Taking an Anti-Oppressive Lens to ‘Borderline Personality Disorder’
Many of you know that taking a critical, anti-oppression lens to the psychiatric diagnosis of borderline personality disorder is something that I spend a lot of my time doing. In light of the people who still believe that all people diagnosed with BPD are terrible, dangerous people and who chose to share comments that this “anti-oppression stuff” is just to distract from that, I wrote a short list of what bringing an anti-oppressive lens to this diagnosis means to me.
This is by no means an exhaustive list.
1. Acknowledging multiple ways of sense-making of these experiences beyond the biomedical model
There are endless ways of making meaning of these experiences and traits, some culturally-based, some spiritual, some sociopolitical. Even the neurodiversity paradigm is an alternative to the moralising and hierarchical nature of the pathology paradigm that defines all of these traits as ‘disordered’ and in need of curing.
There are so many other ways of understanding and making sense of our experiences and traits, and an anti-oppressive approach to this diagnosis, to me, involves de-centering psychiatry’s authority as the ultimate or only way of understanding our experiences.
2. Recognition of healing as a relational process as well, instead of emphasising hyper-individualistic approaches to healing
While the importance of relationships is incorporated into aspects of BPD recovery, such as a recognition of the significance of peer support, recovery often remains overwhelmingly individualistic. This is in conjunction with the fact that we can actually interpret many of these experiences and struggles in the first place as the result of living in a hyper-individualistic culture, and this diagnosis as potentially a pathologising of more collectivist values.
Even traits like shame and self-hate, that tend to be considered as individual struggles and are often offered individual forms of recovery, can be seen as relational struggles.
3. A recognition that many ‘BPD symptoms’ can also be responses to ongoing systemic traumas
Get Candice Alaska’s stories in your inbox
Join Medium for free to get updates from this writer.
Closely related to the first point, I thought this deserved to be noted on its own, because once there’s a BPD diagnosis involved, too many practitioners treat responses to ongoing systemic traumas as the result of internal or past issues. How do we talk about ‘symptoms’ like identity struggles, low self-worth, shame and self-hate without talking about white supremacy, for example? How do we talk about dissociation without the ways that capitalism depends on our disembodiment? Bearing a BPD diagnosis does not divorce us from the impacts of the world around us.
4. A recognition that a lot of the ways that recovery from BPD is defined is by ability to conform to oppression and to partake in oppressive institutions
As Bruce M.Z. Cohen writes, “dominant norms and values of society are normalised and deviations from them are pathologised“. The struggles and experiences of people with BPD are real, but much of how ‘recovery’ is defined is by ability to partake in oppressive systems and to conform to values that uphold these systems. I believe that an anti-oppressive approach to BPD should allow for definitions of recovery to be a collaborative process.
5. An understanding that perceptions of these traits, such as ‘emotional dysregulation’, are not neutral and vary based on a person’s social location
What is considered ‘emotional dysregulation’ is not neutral. Here is an excerpt from a post that I wrote for Instagram: “Many of you know that I’m not a fan of the term ‘emotional dysregulation’, considered to be a core feature of Borderline Personality Disorder. It’s vague and elusive and does not account for raced and gendered perceptions of emotions, nor how the subjective interpretation of emotions is used as a tool of oppression […] Can we move past the idea of ‘regulation’ as a standard, neutral concept? Can we consider its limitations, its harms, its subjectivity, its culturally-bound definitions?”
6. De-centering DBT and Western Eurocentric forms of healing as the ultimate or only forms of healing
These are not the only means of accessing healing and recovery, however these terms are defined, and even when they are extremely useful components of our healing process, they may not be the only or main factors that contribute to healing. Recognising the significance of other forms of healing is also a way of honouring the spiritual and healing traditions of other cultures, many of which have been extracted from their cultures of origin and appropriated into the Western psy-disciplines.
7. Moving beyond destigmatising efforts alone to questioning how the devaluing of these mental differences and different ways of being is beneficial to the dominant social order
Destigmatising efforts alone without structural change still leaves us vulnerable to harm, particularly the most disadvantaged of us. In what ways is this socially-constructed hierarchy of bodies, minds and ways of being actually beneficial to the dominant social order?
I don’t believe that an anti-oppression approach to this diagnosis is optional, but that it’s necessary — it can help to deepen our individual healing and to get us closer to a future where these forms of suffering stop repeating themselves at such a large scale. We can move beyond individual healing, and, by applying an anti-oppressive lens, hopefully use our struggles and experiences as portals for collective change.
If you’d like to see more of my work, you can follow me on Instagram here and here, and sign up to my mailing list. If you’re a mental health worker and would like to shift the ways that you may have been taught to view people diagnosed with BPD, you can consult with me 1:1.
