I will never forget that day in school. I was in a class called, “Social and Cultural Foundations.” We were supposed to be exploring our biases. It was a class almost entirely of white people discussing their perceptions about different groups of people. And then the question came up.
“What group of people do you have the hardest time working with?”
A girl in the back raised her hand. She said “I can’t stand working with people who have borderline personality disorder. They are liars and they are manipulative.” Others began to chime in. The unhealthy cries for help. The self-harm and suicidality. The selfishness. The roller coaster. The devaluation and idolization.
Every part of the diagnostic criteria was picked apart and criticized by nearly half the people in the room. My blood boiled. I could hardly breathe. I want to shout out, “Hello, I’m right here. You are talking about me. I am a person, not a list of symptoms. And you haven’t the faintest idea of what I go through on a daily basis to get here, to sit in this class with people like you and be judged because I have some letters that equal a diagnosis that describe my pain.” But, I couldn’t. Because they don’t know. I don’t tell them for many reasons. I feel they may not understand. I am afraid of the stigma and being ostracized. But, most of all, that is a very personal thing to share in a room of 23 counselors-to-be. I’m not that brave.
I get it wherever I go. I work in mental health as well, as a case manager at a community mental health center. I connect people with mental illnesses to services — make sure they go to the doctor, see a psychiatrist, have health insurance. I provide emotional support as well. And yes, I have clients that have my diagnosis. Some are easier to work with than others. I am lucky. I actually used to be a client at the community mental health center I currently work at. I did dialectical behavioral therapy (DBT) there for a year and progressed to the point where I could do it privately with a trained therapist. That was three years ago. I was in and out of the psychiatric hospital, self-harming and self-destructive. And now, I work there, helping people who were like me, trying to claw their way out.
I’m healthier, but I work hard to be that way. My one complaint is this: the language that we use as mental health professionals has to stop. Between work and school, there are times when I feel sick. I’ll hear, “That person is acting so borderline.” No. That person is experiencing symptoms that are directly related to their diagnosis of borderline personality disorder (BPD). You can’t be borderline. It isn’t a state of being. It’s a description of a series of behaviors. Not a noun, not a verb, an adjective. If we want to fight the stigma, then it has to start from within.
When I told a co-worker I had BPD, she said, “You don’t present that way.” No. I don’t. Because I am one person with borderline personality disorder. Just one person. And that other person is also one person with borderline personality disorder. How we present, how we behave, may be similar, but it’s also different. So treat everyone with respect to their face, but also behind their backs. If we want to break this stigma, we need to work at it, too.
We need to change our language. We need to find kindness and compassion in our hearts to do so. And we need to stop using the term “borderline” like we do. It’s not nice or fair. You wouldn’t call someone with developmental disabilities the “R” word. You wouldn’t call someone who had difficulty walking a “gimp.” So why it OK to refer to someone with a mental illness by their disorder? Why is it OK to call someone’s behavior “borderline” or “bipolar”? We need person-centered language when it comes to mental health. And if we, as clinical professionals, don’t begin to change the way we talk about people behind closed doors, then how are we supposed to break the stigma?
I want you to know recovery is possible, but it’s a process. There are times I leave work and go home and cry. There are days when I’m on cloud nine. Progress isn’t linear. I had a nervous breakdown not even two weeks ago, when I was out of work for a week and trying to stay out of the hospital because something I did went right. That’s correct. The interaction went well and I couldn’t handle it emotionally. It pushed me right over the edge. So for those of you who want to work in this field, for those of you who want to help people like you, know it is possible. I’m living proof. But, do it with a good counselor, psychiatrist and support system. Be honest with your supervisor. And hopefully, the pieces will fall into place like they did for me. You can do it. I have faith in you.