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Living with… borderline personality disorder

Hollie Berrigan discusses the sometimes devastating effects of a BPD diagnosis

Practitioner and counsellor Hollie Berrigan discusses the sometimes devastating effects of a BPD diagnosis and its labels and misconceptions as well as the benefits of nurse support and care

  • Professionals who immediately link BPD with suicidality and self-harm may miss vital information about such patients
  • Experiences can feel like an infinite number of paper cuts, while recovery appears to erase things lived through
  • Special memories include nurses who allowed relationships to form, soothing and healing rather than holding their patient at arms length

I am a consultant lived experience practitioner and integrative counsellor working with people who have difficulties that are often labelled as borderline personality disorder or BPD.

Practitioner and counsellor Hollie Berrigan discusses the sometimes devastating effects of a BPD diagnosis and its labels and misconceptions as well as the benefits of nurse support and care

  • Professionals who immediately link BPD with suicidality and self-harm may miss vital information about such patients
  • Experiences can feel like an infinite number of paper cuts, while ‘recovery’ appears to erase things lived through
  • Special memories include nurses who allowed relationships to form, soothing and healing rather than holding their patient at arm’s length
Diagnosis of borderline personality disorder can mean other people label and define a person by their diagnosis
Picture: iStock

I am a consultant lived experience practitioner and integrative counsellor working with people who have difficulties that are often labelled as borderline personality disorder or BPD.

I myself have been given this diagnosis and have spent almost the whole of my adult life in receipt of mental health services. While I’ve been lucky and privileged to have received a range of therapeutic interventions, I’ve found that receiving secondary care with a BPD diagnosis comes at a huge cost.

‘To understand what living with BPD is like, it’s important to understand the repercussions of such a diagnosis’

When people hear the label BPD, their first thoughts are often chronic suicidality, self-harm and an inability to form and maintain relationships with others. These things have definitely been part of my experience and were for a long time, but they are not the full story.

When as professionals we limit our thinking to these themes alone we miss vital information about people’s experience and what they have lived through.

BPD label informs the world there is something intrinsically wrong with me

The use of the BPD diagnosis and the misconceptions that follow it can be actively harmful to many – people are denied treatment, punished, neglected and repeatedly misunderstood. To understand what living with BPD is like it’s important to understand the repercussions of such a diagnosis.

My own emotional dysregulation, a continual need to die, has arguably caused me less difficulty than having to wear a label that informs the world there is something intrinsically wrong with me. To repeatedly have my distress at the things that I’ve survived pathologised and discounted by people in positions of power whose role is to provide care has perpetuated my trauma, not cured it.

My trauma and experiences are why my behaviour makes sense, yet they have been the first things to be denied and minimised by professionals, particularly on wards. In these environments, people’s histories vanish completely from mind.

‘My experiences cover me like an infinite amount of paper cuts. They may be invisible, but they sting and ache every time someone rubs against them’

This wilful erasure of people’s histories often re-enacts the experiences that have led them to where they are now. And professionals continue to label them as disordered and difficult and act as if madness or badness is located in the individual and deny any professional part in it.

A product of my environment and experiences and learning to live differently

The BPD diagnosis infiltrates all areas of life. GPs may no longer believe your symptoms, those you have relationships with may use any expression of emotion as evidence of you being ‘disordered’, and you may be considered difficult, manipulative and attention-seeking before a professional has even laid eyes on you.

The understandable and appropriate distress these viewpoints cause becomes further affirmation of innate badness and not wanting to recover.

Professionals continue to label people with borderline personality disorder as disordered and difficult
Picture: iStock

What am I recovering from? There’s been no wellness before a period of illness, there’s nothing I am returning to. I have lived a life of extraordinary circumstance and have learned to survive in a particular way.

I’m a product of my environment and experiences and learning to live differently – I’m not recovering in the truest sense of the word. Recovery in this context feels like further erasure of things lived through.

My experiences cover me like an infinite amount of paper cuts. They may be invisible, but they sting and ache every time someone rubs against them, with an experience or interaction that feels familiar to those that made them.

Work put into understanding myself is undermined by people who fail to acknowledge my insight

To understand my responses you need to acknowledge and understand my paper cuts. It has taken the years I have spent in therapy to truly understand what those paper cuts are, where they came from and how to heal them, so the slightest brush no longer feels like salt in the wound.

‘My feelings about my life or treatment become symptoms of my disorder and evidence of what’s wrong with me, rather than my feelings being appropriate and proportionate to the things I’ve experienced’

The work and investment I have put into understanding myself and my experience is undermined by those who fail to acknowledge my insight because it doesn’t meet their hypothesis that people with this label are bad, attention seeking, manipulative and time wasting, rather than in need of care and intervention.

A blanket hypothesis is applied to anyone with this diagnosis. Uniqueness and individuation – as in separation from the homogenised group of people with this diagnosis – are discouraged, and we are viewed as an homogenous group, despite potentially only sharing a single diagnostic criterion.

Some nurses believed my life could be different and helped me to facilitate change

Our treatment pathways will be identical, the way we are viewed and understood will often be the same, and people continue to deny the harm that this causes.

On the plus side, there have been many nursing staff who have dressed my paper cuts and helped to soothe and heal them. These nurses did this by allowing me to form relationships with them rather than holding me at arm’s length through fear.

They are people who believed and heard me, who held me psychologically, who trusted me, trusted I knew myself, and allowed me an active role in my care. They advocated for or against treatment they thought would be beneficial or detrimental to me. They believed my life could be different and they stood alongside me and helped me to facilitate change.

My history is why my life makes sense – don’t just write me off as disordered

While I may be living with a BPD diagnosis, what I actually live with is two things.

First, the aftermath of experiences that would have created lifelong difficulties for anyone.

Second, the pathologisation of my pain – that is, my feelings about my life or treatment become symptoms of my disorder and evidence of what’s wrong with me, rather than my feelings being appropriate and proportionate to the things I’ve experienced.

This is because the difficulties I have are defined in such a way by medical professionals and the wider public – my anger is deemed inappropriate, and building a relationship with me is something people are cautioned against. The problems that arise from what happened to me are enough.

My history is why my life makes sense, so please remember my paper cuts and don’t just write me off as disordered.

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