The Basics: What Is BPD?

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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.

 

Am I A Victim Or A Survivor?

Note: this blog post discusses, but doesn’t go into detail about, trauma resulting from being the victim and/or survivor of abuse. If that’s tricky for you, ignore this blog post but watch my Twitter for other, sexier posts in the future!


Originally, this blog post was going to be one word long, and that single word was going to be “yes”. But that seemed a tad bit brief for a blog post, so I thought I’d go into a little more detail.

Y’all know I dislike binaries. The victim/survivor binary might not look so much like a binary, but it is one, because it’s a pair of uncomfortable, mutually exclusive boxes, neither of which I can cram my traumatised little self into – and I’m sure that’s the case for other people, too.

A lot of people who have survived things want to call themselves survivors, and I personally have very little interest in policing the language that individuals use to describe their experiences of the world. I also understand the impulse to reframe trauma so that instead of being something that happened to you, it’s something you actively engaged with and survived. That puts you in more control of the world around you, and highlights how vicious of a fight it can be to make it through trauma alive. I get it.

What I don’t get is the insistence that survivors of trauma are only that, and not also victims of it. People shy away from the word “victim” as though it’s contagious, and I know that they’re trying not to step on the autonomy of already-traumatised individuals by using language they disprefer or by implying that they simply passively endured their trauma. The problem comes when someone wants to describe themselves as a victim and then they’re contradicted by people who think that the word “victim” is disempowering.

Listen, for other people, I’m sure it is disempowering, and it’s not the word I default to for referring to every individual survivor (I usually tend to refer to them with their names). But for me, personally, it’s not disempowering. It feels accurate. I don’t feel like I passively endured my trauma – I feel like I fought with it, and I do feel like I survived – but I do feel like I have been a victim. I have been intentionally selected from a world full of people by abusers looking for the easiest target within arms’ reach. I have been victimised repeatedly, assigned the experience of the victim by people who had more power than me to decide our roles. For me, the word “victim” is helpful.

The thing is, I survived my trauma, sure. I fought against it wherever I had the strength. But I also survived by doing things I’m not proud of, lying and screaming and hiding, and through unique combinations of privilege and sheer luck. There are plenty of people who wouldn’t have survived my trauma, and that’s no fault of their own. I don’t want to imply that I’m stronger than people who die at the hands of their abusers by celebrating my feat of survival. I do want to celebrate my survival, don’t get me wrong, but that usually involves a sarcastic toast to people who’ve wanted me dead every birthday and graduation, rather than any particular label I give myself.

The other thing that gets under my skin about victim discourse is the notion of “playing the victim”. This is a sort of vague and nebulous concept that seems to be applied at random to people who are having a whine, people who are rebelling against legitimate injustice, people who are disagreeing with you, etc., etc. Someone who is “playing the victim” is implied to be illegitimately casting themselves in the role of victim when in fact they are the antagonist, but it’s a very convenient trio of words to apply to someone you are in the process of abusing. The way that “playing the victim” gets thrown around creates an even more hostile environment for people recovering from trauma to discuss their experiences, because we already do enough second-guessing ourselves about who the true aggressor was (hint: it wasn’t the traumatised person) and we already convince ourselves that our feelings of hurt, mistrust, fear, injustice, anger, grief, etc., are a melodramatic response to a situation in which we weren’t really the victim.

“Victim” is a helpful word for me because it helps me to understand my role as someone who was victimised, who was harmed by inescapable power dynamics and choices made by human beings. “Survivor” is a helpful word for me because it reminds me that I fought, that I didn’t just allow my trauma to happen to me but that I actively survived the process of victimisation. I think we need both words! I just also think that if you ever correct someone’s self-description from “victim” to “survivor”, you’re being a dick, because while both of those words can be accurate, it’s polite to use the one that a person actually supplies to you – kinda like pronouns, and names, and most other principles of addressing or referring to someone politely. 

(That’s pretty much the only politeness rule I know, on account of being an autistic gremlin with little interest in social niceties but some interest in communicating compassionately and effectively with other humans. Just… believe people when they tell you who they are.)

Being Alone With Arousal

Note: this post talks about my eating disorder, including mentions of purging through vomiting, and my experiences of being sexually abused, including subsequent dissociation and general difficulty being alone with arousal. If any of those are tough for you, give this one a miss – I’ll be back on Saturday with a post about why you might find more autistic people than you’d expect in your local kink scene!


My fear of wanking came up in eating disorder therapy.

This is not wholly a surprise. Lots of things come up in eating disorder therapy, because eating disorders are deeply rooted, born of decades of cultural conditioning, dysfunctional coping mechanisms and adverse childhood experiences. But the more I’ve reflected on it, the more I’ve come to realise that my fear of wanking and my fear of food are two heads on the same beast.

One common starting point for eating disorder therapy is to consider what we’re actually afraid of. In my first round of it, two years ago, we unpacked a lot of my internalised fatphobia and my fear of taking eating to its extremes, which is an offshoot of my anxiety: it’s pretty common to consider the logical, if unlikely, extremes in any scenario. But I only got six sessions, and we didn’t have time to dive any deeper.

This time, I get a whole eight.

The thing that scares me about food is that I enjoy it. Enjoying things, I have learned, is scary and dangerous and often has real and terrible consequences. Having lived with abusers during a few critical formative periods, I learned and internalised that nothing good is without cost and that the more pleasant the calm is before the storm, the more devastating the storm will be. Best not to let my guard down, enjoy anything too much, or trust my senses to tell me when something is safe or nice.

Then there’s the complicating factor of having learned to wank through being groomed. As well as reinforcing my existing belief that my own sensory pleasures must always come at a cost, it created some really specific associations between the physical act of masturbation and a strong sense of danger. Specifically, fucking myself with an object when nobody is watching feels so wrong that it’s akin to practising a secret handshake on your own,  and fucking myself with fingers is very much the same. If there’s no webcam between my legs, nobody watching my face and nobody talking dirty to me – if there’s no audience to validate my pleasure and benefit from it – it not only feels asymmetrical and disconcerting, but dangerous.

Indulgence has always led to violence in my life.

I am now, of course, free of all the abusers who have made and reinforced that connection, but that doesn’t undo it. It’s wired into my brain like the connection between an object flying at one’s face and one’s inclination to duck. And because I’ve had so much else going on, and so many spectators available to me, I haven’t had time to rewire it.

Being horny alone feels like being in pain. It’s frightening and distracting and I don’t want it. If I do attempt to masturbate, I usually dissociate, failing to orgasm and also failing to feel my own face or entirely remember where I am. If I don’t, I have this constant nagging sensation somewhere in my physiology that feels like an alarm going off, reminding me that indulgence is possible, and therefore, so is danger.

I am fucking sick of it.

I wrote out a plan for a Masturbation Boot Camp (and yes, I titled it exactly that) which instructs me to spend day zero practising mindfulness, day seven touching my body and exploring sensation, and day fourteen actively attempting to come, with every day in between requiring an incremental step towards these goals. I showed it to my tipsy, dyslexic girlfriend, who saw straight through me and said, “And how much of this is procrastination so you don’t actually have to wank?”

It’s a great idea and it’s one I’m going to try, but she’s right. I live in fear of my body and the pleasure I can experience within it, and even the idea of self-massage or watching porn for fun fills me with sickening dread. I suck at most mindfulness activities because, between the chronic pain, the chronic trauma and the violations I’ve been subject to when I have indulged in pleasure, I don’t want to be in my body. I don’t want to ground myself in it. It’s a horrible place to be.

Unfortunately, I don’t have any other vessels to contain my soul (this is a Kingdom Hearts joke), so I’ve got to get used to this one.

I’m getting better at indulging in food, and even at indulging in food without punishing myself. Sometimes I devour cheap kebabs with gusto, and sometimes I go halvsies on a £27 Hotel Chocolat Easter egg with my partner and savour tiny mouthfuls of gourmet chocolate. I’ve managed to bully myself out of the bulimic practice of purging my meals – at first, this was because I was and am on oral hormonal birth control, and consider it a consent violation to jeopardise that without notifying anybody who might jizz in me, but over time, once I’d detached the act of eating from the act of puking, the mere hassle of purging became enough to deter me from it. Eating can still be a challenge, but it’s a rewarding one.

I’ll get back to y’all about my success with Masturbation Boot Camp. I’m hoping it’ll be a challenge, but a rewarding one, and I’ll learn to indulge in self-pleasure like I’m about to indulge in a sliver of salted caramel chocolate.