‘Borderline’ diagnoses

This will be the last of my posts as a guest blogger, a role I have greatly enjoyed. Many thanks to everyone who has read my posts, in particular those who took the time to leave comments and criticism from which I have learnt a lot. I wanted to take some time to write briefly about my experiences with mental health because I have found some cross-over between these experiences and my identity as both a woman and a feminist.

Within the last year or so I have been given the diagnosis of ‘borderline traits’. This means a case of borderline personality disorder that does not currently meet five or more of the nine criteria outlined in the DSM-IV. ‘Borderline’ diagnoses have for some time now been controversial in feminist terms. The emotional lability associated with a borderline personality has echoes of the ‘hysteria’ to which women’s feelings were frequently attributed in the second half of the 19th century.

Quinn Capes-Ivy’s feminist critique of borderline personality disorder has the following:

“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.”

This highlights the crux of the issue for me, and goes some way to explaining why three-quarters of people with a borderline diagnosis are women. I agree with her viewpoint of finding the diagnosis helpful while at the same time questioning whether the diagnosis would exist in a gender equal society.

By finding the diagnosis useful at a personal level, I find myself in a dilemma. I do not want to perpetuate the use of a label which I suspect to be fundamentally sexist, but at the same time I identify with the criteria. Also, the system is flawed in such a way that there is considerable relief that comes with fitting into a category as being categorised seems to result in improved access to mental health services. This is a problem in itself; both for those whose difficulties do not fit neatly into one box, and for those who get labelled inflexibly with particular diagnoses.

I think it is important to keep having this discussion. Psychological diagnoses should always be viewed in terms of what is considered the norm for a particular person (or gender, for example), in a particular society, at a particular moment in history. A lot of the issues contained within a borderline diagnosis may be more indicative of society’s own sickness in relation to gender than sickness in the individual themselves. Despite this, the individual at the centre who is experiencing these difficulties will need support, which is the context in which I still find the diagnosis a useful term.

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