Oh hello.
So, I’d start by saying, any clear meaning of the phrase “borderline personality disorder” was jettisoned a long time ago - if it ever existed - and the phrase originally meant “the border between neurosis and psychosis.” If someone came out and said to you “you’re at the border between neurosis and psychosis,” you could at least ask them which of your thoughts/actions they considered neurotic and why, which of your thoughts/actions reminded them of psychosis and why, and get a clear idea of what they meant and how you might disagree with them. Likewise, “bipolar disorder” was a phrase coined to replace the phrase “manic depression,” mania and depression being the alleged “two poles,” and if someone came out and said to you, “THIS is what I identify as your mania, THIS is what I identify as your depression,” you could at least get some clarity on what they meant and whether or not you agreed with them. Replacing at-least-somewhat clear descriptors with newspeak babble also happens when institutions start referring to consumers or survivors of psychiatry as “peers” - absurdly meaningless and cut out of context.
This is part of how psychiatry presents its labels as explanations, when really they’re only superficial descriptions of observed behaviors - AND they are (most often) descriptions coming from well-off men employed to enforce ruling-class ideas of how people should behave. “Drapetomania” was a diagnosis given to Africans who liberated themselves from slavery, followed up by the schizophrenia diagnosis being 4 times more often put upon black men, often specifically for their civil rights activism or rejection of white supremacy. “Borderline personality disorder” follows from the old “hysteria” diagnosis in a similar way, and at a basic level I see it as misogynist because it’s a label overwhelmingly put on women and not on men.
Specific details make it worse - there is a large population of women who self-report that they were labeled “borderline” for showing signs of child abuse and/or rape trauma, that this diagnosis was used both to deny them services or resources they were seeking because they were “lost causes,” AND to commit medical violence against them under the banner of “addressing their severe symptoms.” This lead Judith Herman to describe the diagnosis as “little more than a sophisticated insult.”
What makes psychiatric labeling even more perverse as a tool of domination is its double-edged catch-22s. While the “borderline” label is put on many women for Stockholm-like signs of complex trauma - identifying with their abusers, having little sense of their own goals or desires and identifying with the goals and desires of other people instead, conversely, many other women are labeled “borderline” precisely for refusing to exhibit Stockholm syndrome, refusing to identify with the wishes of psychiatrists or other authority figures, and having too strong an emotional investment in their own thoughts and their own needs, and so doctors call them “borderline” for being unreasonable and unruly.
The “checkbox” nature of psychiatric diagnoses just make this extra maddening (which makes sense as they’re a means to produce madness!) “Borderline personality disorder,” for instance, will be “diagnosed” by going down a list of nine traits, and labeling the woman if she exhibits five. First, this is crazy because there’s no way to implicate a common cause - just disparate people showing vaguely similar behaviors for disparate reasons. Second, this is crazy because it invokes a “syndrome,” a “collection of symptoms,” where there is none - a person (1) having unstable relationships or (2) fearing abandonment can’t therefore be assumed to be more likely to (3) be self-injuring or (4) have little sense of their own self-interest, or vice versa.
Third, this is crazy because none of these things are a sickness of the psyche - cutting one’s self may be the best means available to someone to process their trauma, fearing abandonment is wholly reasonable (and issue is better taken instead with specific attitudes towards or ways of treating one’s relations), and unstable relationships exist between people, not within people. We should ask anyone in the business of diagnosing other people’s relationship patterns, “What, then, defines a respectful and healthy way of relating to each other?” But the answers we get from professionals who’ve essentially beaten marginalized people’s minds out of their bodies are unlikely to give us much guidance.
Edit:
Metzl’s “The Protest Psychosis” has more on racial discrimination in the schizophrenia diagnosis.
Herman’s “Trauma and Recovery” has more on c-ptsd and the gender politics around it.
Chamberlin’s “On Our Own” is a great roadmap of non-medical psych survivor autonomy building - and right now I’m also feeling ways about Kasl’s “Many Roads, One Journey” as a holistic anti-oppression recovery text, and also bell hooks’ text “communion.”
Best luck to you!
