What is Borderline Personality Disorder? Is there a better way to think about these issues and symptoms?
At PCH Treatment Center in Los Angeles, we believe that there is a serious need for a paradigm shift in how we conceptualize and treat behavioral health issues and the way in which mental health services are categorized and delivered. The term Borderline Personality Disorder has become pejorative and polarizing. While some centers encourage its usage, at PCH we find that the negative connotations of this term outweigh it’s appropriateness. In concert with our philosophy of avoiding stigmatizing labels, we prefer that our clients conceptualize their psychological issues in terms of trauma, emotional states and behaviors.
Many psychiatric diagnoses conform to the medical model of illness, in which the problem is seen to be residing within the person. We feel this model is not appropriate for conceptualizing all behavioral health issues. The medical model is reductionistic and convenient, as it provides a clear-cut approach to handling individual situations by diagnosing a mental health disorder (which can often be stigmatizing). These diagnoses are then increasingly used as a vehicle for prescribing psychotropic medications. At PCH, we feel there is a need to shift from a model in which psychotropic medication is seen as first line treatment for behavioral health issues toward psychosocial and holistic approaches with pharmaceuticals as adjunctive when necessary and appropriate.
Complex Psychological Trauma and its relation to “Borderline Personality Disorder” and Personality Disorders in general.
Letter from Dr. Jeff Ball
PCH Treatment Center was designed to fill a gap between outpatient treatment and psychiatric hospitalization. The population that needs this type of service includes many bipolar and mood-disordered clients, anxious clients, and clients that we’ve labeled with “AXIS II Disorders” or “Personality Disorders.” But what does that mean? So many of our younger clients, who range between 18-30 years of age, tend to have emotional regulation problems and would fit the criteria, as written, of Borderline Personality Disorder. But they also have significant trauma histories and would also fit a definition of Complex Post-Traumatic Stress Disorder (PTSD). Over the years, I have questioned the meaning of “Borderline.” Is the term really useful anymore? Is it now a pejorative term for difficult people? Is it even useful to use that label? At PCH Treatment Center, we have rethought the concept, asking a lot of questions about the utility of the personality disorder concept. We have instead chosen to focus on the causes of the person’s symptoms and behaviors in the context of psychological and emotional trauma.