The Strange History of Borderline Personality Disorder
How the world’s worst mental health label came into existence and why it matters.
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Depression was studied in 1621, OCD in the 1830s, Schizophrenia in the late 19th century, and trauma after the First World War. And yet the infamous Personality Disorder is a mere infant in terms of diagnosis. This is especially true of the ‘Borderline’ type. First identified in 1980, the condition has actually been lurking around for quite some time.
But what is Borderline Personality Disorder? Briefly put BPD, is a severe mental illness marked by emotional, behavioural and cognitive instability, relationship chaos, and chronic self-harm. The statistics are shocking: 10% of those with the condition commit suicide, 70% have attempted it. Despite the fact the BPD sufferers account for half of all psychiatric admissions and collectively cost billions , no one is talking about it — nor how the label shapes the outcome.
What’s in a name? Take a tour of the dusty vestibules of psychiatry, from the analyst’s couch to the hospital corridor, and you’ll see how the diagnosis was created and what it says about our deepest held beliefs.
1900s-1950s:
Brain Damage and Birth Defects
The patients display from youth up, extraordinarily great fluctuations in emotional equilibrium […] they fall into outbursts of boundless fury […] the colouring of mood is subject to frequent change […] they shed tears without cause, give expression to thoughts of suicide, and bring forward hypochondriac complaints […] In consequence of their irritability and their changing mood, their conduct of life is subject to the most multifarious incidents.
The youthful musings of a psychological undergraduate? Rather the work of pioneer psychiatrist Emil Kraepelin who in 1921 created the excitable personality, a diagnosis soon consigned to the dustbin of history on account of its poor outcome. The good German doctor considered those with the condition brain-damaged from birth.
Nevertheless, as psychiatry dragged its heels into the 20th century, biology was replaced by psychology, Victorian Doctors, by modern Freudians. By the 1930s…
