The concept of Borderline Personality Disorder (BPD) has evolved significantly since the designation was first described over 70 years ago. In 1980 when BPD was formally defined in DSM-III, most professionals viewed it as a diagnosis bestowed on difficult, unremitting, pain-in-the-ass patients. But it remained obscure to the general public. The original edition of our book, I Hate You, Don’t Leave Me: Understanding the Borderline Personality, in 1989 was one of the first referenced books directed to a general readership, as well as to professionals.
Starting in the 1990’s and into the twenty-first century other books on BPD have been published. Several of these are memoirs written by non-professionals describing family members, lovers, and themselves with borderline symptoms. During this time, greater public awareness of BPD has emerged. Movies, TV shows, and other fictional media references to BPD often portray those afflicted as wildly crazy, frequently suicidal, and sometimes dangerous. Fictional characters with borderline quirks can be attractive, dramatic, and colorful enough to animate a story. But they are often depicted as the villain of the piece. BPD is lumped with schizophrenia, bipolar disease, and substance abuse to explain erratic behavior.
Over the past 10 years, studies have demonstrated that, in contrast to previous assumptions, patients with BPD get better. They are no longer considered problem patients who never improve, and whom clinicians should try to avoid. Several treatment approaches have been developed specifically addressing borderline symptomatology. Clinical understanding, however, continues to surpass conceptualizations by the general public. Media references continue to characterize BPD as a dark, dangerous label for “crazy” behavior. Eventually, general understanding of BPD will catch up with scientific knowledge. For many years in the past, fictional characters who committed violent acts would often be labeled schizophrenic, even though few individuals with the diagnosis are ever violent. Someday, BPD will also be recalibrated in public awareness in a more realistic way.