I still remember clearly my own struggles when I was perceived to have BPD (EUPD). How hard it was to get people to listen and how often, when they did listen, they simply put whatever I said into a box that was already neatly awaiting my words. I am aware that people who have, or are perceived as having, PD are routinely given this same treatment. I am aware of this because of the experiences of my friends on-and-offline, and also because of my interactions with professionals, as a professional. It’s amazing what people will say to you when they have no idea who’s listening.
So, from multiple angles of experience, here is another thing I have noticed about the ways in which people with PD are often viewed.
Professionals often think that one of the markers of PD (and, to a lesser extent, of mood disorders) is wanting to change care providers (whether care-coordinators, therapists or entire care teams) frequently. This is seen as evidence of the fickleness unfairly attributed to people with BPD; or as evidence of a wilful desire to destabilise the team dynamic of professionals involved in their care; or of ambivalence, uncertainty, and the inability to make important life decisions. Or this old chestnut- it’s a sign of being manipulative. Of course.
Here’s another way of thinking about it. In what other situations are we expected to put up with a service that is inadequate or, for whatever reason, simply unsuitable for us? I’m planning to change my mobile phone service provider when my contract is up this winter. In the grand scheme of things, my data allowance is of minimal importance (even to me). Yet it is accepted- even expected- that if I experience even the least dissatisfaction with the service after several times of trying to “make it work” (if that!)- then I should change it.
Given this widespread acceptance of people changing services when a service doesn’t suit them, why does a similar understanding not then apply to people experiencing severe and enduring distress? Surely, by contrast with me finding my phone company unsuitable, it is much more crucial for a person needing help to ensure (within the limits of what is available) that the service is appropriate. Changing care-coordinators isn’t always an expression of “liking” or “disliking” someone (come on, let’s not take things so personally!) but a matter of finding someone it’s comfortable- or the least uncomfortable- to be supported by. Granted, this can be frustrating for care providers when needs/ wants have to be accommodated by overstretched teams of overstressed people. That’s understandable. I empathise. But that is absolutely not the fault of the person seeking help that it appropriate and suitable for them.
I also understand that, as within any group of people, with or without any kind of “disorder”, there will always be those (extremely few) who “play the system”; those who actually are indecisive, and those who can be straight-up disruptive. But associating these behaviours or attitudes solely to those with a diagnosis of PD, based on your subjective experience of what you perceive to be their “manipulation/ splitting/ indecision”, is unhelpful, discriminatory and often inaccurate.
Further, people who have experienced trauma (which many people with a PD diagnosis have) may experience issues with trust towards those in a position of either “authority” or “care.” Considering that trauma quite often involves the abuse of authority by someone who is supposed to care, it isn’t actually difficult to comprehend that someone who has experienced trauma might display a confused (and confusing) attitude to those that they perceive to be in a similar position. So yes, the desire to change care providers might be symptomatic of trauma (with or without a diagnosis of personality disorder)- but not because the traumatised person has some perverse desire to manipulate, cause chaos or upset people.
When I notice these negative attitudes towards people with PD, I try to challenge them. When I notice a negative myth about PD affecting my own views, I stop myself in my tracks and correct it. It’s impossible to offer positive and meaningful support to someone you have already second-guessed as being obstructive, manipulative, or unwilling to work with the (limited, sometimes inadequate) resources that you have.