A rose by any other name…

Still dies, rots and decomposes like anything else, I suppose.

Last week I talked about where Borderline Personality Disorder got its name. It may not stay that way forever though. Borderline Personality Disorder renamed? For some time now clinicians have been calling for the label of Borderline Personality Disorder to undergo official change. There are a number of different names used around the world and under consideration for the same disorder:
Borderline Personality Disorder (BPD) – Current
Emotional Regulation Disorder (ERD)
Emotional Dysregulation Disorder
Emotional Intensity Disorder (EID)
Emotionally Unstable Personality Disorder (EUPD)
Emotion-Impulse Regulation Disorder (EIRD)
Impulsive Personality Disorder (IPD)
Impulse Disorder
Post Traumatic Personality Disorganization (PTPD)
Complex Post Traumatic Stress Disorder
The most commonly used name today is Borderline Personality Disorder – or BPD – as defined in the American Psychiatric Association’s Diagnostic & Statistical Manual (DSM-IV-TR).
The term “Borderline” is a historic term coined to describe people who were diagnosed to be on the borderline between a neurotic and psychotic disorder. It is commonly felt that the “Borderline” label is misleading and stigmatizes the disorder. From the beginning the term Borderline Personality Disorder has been stigmatized and this has only been compounded by decades of misunderstanding. It implies that the entire person is flawed instead of looking at BPD as a medical problem. By renaming Borderline Personality Disorder it will be easier to move away from those stigmas that are automatically associated with the label. Originally it was termed Borderline Personality Disorder because it was thought to be on the ‘borderline’ of multiple diagnoses but not falling into any one category. However this is no longer believed to be the case. It isn’t on the border of anything. It is its own distinct problem; a disorder characterized by intense emotional experiences and instability in relationships, behavior, and emotions. Some clinicians don’t even want it labeled as a Personality Disorder because it implies that there is no hope for a cure when in FACT it has been proven that with psychotherapy and the aid of medication there is the ability to heal and live a life free from the symptoms that categorize BPD. They want it renamed and removed from Axis-II designation and placed firmly in the Axis-I category because of the high rate of comorbitity with other Axis-I disorders (as previously mentioned here).
Rumor has it that the fifth version of the Diagnostic & Statistical Manual (DSM-V) is likely to rename Borderline Personality Disorder (BPD) as Emotional Regulation Disorder (ERD) or Emotional Dysregulation Disorder (EDD). Indeed, Emotional Dys/Regulation Disorder is the most popular alternative for Borderline Personality Disorder. It’s felt that this more accurately describes the expression of the symptoms encompassed by BPD as it is just that, a disorder of regulating emotions.
Another term is post traumatic personality disorganization (PTPD) or complex post traumatic stress disorder, reflecting the condition’s status as (often) both a form of chronic post-traumatic stress disorder (PTSD) and a personality disorder in the belief that it is a common outcome of developmental or attachment trauma. I’m not sure I entirely agree with this because there are many people with BPD that don’t report any kind of traumatic event.  Personally, maybe, MAYBE, some arguable attachment traumas when I was a toddler, but even I don’t think this was so much environmental trauma as a predisposition to reacting the way I did. As I’ve mentioned in a previous post, I don’t agree that PTSD is an accurate diagnosis for me at all. I’ve had plenty of traumatic events to speak of but not until after my BPD began to present at a young age.  
Emotionally Unstable Personality Disorder…. Really? REALLY? Yeah, I see that diminishing the stigma that Borderline already has. Why don’t they just name it I-Am-Insane-And- Potentially-Violent-It-Is-In-Your-Best-Interest-To-Remove-Your-Children-From-My-Presence-Duck-And-Cover Disorder. IAIAPVISIYBITRYCFMPDAC Disorder is rather a mouthful though.  How about simply, BitchPleaseI’mCrazy Disorder. Seriously.
I’m against renaming Borderline Personality Disorder.  Renaming it doesn’t actually change a thing. Anyone with half a brain is going to know that ERD/etc is the same thing as BPD just with a new name, IF they even knew what BPD was to begin with. The symptoms are The. Same. Damn. Things. I mean, yeah it’ll take away the general stigma of BPD but then again, it may work to perpetuate others. BPD is already stigmatized as a female disorder. “Emotional this/that Disorder, Post Traumatic Something Disorder, those will all only perpetuate if not increase that particular stigma. It’ll make it more difficult for men to be diagnosed and make women an even easier target for ridicule. I can just imagine anytime a woman speaks her mind or has a strong opinion because she has an actual voice and isn’t a doormat, some douchebag guy is going to replace “is it that time of the month?” with “Emotional Disorders are treatable, get help for that shit”. It’s all ridiculous. In that way, Borderline is safer because a good majority of people don’t even know what it is so they can’t jump to asinine conclusions. So while, yes, ERD, encapsulates the fact that it is a disorder of emotional regulation, at the same time it almost trivializes the severity of what this disorder is. That is not okay.
Personally? I’m not sure I want it to be renamed. I like the term Borderline Personality Disorder. I like the idea that something can overcome the stigma and be understood for what it is; kind of civil rights activation for personality disorders, haha (for that matter I don’t like that there will be a full re-categorization of PDs from 10 to 5 in the new DSM V). I still don’t like admitting that I have a disorder of emotions because I was lead to believe that I needed to repress them for so long. At least Borderline doesn’t directly state a disorder of emotional problems (though obviously it is) since it doesn’t have Emotion in the title. It doesn’t stamp CRAZY BITCH on my forehead right away. Someone hears Borderline Personality Disorder and they may cock their head and ask, ‘what’s that?’. Someone hears Emotional Dysregulation Disorder and they’re going to start creeping backwards because this person is OBVIOUSLY emotionally unstable.
Idk, maybe I have no logical reason for it. Mostly it’s probably due to my attachment issues. I have a hard time giving anything up that I’ve become accustomed to and this label is one more example of that. I like the name, I don’t want it to change. I’m familiar with it. I mean… BPD is a disorder characterized by abandonment! Don’t make us abandon our label! It’s mine. I’ve embraced it. Don’t take it away from me! (Jokes. Sort of). And quite frankly, all the other names for it are kind of lame.
While I’m on the topic of continued designation of things; please return Pluto to its previous planetary status; “Dwarf planet“ is just insensitive.  

Borderline Between What and What?

MRS KAYSEN: So what is this borderline business you mentioned on the phone?
SUSANNA: What borderline business?
MELVIN: See, the mind…
SUSANNA: Borderline what?
MELVIN: …is the…
SUSANNA: Borderline between what and what? Melvin!
MELVIN: It’s a condition, Susanna. And it’s called Borderline Personality Disorder.
MELVIN: It’s not uncommon. Especially among young women.
MRS KAYSEN: What causes it?
MELVIN: We’re, we’re really not sure.
The name “borderline” comes from a school of thought that was common in psychiatry in the 1930s. These patients were then thought to be midway, or borderline, between psychotic patients and those who were simply “neurotic,” or had problems that could be easily helped by psychotherapy. In fact, the “borderline” patients at this time often seemed to get worse with psychotherapy. Many people would like the official name of the disorder to change to something that better reflects the actual difficulties people with it experience.
Borderline between neurotic and psychotic. Those are some disquieting diagnoses to fall between.
Don’t know why I haven’t posted this sooner. Oddly this explanation of borderline was surprisingly difficult to find when I first started looking for it. I wonder if that was intentional. It’s clearly where the stigma surrounding BPD originated.
You know what I think would be interesting. Uncovering how the treatments for Borderline have evolved throughout the decades. Dismissed, institutionalized, medicated, misdiagnosed… Curiouser and curiouser. Perhaps a post for a different day.
*I hate referencing Girl, Interrupted. It feels so cliché. However, I may write a Book Review because it’s actually more insightful than the movie.