Sunday, July 25, 2010

Beyond Remission, Beyond Stigma

Check out Kiera Van Gelder's intelligent discourse on the challenges facing individuals with borderline personality disorder as they reduce symptoms but continue to experience baseline affective dysphoria, longings for intimacy and community, and the stigma attached to the diagnosis.  Kiera is the author of the newly released memoir, The Buddha and the Borderline, and her work as an advocate for BPD individuals and as an educator of the general public and the professional psychoanalytic community is pathbreaking, passionate, and highly admirable.  I count her among my friends, colleagues, and best writerly compadres. 


Beyond Remission: Mapping BPD Recovery by Kiera Van Gelder from Kiera Van Gelder on Vimeo.

I plan to write a series of articles in the upcoming academic year about the question of calling someone A BORDERLINE or self-identifying as A BORDERLINE.  In this lecture at Yale University's annual BPD conference (in 2008), Kiera states a strong dislike for the rhetorical pattern of calling someone A BORDERLINE because it holds a person in the stigmatized and static space of a diagnosis and identity that is widely maligned.  She is totally right, but I want to complicate the picture a bit by using this idea as a point of respectful departure in order to begin thinking about what a queer feminist crip theory of borderline personality disorder would look or sound like.  I'm interested in borrowing Rosemarie Garland-Thomson's description of feminist disability theory -- embracing the supposedly flawed body of disability -- to make a similar proposal for mental illness in general and personality disorders in particular.

By embracing the term BORDERLINE as an identity, I am working to destigmatize the label and to throw light on the biased norms that shape the stigma, to demystify the illusions of normalcy that make us believe most people are mentally balanced and physically whole and symmetrical, while a few of us freaks or gimps or borderlines are tearing our hair out and muttering to ourselves about paperclips and conspiracies on the subway.

I'd like to begin thinking about ways of reclaiming and revalancing BORDERLINE like others before me have reclaimed and revalanced QUEER and CRIP, drawing on the work of Nancy Mairs, who wrote the oft-cited essay, "On Being a Cripple," and the more recent follow-up piece, "Sex and the Gimpy Girl," as well as on Robert McRuer's powerful philosophical treatise, Crip Theory, and on the examples being set by figures like Bethany Stevens on Crip Confessions and another up and comer blogging under the name CripChick.

"We're here, we're borderline, we're fabulous!"

It has a certain ring to it.


This approach would be less about educating the public on neurodiversity and more about taking an anti-bias approach to borderline personality advocacy.  (For more information about anti-bias education, look here and here and here.)  What I like about the anti-bias approach to education is the way it replaces the so-called politeness of ignoring difference with attention to the social production and maintenance of difference through the internalization of bias, the reproduction of stigma, the manufacturing of consent to norms that are unhealthy and unjust, and the inequitable distribution of resources.

I'm curious to hear everyone's thoughts on this preliminary sketch of an idea to use crip theory (a kind of in-your-face self-naming that refuses the usual hierarchies of normal/abnormal, able/disabled, sane/insane) in order to get past the mistaken notion that personality disorders, attachment disorders, and mood or affective disorders are unusual or rare,or signs of weakness or marks of moral failure.  They are actually, as I say in Girl in Need of a Tourniquet, as common as dirt, and it would be nice if the world around us stopped pretending otherwise :-)

Of course, just like the word queer, it's one thing to self-identify as queer and quite another for someone else to call you a queer, so perhaps a queer feminist crip stance towards reclaiming borderline personality may need to remain a first-person kind of thing, something you call yourself in specific contexts to make specific interventions in cultural narratives of mental illness or misogynist bias, not something other people (your doctor, your ex, your boss, your lover) should ever call you.

What do you think?

Can BORDERLINE be reclaimed and revalanced in an analogous way to QUEER and CRIP?

And what do you think about using crip theory to talk about mental illness and personality disorders in addition to the usual topic of physical impairments?

Should CRIP be reserved for radical disability activism devoted to physical/visible impairments?

Is "borderline pride" a useful strategy for acknowledging borderline personality as a "type" rather than a terrible illness or untreatable condition?  Or does it undermine potentially life-saving changes in behavior among borderline personalities?  Can one have borderline pride and a deep commitment to improving quality of life (a.k.a., recovery) for borderlines?

Let me hear from you.

4 comments:

  1. Thanks for the props Lisa! It's always important to put references in context, and in that presentation, i am addressing 300+ psych/ med students who are training in DBT and BPD. I don't believe i stated the term borderine shouldn't be used but that it exists within the dialectic of "I am / I am not" a borderline. and the use of it needs to be done carefully. I will have to watch the video again, however, as it's been a while since i gave the talk!

    I do know that I never encourage clinicians to call a person with BPD a "borderline"--it's the psychiatric equivalent of a white person calling a black person a nigger. but as black people, homosexuals, cripples, alcoholics and others know, reclaiming the language is an effective way of taking the wind out of others' sails and regaining voice and power.

    In my book, i refer to myself and others as "borderline" very consciously, and everyone close to me feels comfortable using the term, as it's part of our shared language. I live with another "borderline"in my buddhist community and we work with the disorder as both a separate experience (a disorder) and as a common manifestation of suffering. With six people in our house and a larger community (Sangha) who have now read my book and known me for many years, the word "Borderline" has not only become common, but is infused with a depth and level of understanding i've never experienced anywhere.

    I'd never get rid of the term, and argue against the movement to change to label. (but that's another topic!)

    When I've educational work at conferences in the past, I printed up stickers to wear that said "proud to be a borderline" and people would literally walk away when they saw me wearing one. but other people started picking them up and wearing them too :)

    I suppose the issue for me is always both/and rather than either/or. I am a borderline and I am not. Others are not allowed to call me that/and they are not. Claiming and reshaping the word by embracing it seems to be the fastest to reducing stigma but as the name can still perpetuate the stigma, it requires a dual approach.

    This is a great topic Lisa! Thank you for opening up a great discussion. Merinda Epstein has written on this topic as well from a gender perspective-- definitely worth taking a look! Links here:

    http://www.takver.com/epstein/articles/emperors_new_clothes_themhs_2006%20.pdf

    http://www.takver.com/epstein/articles/borderline_personality_disorder.htm

    http://www.sistersinside.com.au/media/papermepstein.pdf

    In borderlinehood,
    Kiera

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  2. Great blog Lisa in reference to Kiera's great work :) I really like your idea about exploring neurodiversity as well.

    I agree with both of you that the term or label "Borderline" is one that forwards stigma, and not only in the eyes of others or mental health systems, but in ways that leaves those with this diagnosis internalizing that very stigma along with all the accompanying shame.

    Much like those of us who are lesbian, bi, gay, or transgender have experienced, at some point in our lives, homophobia, so too have many of us, for a time in our lives, internalized those negative and shaming messages.

    These are exciting times for BPD advocacy I think. I am, myself, just starting a new website and iniative that I am calling, simply, Beyond Borderline Personality. Notice I'm dropping the "disorder" as you so cleverly and aptly did in your wonderful memoir.

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  3. wow--what a great set of exchanges. great blogs--all of your work has helped me a great deal. i have read a great deal about bpd, related traits, and such and in times of low stress, i am a ok and able to thrive. however, when i am stressed out my ability to adapt and relate is severely altered. i finished a master's and have trouble finishing my phd. it is not for the status but i want to be a more independent researcher and contribute work that might be modestly meaningful. i thank you for such candid exchanges. i read the news and see people with bpd mentioned in relation to violent crimes. i am so grateful to you--i moved to nyc to get help but there was such a void in understanding how people living with bpd function and thrive. thank you. i can not tell you how grateful i am--i found out about bpd this year and it has been so humbling and hopeful at the same time. i hope to stick with dbt and live a life worth living (as linehan would say!)

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