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Borderline personality disorder, stigma, and treatment implications.

Harv Rev Psychiatry. 2006 Sep-Oct;14(5):249-56

Authors: Aviram RB, Brodsky BS, Stanley B

Borderline personality disorder (BPD) is often viewed in negative terms
by mental health practitioners and the public. The disorder may have a
stigma associated with it that goes beyond those associated with other
mental illnesses. The stigma associated with BPD may affect how
practitioners tolerate the actions, thoughts, and emotional reactions of
these individuals. It may also lead to minimizing symptoms and
overlooking strengths. In society, people tend to distance themselves
from stigmatized populations, and there is evidence that some clinicians
may emotionally distance themselves from individuals with BPD. This
distancing may be especially problematic in treating patients with BPD;
in addition to being unusually sensitive to rejection and abandonment,
they may react negatively (e.g., by harming themselves or withdrawing
from treatment) if they perceive such distancing and rejection.
Clinicians' reactivity may be self-protective in response to actual
behavior associated with the pathology. As a consequence, however, the
very behaviors that make it difficult to work with these individuals
contribute to the stigma of BPD. In a dialectical relationship, that
stigma can influence the clinician's reactivity, thereby exacerbating
those same negative behaviors. The result is a self-fulfilling prophecy
and a cycle of stigmatization to which both patient and therapist
contribute. The extent to which therapist distancing is influenced by
stigma is an important question that highlights the possibility that the
stigma associated with BPD can have an independent contribution to poor
outcome with this population. A final issue concerns the available means
for identifying and limiting the impact of stigmatization on the
treatment of individuals with BPD.

PMID: 16990170 [PubMed - in process

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darck skul

How very true. My own local hospital refused to treat me with a therapist
for six months because of this. The worst part about it is that they didn't
even have the decency to give me the reason why. They wouldn't say any
thing. So this article you have posted makes that much more sense to me.

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