On the Borderline

In this episode we discuss Borderline Personality Disorder (BPD), also referred to as Emotionally Unstable Personality Disorder (EUPD). Somewhat unintentionally Alejandro gives an overview of the TV show Bojack Horseman but this leads to a discussion of the characteristics of BPD using the character of Bojack as an example. We also bring in Anakin Skywalker as another example of a fictional character who may potentially fit the characteristics of someone diagnosed with BPD.

We centre our discussion around a 2006 paper written by Pamela Bjorklund titled, “No man's land: Gender bias and social constructivism in the diagnosis of borderline personality disorder”.

In the process, we break down the diagnostic criteria used in the DSM V for BPD but if you’re interested, see below:

Borderline Personality Disorder:

A pervasive pattern of instability of interpersonal relationships, self-image and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) or the following:

1. Frantic efforts to avoid real or imagined abandonment (Note: Do not include suicidal or self-mutilating behaviour covered in Criterion 5)
2. A pattern of unstable and intense interpersonal relationships characterised by alternatingbetween extremes of idealisation and devaluation
3. Identity disturbance: markedly and persistently unstable self-image or sense of self
4. Impulsivity in at least two areas that are potentially self-damaging (e.g. spending, sex, substance abuse, reckless driving, binge eating) (Note: Do not include suicidal or self-mutilating behaviour covered in Criterion 5)
5. Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour
6. Affective instability due to a marked reactivity of mood (e.g. intense episodic dysphoria, irritability or anxiety usually lasting a few hours and only rarely more than a few days)
7. Chronic feelings of emptiness
8. Inappropriate, intense anger or difficulty controlling anger (e.g. frequent displays of temper,constant anger, recurrent physical fights)
9. Transient, stress-related paranoid ideation or severe dissociative symptoms

References

• Bjorklund, P., 2006. No man's land: Gender bias and social constructivism in the diagnosis of borderline personality disorder. Issues in mental health nursing, 27(1), pp.3-23. (https://www.tandfonline.com/doi/full/10.1080/01612840500312753)
• Johnstone, Lucy & Boyle, Mary & Cromby, John & Dillon, Jacqui & Harper, David & Kinderman, Peter & Longden, Eleanor & Pilgrim, David & Read, John. (2019). Reflections on responses to the Power Threat Meaning Framework one year on. Clinical Psychology Forum. 2019. 47-54. (https://explore.bps.org.uk/content/bpscpf/1/313/47)
• Lester, R. (2013). Lessons from the borderline: Anthropology, psychiatry, and the risks of being human. Feminism & Psychology. 23. 70-77. (https://journals.sagepub.com/doi/10.1177/0959353512467969)
• Molly Adler — Back from the Borderline Podcast — https://pod.link/1576242501/episode/b66e124fcbc8095cac0f959cac5f32a1
• Girl, Interrupted (1999). Director by James Mangold. Story by Susanna Kaysen.
• Episode 15 — One Flew Over the Cuckoo’s Nest
• One Flew Over the Cuckoo's Nest (1975) directed by Milos Forman
• One Flew Over the Cuckoo's Nest (1962) written by Ken Kesey
• Bojack Horseman (2014—2020)
• Bojack blogpost on Tumblr by @characterdiagnosis
• Star Wars Episode III — Revenge of the Sith (2005)
• intense dysphoria and “that” ayahuasca ceremony… Episode 22 — Ayahuasca & The Fear
• Gabrielle Brand, Monash University
• Brand G, Wise S, Walpole K. A dis-ordered personality? It's time to reframe borderline personality disorder. J Psychiatr Ment Health Nurs. 2021 Jun; 28(3):469-475 (https://onlinelibrary.wiley.com/doi/10.1111/jpm.12682)

Links

Altered Mates Website

Altered Mates Instagram

Music for the show by Si Mulumby

A Glimpse of Eternity by Alejandro Tuama

• Purchase the novel here (hard copy, ebook and audiobook).
• Listen to the free serialised audiobook here.