Exploring Borderline Personality Disorder for Older Women - An Autoethnography

Abstract

Borderline Personality Disorder (BPD) is one of ten personality disorders listed in the DSM. From a medical perspective, it is thought to require a clinical intervention, to return a woman’s emotions to a socially acceptable level. However, this thesis explores the ways in which it is a gendered psychiatric diagnosis, which labels women’s emotions as problematic. I was diagnosed with BPD at 50 years of age, after an admission to a mental health facility due to severe mental distress. Unfortunately, all subsequent medical treatment proved ineffective and traumatising. It is the purpose of this thesis to examine the impact of the current medicalised approach to BPD on older women and through a critical analysis of my own experience, to address the research question, “How would a sociological perspective improve society’s understanding of older women with a BPD diagnosis?” This research is a user-led exploration of the impact of a BPD diagnosis on myself and also seeks to make contributions to older women’s mental health, by providing a broader understanding of the drivers of mental distress and highlighting the lack of responses beyond a medical paradigm. The methodology used was an intersectional feminist autoethnography to examine my BPD diagnosis. My data consisted of vignettes extracted from a diary I maintained for more than a three-year period (2019 – 2022). This data was thematically analysed, resulting in five themes including the invisible generation and the dismissal of women. The findings reveal that despite having no biological injury or illness, I was considered sick and expected to abide by a medical model of treatment. This model failed to consider the social determinants underpinning my mental distress and resulted in significant disadvantages and harms. These findings demonstrate that new approaches are required, including a substantial shift in understanding the social causes that lead to women’s distress and emotional responses.