The best part of my job as a service user trainer is seeing a professional change their opinion, or at very least want to explore their preconceived ideas surrounding personality disorder. I struggle to accept or sympathise with the blanket generalisations placed on people with the diagnosis without any real thought or exploration. I have lost count of how many times I’ve heard that people with personality disorder are manipulative, attention seeking, aggressive or purposely obstructive when delivering training. These thoughts are constantly held in mind and are often applied to people before they’ve even met them.
A personality disorder is not a ‘fashionable’ diagnosis. We don’t get the media coverage and celebrity backing that other diagnoses do; that leaves personality disorder being pretty much unknown about by the general public. We’re misunderstood and underrepresented.
Everybody has the capacity to be manipulative – people with personality disorder are actually incredibly bad at it. The best manipulators are those that leave you unaware of any manipulation taking place at all. What people fail to recognise is that what comes across as manipulating is actually a really clumsy way of communicating what someone needs. When you’ve gone through life not having your needs consistently met, sometimes you have to shout a little louder than everyone else to get what you need.
I’m not saying that people with personality disorder never manipulate people, I’m saying they don’t do it any more than anyone else would. It’s just how their communication is interpreted that’s the problem.
I have often felt stigmatised because of my diagnosis. I too have been accused of being manipulative by clinicians, family and friends. I don’t think I have ever consciously thought about how I can manipulate people to get what I want out of a situation – only the all consuming need to get my needs met in some way. When you can’t verbalise how you feel because you struggle to understand and process emotion, it becomes a game of I can’t tell you, but I can show you. When I was really unwell, I asked my psychiatrist to admit me as an informal because I felt like I was either going to hurt myself or someone else. He refused and told me that my manipulation wouldn’t work on him; apparently I was only asking for this because I wanted someone to look after me. I didn’t, this was a genuine attempt at getting help. A few days later I couldn’t fight the urge anymore. I was sectioned.
Now I’m not in crisis, I find that people have this sensitivity surrounding risk. This is something that also seems to fuel stigma surrounding the diagnosis. If I express feelings of struggling with something to my Community Psychiatric Nurse (CPN), her instant reaction is “shall I put you on home treatment?”. I don’t need home treatment. I feel my CPN doesn’t truly believe that someone can ‘recover’ from or manage BPD long term. I sometimes almost feel she’s waiting for the next crisis.
Sadly stigma is also alive and well within academia. When I applied for a counselling and psychotherapy degree, I got through all of the interviews and workshops and was then asked to fill in a declaration form regarding my mental health. Questions included what is your diagnosis? I thought being honest was the best policy, but I was wrong. Due to the information I had given them they were unable to provide me with a place because their indemnity insurance would not cover me due to potential risk. I couldn’t even make a discrimination complaint, because legally, they could not accept me.
Eventually, I got a place at the university I’m at now, after several attempts with private counselling schools, all of which refused, I feel, mainly due to my diagnosis. When at university, I was asked to be screened for dyslexia. It was in my notes about my mental health and the guy assessing me suddenly decided to start asking me questions… He asked what my diagnosis was and so I told him. His response was “You know they diagnose people with that when they don’t actually know what’s wrong with them, if anything?”. He then implied that it might be in my head despite me meeting the criteria for dyslexia. That’s right, everything that anyone with a personality disorder experiences is made up or psychosomatic, of course...
Really I should have made a complaint but I just couldn’t be bothered. I was concerned that he would use my diagnosis against me and make out I was a liar or I was being dramatic… Its not as if this hadn’t happened before, when it’s concerned my physical health and doctors have decided that it’s all been in my head.
Doing the job I do, I’m not really that shocked or surprised by the things people say anymore. I’ve heard it all before; but what does bother me is that others might not be able to shoulder it as well and the impact it could have on someone could be disastrous. I guess that’s what pushes me to do the things I do. No one should be made to feel bad about a label that they’ve been given on top of all of the other horrors that they experience day to day.
However, sometimes it feels as though whatever I do in life, it will always be discredited thanks to those 3 letters.