Shame, stigma and BPD anger
4/6/2008 11:36:32 AM
As long as the medical community does not modulate its use of words in their description of people who have "Borderline Personality Disorder," as long as these descriptions, especially when addressed to the general public, are not nuanced to carefully include the spectrum of mild, moderate and severe, they will never be able to do more than increase the suffering of a long suffering group of people. At their best, words like "manipulative" or "exploitive" are an erroneous interpretation of maladaptive behaviors that stem from intense emotional pain and past experience of a world that is cold and indifferent and blameful towards this pain, and at their worst these words are used in a much more vindictive way than the great majority of people who make up this tragic population would ever be capable of doing themselves.
It is time that medical practitioners learn to see the role they play in exacerbating the extreme feelings of shame that already paralyzes the BPD sufferer before their "diagnosis." It is time to seriously search our own conscience to see our role in fueling the anger of our patients - anger as an ultimate defense against a shame so intense it threatens to annihilate the "self" - with our language full of moral judgments and void of any responsibility we (the medical community) might have had in fueling it.
Someone diagnosed with BPD is effectively told their anger is unreasonable. We totally ignore the connection between shame and anger in shaming this population into silence and then shake our heads when their anger can only express itself in impulsive paroxysmal outbursts. We talk about the anger to such a degree we miss the fact that these are people who suffer from a hypersensitivity to all negative emotions and desperately need help with feelings of sadness, remorse, hopelessness, despair, etc. Has there ever been a more maligned population by the healthcare industry?
Once marked with the scarlet letter of BPD, the sufferer learns that he/she alone has no right to feel angry, or mistreated, or to accuse someone else of callous indifference: For to feel anger now means that they are bad, flawed in their very "personality." With their hypersensitivity they will continue to soak up everyone else's hate without daring to criticize and become more and more convinced that the world thinks they would be better off dead. We leave them to drown in their shame; our final revenge will be to interpret their suicide as "manipulative." We have truly created a population that is damned if they do and damned if they don't.