Borderline Personality Disorder and the experience of women's trauma within psychiatry: a service user perspective

Lead Research Organisation: King's College London
Department Name: Health Service and Population Research

Abstract

My research will examine experiences of trauma among
women diagnosed with Borderline Personality Disorder (BPD).
BPD is a psychiatric diagnosis characterised by symptoms
such as fear of abandonment, suicidal ideation & behaviour,
self-harm, stress-related dissociation and unstable
relationships (APA, 2013). It is estimated that 75% of people
diagnosed with BPD are women (APA, 2013), while various
research studies indicate a strong association between
childhood trauma and the development of BPD in adult life.
Battle et al (2004) estimate that 81% report instances of
childhood abuse and 90% report neglect. One explanation of
this is gendered stereotyping of the BPD diagnosis, with
women perceived to be overly-emotional and attention
seeking. The negative impact of gendered stereotyping is
central to feminist critiques of BPD diagnosis on the grounds
that it pathologises women's struggles and women's
socialisation (Becker, 1997). In addition, current
recommended treatment methods such as DBT (Lineham,
2014) and medication (Hilger et al, 2003; Perrella, 2007) fail
to address the lasting impact of trauma, which may be
essential to the aetiology of Personality Disorders (PD's).
Sociological and service-user research suggests that voices
of BPD service-users go unheard, in part because mental
health professionals perceive people diagnosed with BPD to
be unreliable witnesses to their own experience (Nehls,
1999). Significantly, negative, jarring stereotypes at work in
this judgement are found in the work of leading psychiatrists
in the field of PD's, such as Peter Tyrer. His new book on BPD
is titled: Taming the Beast Within (2018). The book, it might
be said, is part of a general trend reaching from clinic to
popular culture. For instance, a hugely popular 'self-help'
book for loved ones of those diagnosed with BPD is titled,
Stop Walking On Eggshells (Randy & Mason, 2010). The blurb
reads: "Do you feel manipulated, controlled, or lied to? Are
you the focus of intense... irrational rages? ... If the answer is
'yes,' someone you care about may have BPD". The problem
of stereotypes related to a BPD diagnosis is summarised in
the words of a service user, Rowan-Olive (2018). She writes:
"My personality is who I am. You cannot tell me my very self
is disordered and then convince me you do not want to
reduce me to a stereotype.

Publications

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Studentship Projects

Project Reference Relationship Related To Start End Student Name
ES/P000703/1 01/10/2017 30/09/2027
2293355 Studentship ES/P000703/1 01/10/2019 30/03/2024 Amber Cait Mulcahy