Borderline Personality Disorder – a feminist critique

Quinn Capes-Ivy wrote in 11/06/10 for the f-word blog:

Among my many diagnoses, I have what is known in the UK as Emotionally Unstable Personality Disorder (Of The Borderline Type), known elsewhere as Borderline Personality Disorder. BPD is described by Wikipedia as “a prolonged disturbance of personality function … characterized by depth and variability of moods.” It manifests in many ways, including rapid cycling mood swings, ‘self-destructive behaviour’, black and white thinking, disassociation and extreme fear of abandonment.

BPD is a serious mental illness and is difficult to diagnose. Unfortunately it is also well-known as being used by psychiatrists and mental health professionals as a way of labelling ‘difficult’ or ‘problem’ patients – I know at least one woman who was threatened with a diagnosis of BPD by a mental health professional because she wouldn’t do as she was told.

Three-quarters of patients diagnosed with BPD are female. I’ve spent some time since my diagnosis wondering why that is, when one would expect the split to be roughly 50/50.

My first thought is that the diagnostic criteria cover much of what is considered to be “stereotypically feminine” behaviour, but to a more extreme level. For example, one of the diagnostic criteria, “Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability or anxiety usually lasting a few hours and only rarely more than a few days).” – well, women are supposed to be overly emotional people anyway, right? Another of the criteria is “Frantic efforts to avoid real or imagined abandonment.” We’ve all heard the stereotyped stories of bunny boilers, of women who get pregnant to ‘trap their man’, of women who are controlling and possessive and who are terrified of being alone. Women are supposed to be flighty, unable to control their emotions, and to have trouble navigating their interpersonal relationships.

The second thing I’ve been thinking about is that it’s possible that women get the diagnosis of BPD because some of the diagnostic criteria include things which are considered ‘normal’ for men, but ‘abnormal’ for women. For example, if a woman behaves in an ‘unfeminine’ way, say by expressing extreme anger (another of the diagnostic criteria is “Inappropriate anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)”), the label of BPD is slapped on her by the psychiatrist…

To read the rest of the article, and the interesting comments on it, follow this link

 If you found this article interesting, make sure you take part in The Big Mad Experience (@BigMadTweeter)’s weekly #BigMadChat on Tuesday 29th April 2014 8pmBST/3pmEDT, when we’ll be discussing the social politics of the Borderline Personality Disorder diagnosis!

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