Julie Miller's Mental Health Blog

“B” is for Borderline Personality

Posted on: February 22, 2010

“She’s borderline.”

“What a borderline.”

Ever hear these, or other such statements?  Many people today are familiar with the label “borderline” and use it indiscriminately.  I’ve heard even mental health professionals say such things with an attitude of disdain.

So what does “borderline” really mean?  It is a clinical diagnosis, officially “Borderline Personality Disorder,” and can easily be confused with other conditions like PTSD, bipolar, or other personality disorders.  It sometimes is used in a very dismissive manner, because “everyone knows you can’t treat borderline personality disorder.”

I couldn’t disagree more.  Of course borderline personality disorder is treatable.  Even if we don’t all agree on the cause of borderline personality (genetic?  attachment trauma?), we can treat these issues with therapy, medications, behavior modification, education, etc.

Could it be that the dismissive mental health professional attitude about borderline personality comes from frustration?  Many borderline personality behaviors do defy rational thought processes.  “I hate you, don’t leave me” is an example.  Black and white thinking.  Volatile personal relationships. Exquisite sensitivity to rejection or abandonment, even if it is imagined.  It isn’t easy to continue to express compassion for an individual who tests and pushes away and accuses and blames and angrily rejects and tearfully returns.

Borderline personality disorder is a terrible mental illness that causes horrific suffering for the individual, their family and friends.  The behavioral expression of the underlying trauma (or genetic vulnerability) can be unpredictible and mystifying, but it is no less deserving of compassion than any other mental health issue.  If an individual diagnosed with borderline personality is dismissed by a mental health professional who believes it’s a terrible pain to have a “borderline client” and “it can’t be fixed anyway,” the client will continue to suffer without hope of recovery. Plus, what if that “borderline client” really is suffering from something else, not borderline personality?

Having seen many individuals in treatment who have had personality testing, I have learned that what I had previously heard others talk about as as borderline personality could actually be diagnosed with another personality disorder, or with PTSD or bipolar, etc.  I’ve learned to look a little more closely and not make assumptions.

There is hope for anyone suffering with borderline personality disorder.  The treatment is available, and mental health professionals are responsible for learning how to treat this disorder, or referring to someone who can treat the individual.


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