too caught up in their own emotional turmoil to be mindful of others.    Unlike people with NPD, they also don’t have a sense of entitlement.   In fact, they often feel like they deserve nothing.

BPD is much more treatable and receptive to therapy than other Cluster B disorders like NPD or Antisocial Personality Disorder.   Unlike those disorders, too, people with BPD can be helped by medication.

 

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Show your pride:

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Order one here: 
http://www.zazzle.com/bpd_pride_button-145549130796752314

BPD/mental illness awareness/LGBT bracelets and jewelry: 
https://xsullengirlx.wordpress.com/shop/

“Crazy” blogs help reduce stigma against mental illness.

Through our “self indulgence” and “shameless” willingness to publicly talk about personal struggles and issues most people wouldn’t even tell their second best friend,  we forge communities where we can offer strength and comfort to others–and receive it in return.

 

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Do you, like me, administer a “crazy” blog?

I was thinking about how in the past few years, “crazy” blogs like mine (highly confessional blogs that document an individual’s mental illness and their journey to wellness, or an abuse victim’s struggles to find peace of mind and emotional freedom) have proliferated like mushrooms after a rain storm.

Is this a blessing or is it the Internet version of the worst kind of TV reality shows?

Those who don’t understand, many of them older people who aren’t used to such public candor on or off the web,  like to pass judgment and accuse us “crazy” bloggers pf being self-indulgent, narcissistic, exhibitionistic, shameless, or just plain, well, batshit crazy.    They can’t understand why people with such delicate and personal…issues…would want to blab about them all over the web to strangers all over the world.   They think that by us doing so,  we just prove we’re as insane as whatever mental illness we are struggling with. They think that abuse stories belong behind closed doors and the only public place where they should be discussed is in the courts.

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Highly subjective, confessional stories of mental illness and abuse didn’t start on the web, though the web makes it possible for the average non-celebrity type of person to make their story known through blogging and forum posts, and in the process, enlighten, warn, or provide hope and support to others in the same boat.   Through our “self indulgence” and “shameless” willingness to publicly talk about personal struggles and issues most people wouldn’t even tell their second best friend,  we forge communities where we can offer strength and comfort to others–and receive it in return. Back in the days before the Internet was available, we so often had to struggle alone without any support–or never be able to use what we learned to lift up someone else.

I think “crazy” blogs in particular help reduce stigma against mental illness by describing what it’s like to actually live with one, rather than just listing a bunch of criteria in a psychiatric textbook, which tends to increase stigma.  Instead of being reduced to “Exhibit A-104.3G, our stories and struggles show our humanity.

 

Further reading:  Why Crazy People Make Better Bloggers.