I recently read an article on the Psychology Today website that made me pretty angry. I’m not in the habit of reading Psychology Today. I prefer to get information about BPD (and mental illness in general) from peer-reviewed scientific journals. I came across this while looking up something else.
Here’s a link to the article for those interested, but if you’ve got BPD this will probably make you angry (the comment section is even worse).
This article ticked me off because of the way the author, David M. Allen, MD, talked about people with borderline personality disorder. I found his language to be stigmatizing and some of the things he said were just flat out wrong. I tweeted angrily about this but then I decided I should write a thoughtful response. After all, I’m trying to fight stigma, and if someone who buys into the stigma just sees a pissy tweet about the article, that’s not going to change their mind.
First of all, Allen refers to BPD as the “‘jack of all trades” of personality dysfunction.’ I think that’s a bit of an overstatement, but whatever, bro.
In the fifth paragraph, he talks about splitting. He gets it wrong.
They engage in behavior referred to by therapists as splitting: Everyone else is treated either like a god or a complete pile of manure, with nothing in between.
This isn’t exactly accurate. Splitting doesn’t occur 100% of the time with 100% of people. In my experience, and from what I understand, the experience of many others with BPD, splitting often refers to the way we feel about another person, not the way we treat them. So he’s simplifying it in a way that makes it sound more negative than it is. This contributes to misconceptions about BPD because it creates an image of us arbitrarily treating people in irrational extremes. That’s not what happens.
Next comes the “borderlines as manipulators” trope.
Interestingly, patients with BPD are often described by therapists as being superb manipulators. One must wonder how anyone who cannot simultaneously evaluate another person’s strengths and weaknesses could possibly be a good manipulator. Simple answer: They could not. While the tendency of thes individuals to “split” others into all good or all bad does derive from the bewildering contradictory behavior of the patient’s parents or primary caretakers, usually it is just an act.
Okay, so right there he says that splitting is usually just an act. An act. I’m not even sure how to address this. Why would someone pretend to experience splitting? What could be gained from that? I guess one could argue that maybe it’s easier to categorize people into groups of “all bad” or “all good,” but if a person were doing it for that reason, I think it would be because they genuinely thought that way, thus making it NOT an act.
Another thing: the thing he says about a person who can’t evaluate a person’s strengths and weaknesses at the same time not being a good manipulator? He’s right, and that’s EXACTLY what happens. People with BPD often think in black and white; it’s very difficult for us to see multiple truths in the same situation. We have problems with interpersonal effectiveness, and that makes it difficult for us to be good manipulators. Are there people with BPD who are manipulative? Yeah, I’m sure there are plenty. But it’s not an inherent part of having borderline personality disorder.
One of the crappy things about this myth that all borderlines are manipulative is that people who believe that aren’t going to believe us when we say that we aren’t. That’s why articles like this make me so angry. This guy has an audience and gives the appearance of credibility (by being an MD and a published author) and he’s spreading the stigma.
In the seventh paragraph, Allen says that people with BPD can turn most of their symptoms on and off very quickly.
I noticed that patients with BPD could turn most of their symptoms off and on like a faucet – and at a moment’s notice.
Nope nope nope. Maybe borderlines can hide/alter behaviors in public or in the presence of certain people, but that is NOT the same as turning off symptoms. And this ability is not exclusive to BPD. If everyone with a mental illness were incapable of hiding symptoms/behaviors, the world would be a very different place. People wouldn’t wait until they got home to binge and/or purge. People with depression would no longer be able to force smiles or fake happiness around co-workers or classmates. The majority of those suffering with mental illness have the burden of trying to hide our symptoms and change our behavior in certain circumstances.
If he’d given an example of what he’s talking about, that would help, but he doesn’t. He says “most” symptoms. Which ones? The unstable sense of self? The chronic feelings of emptiness? Recurrent suicidal attempts and/or self-injurious behavior? A pattern of unstable relationships? Those by definition can’t be switched on and off because they chronic and persistent. So does he mean the impulsive behavior? The mood swings that might last only a few hours? Well, it makes sense for those things to change in a matter of moments. That takes care of 6 of the 9 diagnostic symptoms there.
I’m not even going to get into this guy’s whole “spoiler” role theory. I’m not interested in that. However, I do want to point out that he refers to the movie “Thirteen” as “almost an instruction manual on how to create patients with BPD without abusing them.” I’m sure he was being a little tongue-in-cheek when he was saying this, but it comes across as unprofessional to me.
Also, later in the post when he is discussing the “spoiler” child he says that the child “will figuratively piss all over everything the parent does for them.” Again, pretty unprofessional.
This whole piece reads like an op-ed to me. It’s not based on real research, just on the guy’s interactions with patients with BPD and their families. If it were just posted on his blog, it would be annoying and I’d still think he’s wrong. But it’s not on his personal blog; it’s on Psychology Today, where the impressionable and uneducated masses are going to read it.
We got a long way to go, stigma-fighters.