Thursday, 19 February 2015

Borderline Personality Disorder: New Perspectives on a Stigmatizing and Overused Diagnosis

In this post, Jacqueline Gunn and Brent Potter present their recent book Borderline Personality Disorder: New Perspectives on a Stigmatizing and Overused Diagnosis (Praeger Publishers Inc). Dr Gunn is a licensed clinical psychologist in private practice in New York, specializing in Eating Disorders, Trauma, Interpersonal Problems as well as a variety of other psychological disorders. Dr. Brent Potter is a psychotherapist and wellness specialist with 20 years of direct clinical service. He is the Director for the Society for Laingian Studies, based in Thousand Oaks, California.


When you are reading our book, be prepared to challenge your view of what is called “borderline personality disorder” and even the way you see all so-called psychiatric ‘disorders’. This is what we have done as co-authors. We sound a little strong at times, but we really believe in what we are presenting.

We take you through exactly why we take this approach, give you historical context and also explain some experiences with real people who are suffering. To this end, client’s stories at the end along with a few narratives written by clients themselves along the way. We stick faithfully to the experiences themselves rather than upon theoretical constructs and other abstracted materials. Our approach is not experience-near, but experientialist; we don’t hypothesize, abstract, nor construct theories from human experience.

Here’s the overview of the journey that’s in store in our book. The fields of psychiatry and so-called scientific, evidence-based psychology are as aware of their historical-environmental context as a fish is to its being wet—they are oblivious; the most obvious and necessary context eludes them. You’ll notice in every book you pick up on ‘borderline personality disorder’, that the authors assume that it is a psychiatric syndrome / disease as outlined in the clinical literature. None of them even look at the basic assumptions or historical, cultural and environmental contexts wherein the supposed syndrome or disease was invented. You read this correctly: All of the mental illnesses outlined in the diagnostic guide for psychiatrists and other mental health professionals, the Diagnostic and Statistical Manual of Mental Disorders (DSM), are inventions. Said differently, there is no biological evidence for any one of the disorders outlined in the DSM. There is no blood test, mouth swab, hair sample, biopsy, spinal tap, x-ray, brain-imaging, nor any other sort of “We’ll have to send this off to the lab,” way to diagnose or confirm psychiatric diseases. Zero. The contents of the DSM are constructed by committees of professionals, most with financial ties to the psychopharmaceutical industry, and then voted upon.

That the diagnoses are diseases and/or syndromes reflecting a chemically imbalanced or otherwise defective brain organ is a ‘given’. Yet the fields of psychiatry and natural science psychology proceed as if their hypotheses, perspectives and diagnoses are facts, like wind or gravity. And like wind or gravity, diseases just happen. If brain diseases are like other medical diseases, they happen independent of other factors. They simply are due to this or that neurochemical mishap and there is no need for any further investigation or thinking outside the realm of biology. When varieties of human distress are understood as diseases, critical thinking is off the hook. The phenomena are decontextualized, stripped of context and any meaning outside of biological hypotheses.

‘Borderline’ is to psychiatry as psychiatry is to medicine. Psychiatry’s multiple functional failures—scientistic, misogynistic, literalistic, moralistic, personalistic, pathologizing, Eurocentric, etc.—have sparked interest in what actually works. Most people, these days, have had or know someone who has had a horrible, if not outrightly dehumanizing, experience with the mental health system. Upon this ground of failures, new approaches are emerging, such as the recovery movement. This thorough and unconventional book is part of this movement. We offer an alternative way of understanding so-called ‘borderline personality disorder,’ and with it shred the stigma, while offering a new sense of hope and possibility for those suffering.

3 comments:

  1. thanks. could you briefly summarise your new way of understanding BPD? The latest DSM refers to Emotional Dysregulation Disorder which may be slightly more accurate. Although of course "regulation" is a normative term and susceptible to all the biases you mention. Leaving the DSM aside some people are clearly suffering extreme emotional anguish and expressing that or coping in ways which damage them and people close to them. It would be nice to see your alternative approach briefly compared to e.g. DBT with points of difference highlighted and suggestions about how to evaluate them.

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    1. Thank you for your comment! I agree, of course, that there are many people suffering and suffering due to developmental stress and/or trauma. We outline not one modality of intervention, but many in the book. Check it out and let me know what you think. All the best, Brent

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  2. Borderline Personality Disorder is the most difficult to understand and diagnose mental illnesses. As a consequence there is little awareness of its existence in the general public. If there were greater awareness, more resources would be brought to the table to help these people. I believe the biggest problem is its name. "Borderline" means nothing in helping us understand the condition. I have proposed that we change the name to Faultfinding Personality Disorder based on the most important diagnostic criterion - chronic finding of fault with themselves and others due to their black-and-white thinking which leads to disturbed interpersonal relationships. To back this up I wrote the book "Faultfinders: The impact of borderline personality disorder." I explained the condition using examples of numerous famous people to make the symptoms memorable. I would be interested to hear what others think about a possible name change.

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