The Basics: What Is BPD?

Blue and purple text box which reads "The Basics: What is BPD?"

Content note: Unfortunately, (and as no surprise to people with BPD and their loved ones), this post discusses suicide, abuse and ableism. If any of those are hard for you, I promise that your mental wellbeing is more important than my website stats. Go and find some cat videos 💙


Welcome to The Basics, a series in which I outline a concept that comes up a lot in my work! This time, we’re looking at Borderline Personality Disorder (also known as Emotionally Unstable Personality Disorder) – what it is, how it affects a person’s life, and what might help them. This article refers to “people with BPD” rather than “BPD sufferers” or similar, because I think the emphasis on suffering is unhelpful and because we are people. My personal opinions on whether it’s truly a personality disorder, versus a subtype of PTSD or a neurotype all of its own, are less than relevant here, but if significant new information comes to light along those lines you can expect an update to this post.

I was almost angry when I first learned about BPD, in that indignant way that you’re angry when you discover a resource that you had previously never heard of, sitting right in front of you. A while before I was formally diagnosed, I was already using BPD in my vocabulary and exploring how it might explain particular events scattered throughout my childhood. It explained so much, in fact, that I was formally diagnosed, and started writing a little more about having BPD.

BPD affects your mood, the way that you process and tolerate emotional distress, the way that you conduct your relationships and your self-perception. That’s a lot of things, so let’s start with the emotional bit. Sometimes I call my BPD “Big Emotions Disorder”, or “Tinkerbell Syndrome” in reference to the fairy in Peter Pan who can only feel one, extremely intense emotion at the time. These big emotions can cloud my judgement, especially when it comes to interpersonal interaction, and can escalate into an acute crisis very quickly. One problem with BPD is that our distress is so intense and specific that it can look very different to neurotypical distress, sometimes looking performative and thus not being believed – but we often are in that much distress, at least, and assuming otherwise is one of the reasons that people with BPD die by suicide at a rate of around 10%; for comparison, the Samaritans put the suicide rate of the general UK population at 10.0 per 100,000, or 0.01%

The relationship side of BPD is obviously impacted by the emotional side of it. BPD usually features an intense fear of abandonment and feelings of dependence on our loved ones, and our attachment styles can lead to clinginess and avoidance, sometimes both within the same person, same relationship and same hour. Relationships with a person who has BPD can often feature a lot of reassurance that you aren’t going to leave, as well as supporting the person when they have their characteristic Big Emotions. This can be taxing, especially when communication isn’t great, the person with BPD doesn’t know how to ask for reassurance (or even that that’s what they need), the person with BPD doesn’t take responsibility for their behaviour during times of Big Emotion, etc. Much like with the rest of the disorder, any stumbling block in the department of relationships is magnified so as to be almost insurmountable, so people with BPD report losing treasured relationships as well as ending up in terrible ones.

There is an argument to be made that entering terrible relationships, much like impulsive risky sex, drug use and dyeing one’s hair bright colours, is a self-sabotaging behaviour that we engage in because of our poor and typically unstable self-image. I personally think there is also an element of talented abusers finding and grooming people with BPD because we are likely to be grateful for the attention, eager to change and to please, and less supported by friends, family and professionals. Regardless, I’ve found in research and in my personal life that people with BPD are more likely to be abused in our interpersonal relationships than the general population, which is also more likely to do significant harm since we’re so sensitive to begin with.

(I also have to wonder whether dyeing one’s hair is definitely a response to unstable self-image, or whether it is sometimes done all or in part because of a desire to feel in control of one’s body and/or to make a statement. This is especially possible because there is an overlap between marginalised groups who dye their hair to be subversive, such as us gays, and people who are traumatised, what with trauma having known links to the development of BPD and all.)

Risk-taking behaviours are a real problem for people with BPD, and it can sometimes be hard to find the distinctions between deliberate risk-taking, altered perception of risk, and risks taken due to a feeling of passive suicidality. Personally, I’ve tried to obstruct a number of the risks I take, accidentally or on purpose, with things like a Blue Badge that stops me from wandering across car parks, and the deletion of Tinder from my phone. My experience with kink has given me, I think, a pretty good understanding of my ever-changing risk appetite and which risks I can take safely if I so need. I have to urge patience if there’s someone with BPD in your life taking risks that alarm you, especially because I know that sometimes I’m more likely to take risks if I have been specifically warned against them (there’s that avoidance coming through again). I also want you to trust that the adults in your life with BPD definitely are adults who can make adult decisions, and who will probably ask you if they need your help in managing their risk-taking. 

Personality disorders in general are heavily stigmatised, and this is especially true of what are sometimes called Cluster B personality disorders, like Antisocial Personality Disorder, Narcissistic Personality Disorder and Borderline Personality Disorder. I like to refer to Cluster A as “Cluster Your Problem” and Cluster B “Cluster Other People’s Problem”, because that does seem to be where the demarcation lies. BPD is among the disorders most vilified and misunderstood by the public, but I am here to tell you that there’s no personality disorder that makes you an inherently bad (or good) person – it’s your behaviour that dictates that. 

By the way, I’m going to insist on calling it BPD, instead of EUPD, or Emotionally Unstable Personality Disorder. There are a lot of reasons for this (including my inability to resist jokes about my European Union Personality Disorder), but my main one is that I think EUPD is misleading in two senses. The first is that it conveys that this is a primarily emotional disorder, which in turn conveys that it is perhaps less serious than other disorders, when in fact those emotions are a result of brain chemical activity just as in other mental health problems, and can be so intense as to lead to psychosis (delusions and hallucinations). The second is that it suggests a person with BPD is doomed to a life of emotional instability, which I don’t believe, having felt and witnessed the improvements that appropriate interventions can make. This doesn’t just mislead people who have BPD, rendering them desperately hopeless, but it also seems to mislead the public and professionals into thinking that severe emotional instability, and particularly distress, is so inevitable in people with BPD that it isn’t worth addressing in the way it would be addressed in anyone else.

This is not just a paranoid hunch I have; multiple articles point to a need for more research into BPD and how to treat its symptoms. Disorders aren’t chronically under-researched for no reason; funding goes to certain causes over others, which sucks because those other causes are usually also deserving of the funds. However, BPD isn’t as appealing or relatable to the public as disorders like depression, partly because of the very visible and vocal ways it presents. I also have to wonder whether it would get more research funding if it weren’t for the fact that “women present to services more often than men” (their cissexist language, not mine) and the related fact that we live in a patriarchal hellscape. Nonetheless, we don’t need research to approach people with BPD with the empathy and dignity that we deserve. It’s beyond time to stop treating BPD as Tantrum Disorder and start treating it like the complex constellation of traits and symptoms that it is – a disorder that can and does kill people. This dismissive attitude kills people.

In summary:

  • BPD is a disorder which acutely affects your relationships, your emotional state, your risk-taking behaviours and various aspects of your functioning
  • We are at high risk of harming ourselves but we are not fundamentally evil people bent on harming others
  • BPD is dismissed by professionals at an alarming rate, but the distress we’re communicating is legitimate
  • Helping people with BPD is the same as helping any other individual, but it will sincerely help us to elevate our voices and educate the public and professionals about the reality, and seriousness, of the condition
  • We need a lot more research on BPD, which you can also help to campaign for
  • If you have BPD and this post exhausted you emotionally, you’re not on your own. And if it helps at all, here is a photo of my cat:

My black-and-white cat on a blue-and-purple background, lying on his back with his legs spread wide. He learned this from me.

 

The Basics: What Is Autism?

Purple and blue box which reads "The Basics: What Is Autism?"

Welcome to The Basics, where I give an overview of a topic that I talk about a lot. This time, already more than a week late for the start of Autism Acceptance Month, I’m here to give an overview about autism. 

I talk about a lot of complex connections between autism and kink, autism and sex, autism and mental health, etc etc. I never want to condescend readers who are already immersed in the discourse, so I usually skip the bit where I explain what autism is and how it affects a person’s life. But there’s no shame in being unaware of exactly what autism is or what it’s like to live with – nobody is born knowing anything and a lot of conversations about it, like with most things, assume a level of knowledge that not everybody is going to have. If you don’t mind that this is a sex blog, this post will hopefully constitute a useful primer that you can send to your loved ones instead of trying to explain it all yourself.

Autism, originally named “autistic psychopathy” because psychiatric medicine was Like That, is a neurodevelopmental condition (that is, it affects the development of the brain), and some autistic people (including myself) regard it as a disability. (We sometimes refer to autism as a “neurotype” to indicate that it is not a disease or ailment but rather a valid way for a brain to be arranged. However, many autistic people express pride in their different neurotype, or neurodivergence, whilst still feeling like being autistic in a world built for allistic (non-autistic) people is disabling for them.) This of course means that autistic people are at risk of ableism perpetuated by individuals, as well as by organisations like Autism Speaks, which most autistic people hate for their emphasis on a cure, their advocacy for unethical practices including ABA, their puzzle piece imagery that suggests we’re incomplete people, and/or for the fact that only a fraction of the money they pull in is spent on helping autistic people in any tangible way (here’s a PDF from ASAN with more info). Because autism affects the brain, it expresses itself in a huge variety of ways, but some common ones can include hyper- or hyposensitivity of one or more of the senses, periods of intense hyperfocus on a singular topic or task, difficulty learning and applying social rules, and difficulty with interoception (the perception of one’s own body including hunger, thirst, etc). My favourite quote on this topic comes from Tony Attwood: “If you’ve met one person on the autism spectrum, you’ve met one person on the autism spectrum,” i.e. autistic people are just as different from one another as allistic people are from one another. 

One thing that often comes up when autistic people talk about their experiences is the fact that they only represent, well, autistic people who can talk. Some autistic people never talk in English words at all, and some (like me) can talk your ear off until they’re overwhelmed, distressed, tired, etc, at which point they lose the use of most or all of their vocabulary. Some autistic people will find use in augmented communication devices that can say particular words or phrases for them, while others use sign language, write things down, or use a combination of different methods of communication. It’s true that I don’t know what it’s like to be an entirely nonspeaking autistic person, but I do know that nonspeaking =/= non-communicative. Some autistic people struggle to read tone, facial expressions, body language etc, but that doesn’t mean that these aren’t ways for an autistic person to communicate. I typically work on the assumption that all people have something of value to say, no matter how they say it, and that it’s worth trying to perceive the atypical, nonverbal ways a person might communicate.

As a linguistics graduate I also tend to assume that language is extremely important in most areas of human existence, but I’m confident in saying that it’s especially important when discussing disability, just as it is with other marginalised identities and groups. You might see a lot of autistic people talk about a preference for identity-first language, as opposed to person-first language. Person-first language refers to “people with autism”, while identity-first language refers to “autistic people”. Many autistic people, including myself, prefer the latter, as they feel that the former (often championed more passionately by allistic people than autistic people) linguistically removes their autism from them, positioning it the way we would a diagnosis of illness rather than neurodivergence, and implying that personhood and autism are at odds with one another. That said, we have the right to decide which language we identify with, and if someone tells you that they prefer to be called a “person with autism”, you should definitely listen to them. Also, given Hans Asperger’s relationship to eugenics as well as some people’s opinion that Aspergers Syndrome is essentially autism, but in a way that’s useful to capitalism, you shouldn’t apply the labels of Aspie or Aspergers to someone else unless that’s the language they use to describe themselves.

Since autism is technically a developmental disability, I once found myself punching one of my Year 7 classmates for using the word “retard”, which I think most people know is an ableist slur. Except I wasn’t defending my own autism; it would take 6 years after my younger sibling’s diagnosis for me to get mine, at the age of 14. There were a lot of reasons for this, but one of them was my assigned-female status that encouraged me to mask a lot of my difficulties and discouraged the adults around me from labelling them as autism. It is well-known that diagnostic criteria are usually sculpted according to the presentation of a condition in your average white male, meaning that many assigned-female autistic people are diagnosed late or never, as are autistic people of colour and autistic people with one or more additional condition. Autism is not a condition which significantly warps your relationship to reality, so you will find that a lot of autistic people (especially online) are self-diagnosed using the plethora of resources that are out there, and formally-diagnosed autistic people welcome them with open arms (and if they don’t, they suck and you should unfollow them), especially given the inaccessibility of a formal diagnosis if you aren’t a cookie-cutter white guy (and sometimes even if you are). 

Autism is often diagnosed in children, in part because they have not yet learned the bundle of masking techniques that make it harder to spot autism in adults, and in part because the diagnostic criteria were originally written based on only child subjects. However, because it’s how your brain is built, it’s a lifelong condition that affects adults as much as it does children, and autistic adults are out there in your communities, hopefully living fulfilling and safe lives. I say this because people often forget autistic adults in their zeal for helping autistic kids, when in reality autism can feel more disabling in adulthood because of the added pressures of employment, housing, etc. Upsettingly, this focus on kids still doesn’t result in them receiving appropriate resources. If you can deal with ableism and child abuse then I strongly encourage you to investigate the #StopTheShock movement, as well as to research the harms of ABA, or Applied Behaviour Analysis; both these things indicate a desire to remove a child’s autism, or at least make it less visible to surrounding adults, rather than increasing their quality of life and equipping them with skills that will make life as an autistic adult easier. Resources for autistic people in general are either non-existent or wildly condescending, which is one of the reasons so many of us are being shouty on the internet, and resources are even more sparse for adults than they are for kids. There are disproportionately more “autism-friendly” screenings of children’s movies than there are of teen or grown-up movies, and autism-friendliness seems to mean little more than “you can get out of your seat and the volume isn’t as aggressive” in most of these settings. Again, autistic people are as different from one another as allistic people are, so trying to make any venue or event “autism-friendly” sounds like something of a fool’s errand to me. (I need audio to either be nonexistent or painfully loud, for example, and dimmed lights make my head hurt because visual processing is not my forte even in regular lighting. This makes so-called “autism-friendly” screenings distinctly Morgan-unfriendly, but I’m glad that some people get benefit from them and I hope we can build on the model to allow even more autistic people, kids and adults, to enjoy cinema.)

There is a lot more to be said about autism and the amazing autistic people educating others than I can fit into a single blog post, but the key points are:

  • Autism is a brain difference that manifests differently in everyone
  • It affects sensory perception, social interaction and attention/inattention, among other things
  • It is a lifelong condition which many consider a disability, especially in a world not built for us
  • Most, but not all, autistic people seem to prefer identity-first language (“autistic person”)
  • If you say “retard” in front of me, in Year 7 or now, I will hit you
  • Autistic girls, people or colour and adults are underdiagnosed, but this doesn’t actually make them any less likely to be autistic
  • I personally stand strongly in favour of self-diagnosis for autism
  • Autism-friendly cinema screenings and shopping hours annoy me an unreasonable amount due to the aforementioned differences between autistic people’s needs
  • There are many, many autistic creators and educators whose voices are valid, valuable and worth your time to check out! I can’t link all of them, but here are a few:

 

Thank you for reading, and I’ll see y’all soon!