Borderline personality disorder: risk and identity

By Caroline Maxwell

The modern psychiatric diagnosis of BPD has its roots in the work of the American psychoanalyst Adolph Stern, who in 1938 described a number ofsymptoms that are taken to be characteristic of this disorder. Having been included in the American Psychiatric Association’s Diagnostic Statistical Manual (DSM) since 1980, whilst many have found the diagnosis useful, BPD has also courted its fair share of controversy, with critics identifying the role of cultural assumptions around gender, race and sexuality in the construction and application of this diagnostic label.

Those diagnosed with BPD are frequently viewed as ‘risky’ by the psychiatric profession, with behaviours such as self-harm, aggression, substance abuse, reckless spending, etc viewed as being symptomatic of the condition, and their occurrence contributing diagnosis of BPD by professionals. There is, however, little known about how those given this diagnosis view themselves in relation to risk, and how such perceptions may shape their sense of identity and their behaviour.

Michael Huggett, a Mental Health nurse and Professional Doctorate researcher at the University of Brighton hopes to examine this issue, looking at how a BPD diagnosis affects the way in which the recipient views themselves and their behaviours, against a background of what he considers to be an increasingly ‘risk averse’ psychiatric profession.

Michael’s study seeks to identify the cultural assumptions at play within the BPD diagnosis whilst looking at the extent to which such assumptions are ‘taken on’, resisted, and subverted by those in receipt of such a diagnosis.

Michael explained: “My specific research interest is how those subject to this diagnosis negotiate their identity in relation to risk, i.e. their ‘risk identity. Whilst I anticipate that their experience of discussions around risk within psychiatry may be influential with regard their’ risk identities’, I’d like to develop a better understanding of the role of other, ‘non-psychiatric’, cultural  experiences.”

“If BPD contains potentially oppressive cultural assumptions, how do those diagnosed negotiate who they are against this backdrop and against the wider culture?”

By conducting research into this little understood area Michael hopes to enhance the knowledge and sensitivity around risk managing such individuals in contact with mental health services. Through sharing the results with both participants and others diagnosed with BPD, the aim is additionally to raise awareness of some of the problematic characteristics of this diagnosis in order to empower those so labelled.

If you have been given this diagnosis and would like to take part in the study, further information and contact details are available through the research website: http://www.riskidentity.com/ .