So I had a certain theory developing of what I truly believe BPD to be and what I think does and doesn’t apply as much as what the DSM and current literature states. I didn’t want to post it without talking to my psych and getting his take on it as I’m no professional and personal experience or not he could have said I’ve totally got the wrong end of the stick, but well, turns out he actually agrees with me and says the way I phrased it was a much better way of putting it.
My take on BPD has come about through my experience of it, my own psych studies, through all the reading and watching vlogs and learning about other people’s experiences with the diagnosis, and what we have in common with other disorders.
The thing is, my opinion is unpopular and most likely would be met with a lot of resistance, as some people are actually trying to move away from what I think because it’s perhaps a lot easier to get stigmatised if one was to accept this. But I’m not looking at what is or isn’t more pleasing to society, or what would make us face less negative stigma, I’m interested in truly knowing what this disorder is. So here goes.
I don’t agree with the move away from the term ‘borderline personality disorder’ to ’emotionally unstable personality disorder’ (which still sounds horrendous). I know a lot of people actually prefer EUPD because emotions do play a big part in the disorder and I am not dismissing that but the disorder was originally termed ‘borderline’ as they believed these patients to be on the border of neurosis and psychosis. Not exactly flattering, or something anyone would be comfortable admitting (Hi My name’s Layl and I’m on the border of psychosis, and when I’m not low-level psychotic I’m neurotic! – wouldn’t exactly go down well at dinner parties, dates, or meetings I can imagine).
BUT, I believe this is true, why? Because I feel there is a mental element where we are constantly running the risk of falling into psychosis. Say this ‘mind’ which wants to live a good life, is rational, is able to think things through, engage in healthy behaviours is running parralel to another ‘mind’ which fears abandonment, wants to act on destructive urges, wants impulsive behaviours, engages in punishing behaviours, the irrational fears, the out of control emotional outbursts magical/paranoid thinking etc. all come from another place where if, indulged into an extreme can lead the person to behave in a psychotic fashion. While we’re not psychos, there is a side prone to that, if you will. That’s why I feel that those who are untreated and have ‘severe BPD’ actually have psychotic breaks. Take for example, my dad, who when he was physically violent I am pretty sure had met a mental break down point where he was acting purely from a place of impulse and destruction. Hence why we are probably thought of as psychos and get the fair share of name calling by bitter online ex’s who may have been on the receiving end of these kinds of behaviours.
I feel like it also explains why we have high functioning BPD individuals who can go to work, hold down great careers, do amazing things and at the same time whilst doing those things are severely suicidal ending up in A&E for attempts and are repeatedly self-harming in some way or another. Then when we are emotional or severely depressed as a result of our BPD we have the neurotic side, the anxiety attacks, the social anxiety, the depression etc. I feel like this mental state or brain whatever you want to call it, is also why so many people with BPD have co-morbid disorders, because this destruction can take different shapes and forms. One person with BPD may have an eating disorder, the other may be housebound because of severe panic attacks, another may be an alcoholic and needing to go to 12 step programs. Sure, they are different diagnoses but the root is the same. They are all some way of coping with this psychotic pain, the emptiness, the destructive longing and then the expression of that to try and rid ourselves of that feeling. Unfortunately, these behaviours never turn out well for us, we know that, people who self harm know it’s not the best way to handle things, but knowing that doesn’t make it any easier to live with.
I feel like some people with the diagnosis prefer the EUPD term because saying ‘we just need to regulate emotions’ sounds a lot more acceptable, it sounds similar to other disorders, say for example, bipolar disorder, etc. It also cuts all of this out. I don’t think it’s the whole picture, I think emotional dysregulation is a result of all of this, it’s a result of how we perceive things, how our brains are hardwired, what we’ve learnt over the years to cope. I feel like this low level psychotic way of thinking is the reason why sometimes I’m paranoid about people around me, that they must be talking about me, why at times we forget things that have happened (I literally used to forget if my ex had apologised to me in a fight it was like he had never said it at all, I learnt later that it was because our brains can literally change the facts to fit our emotions). It explains why I feel the need to count calories, why we can feel like no matter how much we achieve it’s not enough, or the 100 negative interpretations we can come up with about a single event without having any real evidence to back it up.
I also don’t like the DSM criteria in terms of it’s a checklist of symptoms and then you either meet BPD and you have BPD or you don’t. I think BPD is a spectrum disorder and I don’t understand why it isn’t recognised as such as when I studied Autism at University it was called a spectrum disorder that ranged in severity. This idea for me is further supported by the fact that some of my own DBT therapists revealed to the group that some of them too met the criteria for BPD in their past, it was just their learning and growing and use of DBT skills in their daily lives that made them function and move past meeting the criteria and then be considered ‘non-BPD’ or ‘recovered’.
A spectrum makes sense in that so many recovery blogs I’ve read, the individuals even years later, say they are still battling BPD everyday but they are just able to manage BPD, that BPD never really ‘goes away’ but they were able to recover to a point where it’s interference is so minimal that life becomes more of a healthy functioning one (i.e. they’re moving away from the severe end of the spectrum) and that’s why they’re able to go on to get married have kids etc. etc. I mean Marsha Linehan herself was a severely suicidal BPD individual before she went on to recover to the point where she’s created an entire therapy for it!
I told my psych this, that I feel like I literally have 2 minds that are fighting all the time and the only difference is that now, I am just able to contain that destructive side of myself and not act out. But I made it clear that that’s not recovery, I’m not recovered at all, I’m just not making things worse. He said that ‘2 minds’ was a very good way of putting it. He said that there may well be more mental states that it could be broken down into but this was an accurate simplified way of putting it and he too felt it matches the experiences of his clients a lot better than EUPD.
So there it is, it did feel good to know that my thoughts were not a load of BS (lol) but I am really confident on this one and I hope I am one day able to share this and help people who experience Borderline too.