Should I be Ashamed of Having Borderline Personality Traits?

Reader’s Question

About a year ago, after some significant emotional distress, I went to see a psychiatrist. I was diagnosed with OCD (obsessive compulsive disorder) and told that I also had borderline personality disorder traits but not a personality disorder. Most of it involved difficulty regulating emotions, but I am doing much better with it after hard work on my part. I went to counseling for the OCD and took antidepressants for it as well. I am doing much better now. My problem primarily was severe obsessive thoughts.

I didn’t reveal this condition or struggle to anyone I know. I am very ashamed. Some of my family members work in the medical field and have mentioned in the past how no one likes borderline patients and that they aren’t usually people that anyone wants around. While I don’t have the full-blown diagnosis, I feel very badly about myself based on their comments and wonder if what they say is true and therefore I’m not a good person.

Psychologist’s Reply

Unfortunately, emotional and psychological disorders continue to carry social stigma, preventing people from seeking treatment. So, I commend you for taking advantage of both medication and counseling (the ideal combination for the treatment of OCD). Part of the problem with diagnostic labels is that they tend to lump together everyone who meets criteria for that diagnosis, overshadowing the differences among those individuals. So, referring to “borderline patients” as your family have done implies that such people are all the same (in negative ways).

Added to the problem is that your psychiatrist made reference to borderline personality traits, an even more ambiguous concept than borderline personality disorder (BPD). Where I’m going with this is a recommendation not to take too seriously your psychiatrist’s remarks. It was the assessment of one person — who then provided a label for “traits” that he or she apparently perceived through talking with you. Typically it is more productive to focus on specific symptoms that cause an individual problems or distress, rather than implying pathological traits (which implies a lesser likelihood of change).

Apart from the problems of labels, why do medical professionals frequently make disparaging remarks regarding patients with BPD? The primary criteria for such a diagnosis revolve around a lack of core identity, so the individual experiences frequent mood swings and extremes in judgment, based on what is happening in the moment. If someone is treating that person well, the individual with BPD may view the other person as “wonderful.” However, if that other person is then critical or fails to meet the needs of the person with BPD, the judgment about this other person may swing to the other extreme. Also, due to a lack of core identity, the person with BPD may be overly dependent on others emotionally.

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Unpredictable moods, dependency, and such “black-and-white” judgments often make working with patients with BPD stressful and challenging. Such patients are often assumed to be emotionally draining and needy, and at high risk for self-harm and attempted suicide. Accordingly, not all health professionals are equipped to work effectively with such patients. Unfortunately, it is often the patients themselves who are blamed rather than the professionals. My point is that, even if these symptoms of BPD applied to you, disparaging remarks from others regarding patients with BPD do not mean that such patients are “bad” or choose to have those symptoms.