Dr David Jones has led a critical exploration of ‘Borderline Personality Disorder’ (BPD) in a Special Edition of The Journal of Psychosocial Studies as part of his work in the Critical and Psychosocial Mental Health Group in the School of Psychology at The Open University.
BPD has become one of the most ubiquitous of psychiatric diagnoses, despite only emerging in the 1930s, and not entering the Diagnostic and Statistical Manual until 1980. It is now not only commonly used in primary care, outpatient and inpatient settings, emergency services and university and school wellbeing facilities, but it is also a term that has entered popular discourse and culture. Difficulties associated with the diagnosis include experiences of emotional volatility, identity confusion, relationship instability, and incidents of self-harm.
Yet this is also a highly controversial diagnoses, with many pointing to how stigmatising it can as well as questioning its validity.
David comments on the impetus to challenge the conventions around BPD;
“I have felt for some time that ‘Borderline’ was in considerable need of psychosocial exploration to begin to tease out what this diagnosis was doing and why it has become so common. What is going on at cultural and social levels to have created these particular forms of distress in recent decades?”
Working collaboratively with colleagues Jo Lomani, Nilufar Ahmed and Kati Turner, David proposed the creation of a special edition of the Journal of Psychosocial Studies and worked to fashion a call for papers that engaged with critical questions of the conceptualisation and experience of, the diagnosis.
Work was actively welcomed from those who had experience of a BPD diagnosis, and as a result a number of the research papers and all of the Open Space pieces (that allow for the inclusion of personal accounts of lived experience that might use prose, poetry and visual art as well as more academic work).
This invaluable collection helps illustrate how damaging the label can be for some. It can be highly stigmatising and can even lead to treatment neglect. But it is also clear how the experiences of suffering that are associated with the diagnosis are very real. Questions of identity also come across strongly, with articles on the significance of questions of gender, sexuality and ‘racial’ identity to the borderline diagnosis.
David adds, “Taken together the papers in this Editon raise serious questions about what is going on. Clearly there are very distressing experiences for individuals and questions need to be asked about current practices in this area, but there are also social and cultural issues that need to be grasped – to what extent are ‘we’ as a society creating and maintaining these forms of distress? To paraphrase Donald Winnicott, who was described as the ‘analyst of the borderline’ - there is perhaps no such thing as a borderline patient, but only set of relations that create borderline experience.”