Borderline Personality Disorder and the experience of women's trauma within psychiatry: a service user perspective

我的研究将调查被诊断为边缘型人格障碍（BPD）的女性的创伤经历。BPD是一种精神病学诊断，其特征是害怕被抛弃、自杀意念和行为、自残、压力相关的分离和不稳定的关系（APA, 2013）。据估计，被诊断患有BPD的人中有75%是女性（APA, 2013），而各种研究表明，童年创伤与成年后BPD的发展之间存在很强的联系。Battle等人（2004年）估计，81%的儿童报告遭受虐待，90%的儿童报告遭受忽视。对此的一种解释是对BPD诊断的性别刻板印象，女性被认为过于情绪化和寻求关注。性别刻板印象的负面影响是女性主义者对BPD诊断的批评的核心，因为它使女性的斗争和女性的社会化病态化（Becker, 1997）。此外，目前推荐的治疗方法，如DBT （Lineham,2014）和药物治疗（Hilger et al, 2003; Perrella, 2007）未能解决创伤的持久影响，这可能是人格障碍（PD）病因学的关键。社会学和服务使用者研究表明，BPD服务使用者的声音被忽视，部分原因是心理健康专家认为被诊断为BPD的人对自己的经历不可靠（Nehls,1999）。值得注意的是，在这种判断中，消极的、不和谐的刻板印象在PD领域的主要精神病学家的工作中被发现，比如Peter Tyrer。他关于bpdi的新书名为《驯服内心的野兽》（2018）。可以说，这本书是一种从诊所走向大众文化的大趋势的一部分。例如，一本非常受欢迎的“自助”书籍，为那些被诊断为BPD的人的亲人命名为“停止在蛋壳上行走”（兰迪和梅森，2010）。简介：“你是否感到被操纵、被控制或被欺骗？你是紧张的焦点…非理性的肆虐?…如果答案是肯定的，那么你关心的人可能患有BPD。”服务用户Rowan-Olive（2018）总结了与BPD诊断相关的刻板印象问题。她写道：“我的个性决定了我是谁。你不能告诉我我的自我是混乱的，然后说服我你不想把我变成一个刻板印象。

My research will examine experiences of trauma amongwomen diagnosed with Borderline Personality Disorder (BPD).BPD is a psychiatric diagnosis characterised by symptomssuch as fear of abandonment, suicidal ideation & behaviour,self-harm, stress-related dissociation and unstablerelationships (APA, 2013). It is estimated that 75% of peoplediagnosed with BPD are women (APA, 2013), while variousresearch studies indicate a strong association betweenchildhood trauma and the development of BPD in adult life.Battle et al (2004) estimate that 81% report instances ofchildhood abuse and 90% report neglect. One explanation ofthis is gendered stereotyping of the BPD diagnosis, withwomen perceived to be overly-emotional and attentionseeking. The negative impact of gendered stereotyping iscentral to feminist critiques of BPD diagnosis on the groundsthat it pathologises women's struggles and women'ssocialisation (Becker, 1997). In addition, currentrecommended treatment methods such as DBT (Lineham,2014) and medication (Hilger et al, 2003; Perrella, 2007) failto address the lasting impact of trauma, which may beessential to the aetiology of Personality Disorders (PD's).Sociological and service-user research suggests that voicesof BPD service-users go unheard, in part because mentalhealth professionals perceive people diagnosed with BPD tobe unreliable witnesses to their own experience (Nehls,1999). Significantly, negative, jarring stereotypes at work inthis judgement are found in the work of leading psychiatristsin the field of PD's, such as Peter Tyrer. His new book on BPDis titled: Taming the Beast Within (2018). The book, it mightbe said, is part of a general trend reaching from clinic topopular culture. For instance, a hugely popular 'self-help'book for loved ones of those diagnosed with BPD is titled,Stop Walking On Eggshells (Randy & Mason, 2010). The blurbreads: "Do you feel manipulated, controlled, or lied to? Areyou the focus of intense... irrational rages? ... If the answer is'yes,' someone you care about may have BPD". The problemof stereotypes related to a BPD diagnosis is summarised inthe words of a service user, Rowan-Olive (2018). She writes:"My personality is who I am. You cannot tell me my very selfis disordered and then convince me you do not want toreduce me to a stereotype.