Fighting the Stigma of Borderline Personality Disorder
As a therapist who specializes in Dialectical Behavior Therapy (DBT), people with Borderline Personality Disorder (BPD) are the focus of my work. Like most therapists I know who also specialize in DBT, I have so much compassion for people who work so hard to improve their lives, achieve their goals and build a life worth living. I am almost daily rendered speechless by my client’s insights, drive and willingness to do whatever it takes to have the life they want.
Because of that, any time a client or even potential client tells me that they have been researching “Borderline Personality Disorder,” I have a very mixed emotional response. On the one hand, when someone who has been struggling, sometimes for years, to find a label or an explanation for their struggles finally discovers BPD, that can be very reassuring for some people. Everything seems to click into place and their struggles start to make sense. And then to find that there is a type of therapy specifically designed to help them- Dialectal Behavior Therapy- can give lots of hope! People allow themselves to begin to have hope that things can actually get better.
One the other hand I often worry about all the frightening, judgmental things they might read online, or the hope-crushing experiences they may have to endure in trying to find an effective BPD therapist. It does not take long for people to run up against the stigma of Borderline Personality Disorder.
Descriptions such as “manipulative,” “attention-seeking,” “unmotivated” and “treatment resistant” are frequently used by professionals and lay people alike (except for perhaps that last one. I don’t know of many lay people who throw around terms like “treatment resistant”).
Mental health professionals often perpetuate this stigma by misdiagnosing clients, by declining to work with people who have BPD, or by using methods of treatment that have no evidence of efficacy for Borderline Personality Disorder. In addition, incorrect information online can easily reinforce the idea that people with Borderline Personality Disorder never get better.
All of this rattles around in my head when someone mentions they have looked up Borderline Personality Disorder online as I prepare to refute any of the negative things they may have read or validate their frustrations at trying to find a therapist who gets it and can help them work toward their goals. I keep this information in the front of my mind when doing phone consultation and intakes, reviewing disappointing and sometimes harmful experiences people have had in treatment before. It is not uncommon for people with BPD to come to our practice diagnosed with Bipolar Disorder or Major Depressive Disorder, having done therapeutic work that does not quite seem to address all aspects of their life and the symptoms of BPD they struggle with. It is also not uncommon for people to show up in our offices with little belief or hope that this time will be different, or this type of treatment will work.
As a therapist who specializes in Dialectical Behavior Therapy, who made an active choice to learn this type of therapy and work with people who have Borderline Personality Disorder, I am mindful of this great burden. This burden is shared by all mental health professionals – to work to decrease the stigma associated with BPD. We can do this by educating ourselves thoroughly about what Borderline Personality Disorder really is, how to effectively treat it, and holding other mental health professionals to the same standard. We must be realistic about the barriers our clients will face, not only internally but externally due to a diagnosis, and always be prepared to help gently correct misunderstandings and cultivate hope in the lives of our clients.
If you’re struggling with borderline personality disorder, or wonder if this diagnosis might explain some of the difficulties you are facing, contact us today to learn how DBT can help you reach your goals.