Language, Stigma & Borderline Personality Disorder

MEGAN DAVIES, MA, Registered Clinical Counsellor - VITALITY COLLECTIVE VANCOUVER THERAPIST

“Words can inform our mind, caress and comfort our feelings, excite and thrill our spirit, or warm and kindle the flame of our hearts. They can also slap our face, punch us in the stomach, rattle our nerves, kill our desire, or destroy our self-confidence. 

- “The Power of Language,” Michele Toomey Ph.D 

Destigmatizing Borderline Personality

Let’s talk about the language we use when we talk about others with mental health conditions, as well as ways we can converse, hear, and be there for people who are living with mental health conditions. Language shapes how we see the world. Language defines, frames, clarifies or clouds includes or excludes. The words we choose and the meanings we attach to them influence our feelings, attitudes and beliefs. Our language choices have a powerful effect on how we view mental health and people living with mental health conditions. It is not surprising that mental health, which has been systematically stigmatized for so many decades, has historically settled for a discriminatory vocabulary. People have grown up in generations after generations that use terms to describe people with mental health issues as being perfectly normal. Here are a few examples: crazy, nuts, psycho, hoarder, paranoid, manipulative, and loony, the list goes on. Not only are the terms people use to describe someone experiencing mental illness stigmatizing,  so are some of the words used to define and label mental health diagnoses.

 A stigma is a preconceived idea or stereotype that causes someone to devalue or think less of the person in question. What comes to mind when I think of stigma? My immediate thought is fear of exposure. You know, fear of people’s reactions. I mean, you’re very fearful of a change in people’s attitudes toward you or toward your family member who’s ill—and whatever affects the person, affects the family.  People tend to distance themselves from individuals in these groups for negative actions and to discriminate against the stigmatized individuals.  


Let’s talk about the stigma associated with Borderline Personality Disorder. The word borderline itself is stigmatizing. The name implies not knowing how to categorize someone to make them fit societal norms, so they are on the borderline— but on the borderline of what? People diagnosed with BPD are severely misunderstood. There are beliefs that people with BPD are manipulative, dramatic, and even malicious. People with Borderline Personality Disorder, are among the most stigmatized, not only by the definition of the word used to diagnosis their mental illness, but also by how Borderline Personality Disorder is portrayed in the media, and how it is communicated in the community. The media often misrepresent the link between BPD and violence. It perpetuates and sensationalizes inaccurate and untrue stereotypes. Television and movies have represented people with this mental illness as unstable, attention-seeking, and beyond help. Depictions of characters with BPD have led to many upsetting consequences for those who actually live with it.

Feeling misjudged, people who live with this diagnosis, struggle to reach out for help, in fear of being turned away or disbelieved. Not only can people living with BPD feel stigma from their community, but they can also feel stigma from health care professionals. The stigma associated with BPD may affect how practitioners tolerate the action, thoughts, and emotional reactions of these individuals. There is evidence that some clinicians may not work with people with BPD, or may emotionally distance themselves. This distancing and turning away is problematic, as people with BPD can be sensitive to rejection and abandonment, and can perceive such distancing and rejection. Marsha Linehan, the founder of Dialectical Behavioral Therapy, and someone who lives with BPD has stated, “ Borderline Personality Disorder is by far the most stigmatized disorder. If one of my clients ends up in an emergency room for a medical reason, I say to them, do not tell them you meet the criteria for borderline, you’ll be treated differently. Empathy and support are vital to the treatment process, and the stigma attached to BPD can discourage people from reaching out for help and encourage people to hide their disorder. This perpetuates the belief that someone with BPD is unable to heal. 

When you think about depression, does it look the same for everyone? What about anxiety? Does your anxiety look exactly like my anxiety? What about OCD? Does every person with OCD think and act the same? 

The answer: absolutely not. 

So why is there a belief that people with Borderline Personality Disorder act all the same? “ I know someone with BPD, you don’t look or act like them.” “ People with BPD are all very difficult to work with.” This is generalizing, stigmatizing and dehumanizing.  The societal belief around BPD in general needs to be addressed. It can be very isolating living with BPD because of misconceptions, a lack of professional support, and because by virtue of having BPD, relationships are challenging. 

Remember that these are PEOPLE, they are not their illness. They are all different, they have all grown up differently, and experienced different things in life. 


Here are a few things that you can do:

  • Educate yourself    

Educating yourself about BPD is very important. Stigma and discrimination will not lessen if people continue to have no information, are misinformed, or buy into fearful myths. 

  • Inclusive Language 

Paying attention to how language can exacerbate stigma is difficult, these habits can be hard to break. Having an increased awareness of the relationship between language and stigma is key to breaking this cycle. Instead of describing a person as “crazy”, use more respectful language like “annoying, bothered by, frustrated.” Instead of describing a person as “nuts,” use language such as interesting, peculiar, funny. 

  • Person-First Language

Person-first language focuses on the individual while de-emphasizing the illness, this would be saying a person with or a person experiencing, followed by the illness. When speaking about other’s who live with mental health issues, remember that it is not our place to speak about it, this would also be a great opportunity to understand more about how that person relates to or describes their relationship with the illness they are living with. 


If you live with BPD I want you to remember a few things; 

  • you are exceptionally resilient 

  • you are empathetic and compassionate 

  • you are loyal and protective 

  • you are curious and creative 

  • you are bold and spontaneous 

One more thing, 

 I see you, I hear you, and I support you. 


Help Lines

  • 310-6789: BC crisis line available 24 hours a day with no wait or busy signal (do not add 604, 778 or 250 before the number)

  • 1-800-SUICIDE (1-800-784-2433): BC crisis line available 24 hours a day

  • 1-888-4-TARA APD (1-888-4-8272-273): National Borderline Personality Disorder Resource and Referral Center in New York. Toll-free from Canada and available weekdays from 11:00 am to 5:00 pm (EST)


Resources 

https://www.heretohelp.bc.ca/visions/families-and-crisis-vol12/family-friends-and-borderline-personality-disorder

https://www.borderlineintheact.org.au/family-friends-and-carers/guidelines/

https://stopthestigma.org/borderline-personality-disorder/








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