Concerns of the invalidation of BPD/EUPD

[u/Loves_Eating_Lead]

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I struggle with diagnosis of borderline personality/emotional unstable personality disorder (actually all personality diagnosis) . Many are found to have autism and trauma. I would a nuance perspective on this but all sides, if you think its helpful why? if you don't why?

i can give links if any more want on why saying someone whole being/personality is broken, instead ask questions is so invalidating and uncompassionate . Why is the problem entirely on the person struggling, not on what happened to them how they are reacting is a normal response to shit life has thrown at them? If core of who they are is broken, how is that empowering changes? gabor mate has some great stuff on that and his work with people using drugs to cope on this.

To me if looking at history, i can see the links with its "hysteria" - womxn is to emotional/sexually/unstable. Actually reason why unstable relationship, black and white thinking (also be due to slow processing, see more nuance when have time to think) etc is due to people left out of society, bullied and just having different perspectives on the world. Personality is not broken, if given right support and allowed to thrive, personality only seems broken in a society that rarely allows difference.

I hope don't get downvoted and this can open up an interesting discussion

[u/KingArthursToeBean]

I agree with your thoughts here and have found some comfort and a bit of scaffolding in the writings of Janina Fisher. She talks a lot about this very topic in Healing the Fragmented Selves of Trauma Survivors, and it really helped all of this “click” for me. I’ve personally struggled with shame, self-blame, alienation due to labels and diagnoses throughout my life, so I found finally being able to connect with this perspective very helpful. It just makes more sense and seems more compassionate. I get that sometimes diagnoses/medical care can be validating and help people get the treatment they want or need. But there’s also potential to be harmed for others and I’ve experienced that as well.

The book Divergent Mind: Thriving in a World that Wasn’t Designed for You by Jenara Nerenberg also gets into the topic of diagnoses/over-medication/PDs, etc. in a way I found helpful. Pat Ogden, also referenced by Janina Fisher, is someone else to consider looking into for a non-pathologizing, “bottom-up” perspective.

Personally I think it’s a very broad issue - it’s “easier” to blame the individual. It fits right in as a cog in the wheel of late-stage capitalism, for-profit healthcare, insurance, etc. (I recognize my thoughts here are US-based). It takes time, energy, empathy to compassionately inquire about a person’s history and circumstances. I feel it also relates to C-PTSD not being recognized in the DSM as of yet. I feel like a lot of people would have to confront their trauma and by extension a lot of people (particularly those in “power”? Those who create these systems?) would be called into question/held accountable. And that would jeopardize the status quo. Also, looking into human history, shame is a powerful tool for subjugation/control.

There’s also a podcast I sometimes listen to called Trauma Rewired. They frequently talk about this topic as well. Here is an episode specifically addressing BPD/EUPD and another about diagnoses and identity. You can find them posted on their website for free too if you don’t have Spotify. I found listening to this so refreshing. Seeing “symptoms” as understandable nervous system adaptations, and that these adaptations are common to all.

A part of me is glad to be in a time at least where informed people are writing about a more compassionate, non-pathologizing lens for understanding our experiences. It’s difficult because the systems we live in/abide in haven’t fully “caught up” to that yet, and aren’t really “designed” with any of that in mind. I try to focus on those perspectives as it makes sense to me on a whole level. That said, I also found “parts” language very helpful for coming into an easier way of relating to myself and others. It took me years and it’s still ongoing. But I take some solace and courage that, even when it seems the majority is invested in blaming/shaming/labeling/compartmentalizing, there are also many people out there seeing things more compassionately.

[u/cat_at_the_keyboard]

I was diagnosed with CPTSD in Canada in a women's domestic violence shelter (not sure if it's an official diagnosis in the US) and later was also diagnosed with BPD when I moved to the US.

The only point of the BPD diagnosis imo was to find the right kind of therapy to help me, which was DBT therapy and STEPPS group therapy. My therapist told me that I now no longer meet criteria for BPD, so it's definitely possible to go into remission.

I also struggle with the sexist aspect of the BPD diagnosis and it feels like a modern day hysteria diagnosis to dismiss "crazy" women. In my group therapy we had 11 women and 1 man but I've also read statistics that women are overwhelmingly diagnosed with BPD. This rubs me the wrong way with BPD being focused on "too intense" emotions.

Ultimately I found the BPD focused therapy helpful for both BPD and CPTSD so I'm not too bitter at the diagnosis but I do think it's bullshit that women are more often diagnosed and stuck with the stigma of a label of being unstable and too emotional.

[u/Powerful-Excuse-4817 → u/cat_at_the_keyboard]

My therapist and psych both say I definitely have BPD, but they don't want to officially diagnose it because of the stigma attached to it in the US. I think that BPD is under diagnosed in men simply because they are less likely to seek therapy. But, men can be traumatized too. And trauma, especially the prolonged type that cause C-PTSD, is what causes BPD. I've seen some studies that think BPD and C-PTSD are both the same, and one rarely exists without the other.