Harvard Mental Health Letter

In Brief: The stigma of borderline personality

In Brief

The stigma of borderline personality

It's well known that other people's expectations shape individual behavior. Many psychiatric patients feel rightly that friends, relatives, and colleagues who are aware of their status exude discomfort that exacerbates their problems.

Writing in the Harvard Review of Psychiatry, three psychologists consider how this stigma can affect psychotherapists themselves. They focus on a particularly difficult group of patients, those diagnosed with borderline personality disorder. By definition, the moods of borderline patients are unstable, and their behavior is volatile, often upsetting or frightening. They are prone to sudden rage, suicidal thoughts, self-injury, and inappropriate attempts at intimacy followed by sudden rejection. Volumes have been published about the challenges of working with them.

So it's not surprising, according to the authors, that in the world of psychotherapy these patients are widely stigmatized. Psychotherapists think they know what to expect and brace for the encounter. When they discuss cases, the term "borderline" can take on derogatory overtones. A Canadian study found that psychiatric nurses were more likely to sympathize with hypothetical patients if they were labeled schizophrenic rather than borderline, even when the symptoms described were similar.

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