Borderline Personality Disorder (BPD) stigma is when you are feeling depressed and having dark thoughts — but you cannot tell anyone, including your therapist. Will they take you seriously? Absolutely. Will they use it as proof of BPD? Some therapists have in the past.
These therapists point to their Bible (the Diagnostic and Statistical Manual of Mental Disorders, or DSM), which states: “recurrent suicidal behavior, gestures, or threats” (apparently this also includes thoughts) as criteria for BPD.
It does not matter that I’ve battled depression for a while, and that I sometimes feel hopeless or worthless.
What matters to Them is that I thought of the “S” word (suicide).
So, I remain quiet.
BPD stigma is when you have experienced early trauma in the form of abandonment from a primary caregiver. If those wounds carry throughout your life, it’s a sign of a personality disorder.
Their Bible lists ‘fear of abandonment’ as a criterion for BPD (therapists sometimes forget that the DSM states: “frantic efforts to avoid…” said abandonment).
Once a client discloses this deep-seated fear, they may be branded with scarlet letters.
BPD stigma occurs when your therapist mentions the word “manipulative” because as a neurodivergent person, you ask if they can dim the lights or stop tapping a pen on the table. Or worse, you have a meltdown during a session. To them, “manipulation” is synonymous with BPD.
BPD stigma is when you must be careful about your anger. It does not matter if you have experienced abuse or bullying as a child.
If a therapist decides you are being too emotional or too angry, they may view your anger as disproportionate and in need of skills.
I was then referred out to dialectical behavior therapy (DBT), despite my reassurances that I have completed the program (and used my skills).
“Are you sure?” one psychologist asked me during the first session. “DBT is the best treatment for people like you.”
During this time, I was coping with several significant stressors. I had recently experienced a death in the family and lost my job. Additionally, I went through a breakup with my best friend and abruptly lost my therapist of two years. In response, I began searching for a new therapist to continue my healing journey and process these losses.
As a female client with mental illness, neurodivergence, and (then) way too many tears, many of the new therapists viewed me as hysterical or exaggerating.
As I relayed my feelings to these new therapists, I was instead asked if I had a personality disorder.
One therapists suggested I “may have BPD” over a 15-minute consultation call. Another one hurled these letters in her email response to me.
The angrier I became at how I was being treated, the more these therapists justified Disordered Personality and referred out.
Each rejection felt like a knife in my already wounded heart. I wasn’t even given a chance.
One therapist, after initially agreeing to take me on as a client, told me shortly:
“It sounds like you have been diagnosed with a personality disorder” (I have not), and “I do not work with that.”
Another therapist told me that while personality is entrenched, I could find some relief with diligence and DBT. She, too, referred me out.
I just wanted to work through some grief and transitions.
I quickly realized that if I wanted help, I needed to monitor my emotions and my words.
After an entire lifetime of being “Othered,” I was once again shamed into silence.
For me, my trauma and sadness became indicative of a much greater problem that was my entire personality. It did not matter if I did not meet enough criteria for a formal diagnosis.
What mattered is what They wanted to hear, and how They perceived me.
I have a new therapist now who I have been working with for two years. She is incredibly patient and kind. She doesn’t pathologize me, and she encourages me to be myself.
In fact, in turns out that I don’t have disordered personality; I am autistic.
To any clinician reading this: I urge you to investigate neurodivergence, especially in female clients who may be “too” something. Too emotional. Too impulsive. Too challenging.
Sometimes, autism may resemble some BPD traits, especially if the person has prior trauma.
Your unwillingness to expand your skillset and knowledge continues to perpetuate stigma against marginalized populations.
There is nothing wrong with people who have BPD (or autism).
There is something hugely wrong, however, with mental health professionals who are harming the people they are supposed to heal and protect.
Dear therapists: shame on you.
It breaks my heart that in an entire lifetime of having to hide, the therapy room becomes another place where we must remain hidden.
