So there's this french guy, maybe you've heard of him. His name is Michel Foucault and he's a philosopher - the type one would expect to be languidly smoking thin cheroots in the cafes surrounding Notre Dame, discussing existentialism with his peers, Sartre and Beauvoir. In his youth he was considered an oddity; he preferred the company of books instead of people, he was a devotee of the macabre, and very much isolated. In his first book "Mental illness and Psychology", he concluded that mental 'disorders' had been defined incorrectly, due to the notion that they had been measured and categorised in the same way as physical illnesses [otherwise termed organic pathology]. He argued instead that mental "disorder" [or pathology] was relative according to how society historically defined sanity and insanity. Or as he put it in less comprehensible terms,
"I would like to show that the root of mental pathology [aka. disease] must be sought not in some kind of "metapathology" but in a certain relation, historically situated, of man to the madman and to the true man."
- Mental Illness & Psychology, Michel Foucault
Foucault was also gay. And bear in mind also, that in his lifetime homosexuality was considered a mental disorder, so it's likely he had a personal stake in proving otherwise. He attempted suicide in 1948. I am also diagnosed with mental challenges, and have chalked up two active attempts. Naturally, I believe he was on to something.
70 years on, not much has changed. Professionals are still arguing about what is, or is not a mental illness.
Some mental illnesses have thankfully become outdated, for example hysteria, a women-specific illness characterised by anxiety, sleeplessness, irritability, nervousness and “a tendency to cause trouble for others.” This was once thought to be cured by a hysterical paroxysm, or as we call it today, an orgasm. Hysteria does not exist (although sexually frustrated women still do). But “Hysterical neurosis” didn’t disappear from the DSM — often referred to as the bible of modern psychiatry — until 19801Female Hysteria: 7 Crazy Things People Used To Believe About The Ladies’ Disease.
The Definition Difficulty
Like organic pathologies, the definition of what constituted a mental pathology had developed in two stages.
- Symptomatology, the occurance of certain frequently presented symptoms that experts considered a result of illness.
- Nosology, the consequence definition of forms and stages of the illness (as designated by the symptoms), as well as identified variants.
This assumed that was illness was a "thing" which could be specifically traced back through a set of characteristic symptoms. So for example if you have a runny or stuffy nose, sore throat, cough, congestion, a mild headache and sneezing, it is highly likely that these can be traced back to the common cold virus, and thus diagnosed. These symptoms are regarded as unchanging and can be objectively measured2Ideas sources from Foucault, The History of Madness, 1961.
However the problem with a mental illness being derived by a set of certain symptoms is that divergence from the norm is defined subjectively. It may be that women experience more anxiety than men, for exaple, but this statistic lacks social context.
In a nutshell, doctors, who were overwhelmingly white and male, and therefore statistically less likely to experience trauma due to their privilege, defined mental illnesses from symptoms they themselves had not encountered (and were therefore inexplicable).
Some men did understand trauma though. I suggest that Foucault, who according to his biography had experienced bullying as well as potential indicators of other childhood abuse, as well as stigmatization no doubt due to homosexuality, was one of them. Attempting suicide indicates similarly.
Foucault's sexuality is also important to my argument, because for a long time and even nowadays, it was necessary for queer folk to create a false identity, a mask so that they could go about their daily life without experiencing abuse or systemic oppression. They are more likely to live a lie, to believe the narrative that there is something 'wrong' with them because this is still the predominant narrative of our mainstream conservative society. They are more likely to experience deep and toxic shame, simply for being who they are. Hell, the Stonewall Riots were what precipitated my adoptee records being open (my hypothesis).
A hypothesis on Borderline Personality
The term Borderline Personality disorder was coined in 1938, by a man called Adolph Sterne who was at a loss to diagnose certain people who ‘fit frankly neither into the psychotic nor into the psychoneurotic group.’ It was a catch-all diagnosis which basically allowed doctors to move on and stop wasting time on patients they couldn't diagnose (or perhaps, couldn't be bothered to try more, because aren't doctors allowed to have a fear of failure too?)
Many people who are diagnosed with Borderline Personality Disorder, like myself, are given the diagnosis because we have several of the following characteristics. Despair, unstable self-image, loss of self, mood swings, fears of abandonment and rejection and a strong tendency towards suicidal thinking and self-harm.
Historically BPD has also been a woman's disease with three times as many women being diagnosed with it than men, although recent studies have shown otherwise.
Here's the thing, though. A woman's identity and role has tended on the whole to be more fluid than a man's. We're expected to change our names when we marry, we're supposed to assume different but radically opposing roles - the nurturing mother, or the sexual temptress (often in the same day). But woe betide we are too sexual, or sexual in the wrong way, the deviant way, because then we will be shamed simply for being who we are. We are the good girls, the sugar and spice, the obedient daughters who exemplify our parents' virtue. There are signifcant barriers to overcome to develop and live our true identity.
These systemic factors are experienced by many women. Not all of them are Borderline even though it is disproportionately experienced by them. But there is a group of people I suspect who have an even greater propensity to be diagnosed with Borderline, and that's female adoptees. I am a female adoptee.
Due to C-PTSD both directly and indirectly generated by Adoption, I have despaired many times. On the heels of despair, the state where you lose hope to ever be normal or happy, comes suicide ideation. In many ways I'm a product of rejection, and experience fears of abandonment and rejection. I also experience genealogical bewilderment and dysforia, because my face looked like no one I knew (and inaddition I went through a disfiguring car crash when I was twelve). I have had enormous difficulty in forging a Self - there have been many - due to narcissistic parenting which again, occurs disproportionately in adoptive scenarios.
All the symptoms that I experience diagnosed as Borderline can also adequately be explained by Adoption Trauma and it's direct and indirect consequences and/or legacy carried within my body. Others who are not adopted with a piece of paper, may also experience this group of symptoms. And still others might, especially those who also have intersections of childhood trauma and erasure, for example queer folk, where self-esteem issues or poor development of the self due to erasure occur and who develop a false sense of self simply to survive (which in itself is correlated with CPTSD).
And if that is true, you know who is least likely to experience it? White hetero- men with privilege and access to healing; doctors, like those who diagnosed it in the first place (because they couldn't understand it). But in a more modern doctor's words, and one who does know a thing or two about trauma, "if CPTSD was included in next DSM then it would shrink the book to half its size as it manifests in anxiety and mood disorders"- Pete Walker author of CPTSD: From Surviving & Thriving).
Nevertheless, I've written why I'm grateful to have the diagnosis; but if you don't want to read that post here's a big spoiler***whispers conspiratorially***When I fit nicely into a box they've made, they give me medicine.