I‘ve been doing regular Q&A’s on my Instagram stories every week, and I‘ve decided to start publishing some of them here to make them available for longer than just 24 hours, or for anyone who isn’t on Instagram.

Here are my responses to some of your questions from the past week:

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Q: I just got diagnosed with BPD and feeling pretty defeated. Any advice?

A: I’m sorry; getting a diagnosis can be a really difficult experience. A lot of practitioners don’t seem to understand the enormity of receiving a mental illness label and don’t offer enough support to help people cope with that transition into what’s inevitably a whole new way of understanding yourself.

Getting a “personality disorder” diagnosis in particular can make it seem as though everything you understood about yourself has changed. That you’re no longer the person you thought you were. It can come with a lot of confusion about where ‘you’ end and your ‘disorder’ begins.

For what it’s worth, it’s just a label and it doesn’t change who you fundamentally are. You are still you and you are allowed to define what healing means to you and what you would like to change, rather than seeing everything about yourself as broken and in need of changing. And you’re also totally free to ignore what you read about people with this diagnosis, including beliefs like they can never ‘change’ or have healthy relationships, because I guarantee you that’s just nonsense.

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Q: Advice on feeling “too needy”?

A: That’s such a difficult feeling. I think that’s something a lot of people to different degrees struggle with, which is completely understandable in a world that has systematically deprived the majority of us of what we need to survive — including community support, through multiple ways — and then taught us that independence is a desirable trait and that we must be failing at adulting if we’re umable to meet all of our needs on our own, which is literally humanly impossible. For disabled, chronically ill and traumatised people, this is particularly impossible and this messaging is ableist AF.

Unlearning internalised ableism has gone an incredibly long way for me in tending to this fear and insecurity, and constantly remind myself that all bodies and minds are naturally different and we all have different needs. There is NO “normal” body and mind from which we diverge. That’s part of what it means to me to take a Disability Justice lens to this diagnosis.

I might also ask: when do you tend to notice this fear come up in particular? Around whom? Around what needs in particular? How have you previously responded to this feeling that has helped?

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Q: What’s the best way to handle being someone’s FP is you can’t offer them the support they need?

A: In my view, the fact that you can be honest about this — that you’re unable to offer them the support they need — is already a huge step. It’s always going to be difficult when someone needs more than we can offer or that we’re able to connect them to, but what’s worse is how many people tend to handle this — shaming people for their needs, pulling away without saying anything, leaving people to wonder what they did wrong or potentially reinforcing existing beliefs about being “too much” or unworthy of support and care — is much worse.

I know this depends on many factors, but I would be honest and kind. I’d openly explain what kind of support I was unable to give, and make sure to emphasize that I didn’t believe in any way that their needs in themselves were too much or that they were a burden at all. I’d even thank them for trusting me so much with their needs and would communicate about what type of support I could offer. I think it’s so much better when we’re honest and openly communicate about what we can and can’t offer, rather than leaving people to wonder.

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Q: How can I or my FP / Favourite Person interrupt me from splitting? My splits cause a lot of stress.

A: One small thing could be learning your triggers. What triggers these moments in your relationship? Safety planning together for triggered moments can also be helpful; what kind of support would be helpful for you in those moments? What coping mechanisms can help you to ground yourself and to respond differently? It can also be helpful to discuss certain things that are causing harm that may be leading to these reactions. I also find it useful to have a conversation outside of moments of conflict about your boundaries, and what you absolutely won’t say or do in those moments.

Also how can you tell when you’re outside of your window of tolerance, where you may be more susceptible to responding to triggers in ways that don’t align with your values? For eg. you may find that certain things, such as interacting with certain people, make it harder for you to not ‘split’, and working to ground yourself or to take space may be more helpful than reaching out immediately to your FP.

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Q: Do you have any advice for if someone has two “Favourite People” and starts Splitting on both?

A: First off, I’d probably invite you to take a breath and offer yourself some compassion. I’m assuming there’s a lot of self-berating and self-hate coming up? It makes sense to feel that way. But we all cause harm. We all fuck up. We all do things we regret. Offering yourself compassion and grace can help with acting from a place of more clarity, rather than people-pleasing or avoidance out of a place of shame and guilt.

Secondly, how do you know that you’re ‘splitting’? How can you tell? Are you only able to tell in hindsight, or can you notice it in the moment or before? If we’re able to notice that we’re entering a place where we may act in ways we later regret, we can then start to bring more agency into that space. If you’re unable as yet to notice in advance or when it’s happening, taking note now of how you’ve been able to tell can be helpful in knowing what to look for in the future, to help notice and interrupt the pattern.

And, lastly, what feelings / messages were coming up for you in that moment (particularly about your FPs)? Unconscious narratives we create about folks’ actions can sometimes intensify our feelings about something they’ve done (eg. they don’t really care about me).

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I’ll be continuing to do regular Q&A’s for the foreseeable future and share some of them here, so subscribe / follow me on Medium (and opt in for email notifications) for future posts.

If you’re a mental health practitioner, healer or healthcare worker, you can also consult with me 1:1 on understanding and working with people diagnosed with BPD. If you’re someone whose loved one is a chronic trauma survivor (particularly of abuse), and you’d like support in caring for them, you can also consult with me here.

I‘ve been doing regular Q&A’s on my Instagram stories every week, and I‘ve decided to start publishing some of them here to make them available for longer than just 24 hours, or for anyone who isn’t on Instagram.

Before I begin, I do not believe in the construction of the diagnosis of “Borderline Personality Disorder” at all. For many reasons, which I’ve shared over time in my writing and on social media. One reason is that I don’t believe in diagnosing anyone, particularly not survivors, with disordered personalities. Another is that what is defined as a “disorder”, and in this case a “disordered personality”, is strongly rooted in capitalism, colonialism, and white supremacy. That does not mean that I don’t believe that the experiences and struggles of people with this label aren’t real, but that I don’t believe in the diagnosis.

That said, here are my responses to some of your questions from the past week:

Q: How can I deal with my therapist being my “Favourite Person” / FP? We both want me to stop idealising her.

A: I’m sorry; I can imagine that must be really tough. I think the length of time they’ve been your therapist is an important factor to consider here because the idealisation may not last once they start becoming more “human” in your eyes.

Naming that this is an “FP attachment” can also be helpful here when you start idealising them. It’s a recognition that how you feel about your therapist isn’t entirely grounded in reality, and isn’t entirely about them. I find it also helpful to notice what about them makes them your FP. It’s easy to idealising someone who offers you the validation, support, understanding and any other relational needs you’ve been missing for so long. Can you try naming some of the needs you find met through this relationship, if applicable? And reminding yourself that they aren’t doing anything “special”, but treating you the way you inherently deserve?

If your therapist is also the only person you feel safe with, it makes sense you consider them your FP. Finding other ways to help you feel safe and to have your emotional needs met, even if it isn’t through another person, can be a way to become less dependent on your therapist alone.

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Q: How do you cope as a person with BPD with the situation in Palestine / Genocide?

A: I just want to first name that I don’t believe in this diagnosis for multiple reasons (which I’ve got a lot of posts that go into in more detail). This, of course, does not mean that I don’t believe the experiences of people diagnosed with BPD are real, but that I don’t believe in the label they’re being conceptualised through.

Secondly, thanks so much for this great question. Well, I cry everyday. More often now as the violence is increasing. I can understand that this is a difficult time for people who struggle to feel their feelings, especially their grief. It’s important that we learn to make space for our grief. Take classes on (non-pathologising approaches to) grief. There are a lot of folks on IG who offer great courses on grief. Make space for your grief. Create rituals around it. Honour it. Remind yourself that it is safe to feel this grief. Grief is normal response to what is happening. Create a container around your grief. Being able to feel our grief right now, learning how to feel it is going to be so important in surviving this and not turning away from Palestine when they need us.

Also knowing that you are not alone in your grief. Every post that you see about Palestine is someone who is also grieving. You are not alone in this. I beleive that the vast majority of the world is also grieving for Palestine. Following people and joining groups who are speaking out and organising for Palestine right now can help you feel more solidarity and less alone and powerless.

Also rememebring that your suffering is linked to theirs. Our suffering is bound up with theirs. It’s the same systems that are driving us into isolation, traumatising us, diagnosing us as disordered, and withholding resources from us that are destroying Palestine.

Abuse, state violence and systemic oppression are inextricably linked. Our suffering and our own liberation are linked to theirs. Remembering that helps to remember that the grief I feel for them is also the grief I feel for myself. That fighting for them is fighting for my own life as well. Political education can be helpful in making sense of this violence and reminding us that we are part of something much larger at work and liberation, for all of us, is only a matter of time. This degree of violence is unsustainable.

Taking care of your nervous system is also really helpful, which includes not just constantly consuming traumatic imagery without intention. We can show up in solidarity with Palestine while also setting boundaries around how much violent imagery we consume, so we can keep our work sustainable. Rest, turn to the things that nourish you and offer you comfort. Check in with your physical needs.

And, lastly, it’s okay to give yourself grace if you can’t function like before. Not being okay right now is a normal response to what’s happening around the world. We’re not meant to continue functioning like everything is fine. Struggling right now is an important reminder that we’re part of a collective. It’s a normal response to abnormal events.

Reject any BPD account — particularly any white person in the Global North — that tells you to tune out the genocide in Palestine “for your mental health”. It’s not only inhuman for us to choose inaction and apathy when people are being slaughtered and starved, but it’s also unsustainable to think that we can turn away forever from root causes of our suffering (when we understand our suffering to be connected). While it’s important for us to take care of ourselves and find ways to cope and to survive, we also need to be working towards our collective liberation.

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Q: I just broke up with my bf who is also diagnosed with BPD. How do I deal with this? I feel empty.

A: I’m so sorry. The first few weeks of a breakup are especially hard. If it was a relationship that you definitely can’t go back to / that ended for important reasons, I would advise you to prepare for moments when you feel compelled to reach back out to them. That may be moments when you’re triggered and you feel unsafe. They may have been the person you turned to for safety, so safety planning in advance for triggers is a good idea. What will you do when you’re triggered? Who or what coping skills or resources will you turn to? Where else do you find comfort and safety?

I’ve found it helpful to write a list of reasons why I shouldn’t go back to or reach out to this person for later on when the urge feels overwhelming. And also recognising ‘cognitive distortions’ when they come up was helpful for me. It’s unlikely that I can predict the future and know for sure that I’ll never meet someone else or that it’s always going to hurt this way.

Another factor that contributes to how much we’re suffering is that the world feels reduced to this experience. This pain, this loss and grief feel like all that exists in the whole world. This breakup, and looking at our phones, and old pictures of them feel like all that exists. Our perception of the world gets so small and limited. Finding ways to expand your world in any way, even reading books and watching movies and documentaries and peering into other worlds can help make the world feel just a little bigger.

Finding any kind of support or community, such as virtual peer support groups, may also help with the extreme aloneness. I don’t know what kind of support you have, but I hope you have some support. No one deserves to be completely alone, and if a romantic partner was our only source of connection, it’s extremely hard to lose that. Sending love and wishing you the best.

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I’ll keep doing Q&A’s for the foreseeable future, and sharing them here, so make sure to subscribe / follow me on Medium (and opt in for email notifications) to see future posts.

To begin with, the diagnosis of “Borderline Personality Disorder” represents an extremely vast and varied group of people across the globe. It represents Indigenous peoples, people from numerous cultures and historical backgrounds, people with extremely diverse experiences and wounds.

The diagnosis — as psychiatric diagnoses in general do — aims to homogenise an extremely varied portion of the globe, and it’s critical that we resist this homogenisation and remember that the people bearing this label come from significantly diverse backgrounds and that there is no one book, video or anything else that can possibly speak to all of these experiences. They also cannot honour the variety of cultural backgrounds that people are coming to this label from and the specific ways that care looks like in their culture.

That said, this advice comes from a non-pathologising, anti-ableist, anti-carceral lens and is much more compassionate than the majority of the literature that exists on how to “deal with” people with this diagnosis or that advocates for approaches that still rob people of their agency.

1. Pace yourself for the long-term & stop pressuring people to heal

Many people are great at showing up in moments of acute distress, but eventually become burnt out or frustrated with offering long-term care. People tend to become frustrated with their loved ones for “still” being suicidal, for “still” struggling, or for needing care on a longer-term basis than they were prepared to give, and project that frustration onto them.

Can you instead reflect on what your own limitations are? On what kind of help you can offer? What resources and boundaries you would need to be able to show up for that person sustainably? What expectations you have of the other person?

I’m tired of hearing of people with this diagnosis, and disabled and chronically ill people in general, being given a very short timeframe within which to be “healed” or to be allowed certain levels or types of care, and of people becoming exasperated and judgmental when they exceed that allotted window.

A common response to this is that people are just concerned and want their loved ones to be okay. But caring about someone and wanting them to be okay are not synonymous with imposing timelines onto them and pressuring them into your vision of healing. We are also imposing judgments about the capacities and abilities of someone else’s body and mind by deciding for them how long they should be allowed to receive care and what type of care that is.

Instead of determining how long anyone else should need care for, in accordance with the principles of Disability Justice, can we trust people to be the experts of their own bodies and minds, and instead determine what we can offer?

2. Sometimes people will not accept your help

I understand being frustrated with offering help that the other person refuses. Maybe they’re afraid that the help you’re offering is conditional, based on letting go of things they’re not ready to or don’t want to let go of at all.

Maybe they’ve had experiences of care that were traumatic or where they were forced to mask and to ‘perform’ in ways that were more acceptable to those offering it. But trauma survivors don’t always act in ‘logical’ ways. What can make a survivor feel safe may make no sense to someone else. Can your care withstand this? How does the person you’re caring for need to act in more palatable ways in order to receive your care?

And sometimes what we’re offering is just not what they need or want. Sometimes people don’t want to be “helped”, but to be witnessed in their suffering, to break down, to cry, to be validated. Sometimes people simply want your presence. So many survivors and psychiatrised people are never asked what they want or need and are so used to having care imposed upon them in the ableist belief that it’s what’s “best for them”.

As radical as this may sound, people actually do have the right to refuse care.

“As we fight for the right to receive care, we also have to fight for the right to refuse care.” — Mia Mingus

How do you react when the help you offer is refused? Does it anger you? Does it drive you away from person you’re offering to help? What judgments do you make of someone who’s struggling when they refuse your help? Is your care conditional and based on what conditions?

Care work involves much more than just concrete, actionable steps that we take in our relationships — it also involves investigating our underlying values that create distance and wounds in our relationships unnecessarily.

Exploring our values in how we approach care can be the difference between setting boundaries in ways that maintain intimacy and trust and in ways that make people feel like a burden, engender shame and dissolve trust. They can be the difference between someone feeling like a “problem” to be “fixed” and the comfort of knowing that they have the space to safely express and be themselves.

For more in this series, subscribe to my Medium account and turn on email notifications for alerts about future posts. You can also subscribe to my mailing list to receive more advice, writings and resources directly in your inbox.

A “favourite person” or FP is typically defined as someone that you feel a very strong connection with and whose attention and validation can have an immense impact upon your mood and your self-worth. An FP can be the one person in your life that you feel safe with, the person whose attention can instantly change your mood, and, without whom, everything can feel utterly bleak and pointless. Rejection from your FP can feel like the end of the world, and their validation can make life feel worth living again.

Of course, this is an immense amount of pressure to be placed upon just one relationship, as it’s impossible for one person to meet all of our relational needs.

While it’s not that easy to simply stop feeling so intensely about someone, there are things that you can still try to make the relationship easier.

Firstly, letting them know that they’re your “Favourite Person” can be difficult depending on the specifics of the situation, but it can also be helpful. Even if that isn’t the language that you use to describe the relationship, it helps for people to be aware of the expectations that you have of them, the impacts that certain actions can have on you, and what both of you can do to make the relationship work .

An FP is often an intense attachment, and being able to openly discuss this attachment, what expectations you have, what triggers, what boundaries they need in place can make things easier for you both.

It’s also important to be aware of your perception of them. How much are you idealising this person? Are you able to see them as a complex and flawed person? An FP may be someone that you perceive as nearly perfect, but they’re just human and they will make mistakes, including when it comes to your relationship.

Develop a plan for when certain triggers come up in your relationship — such as if they take a while to respond to you or if you have to spend extended time apart. If your mind automatically makes catastrophic meaning of certain actions of theirs, it can help to have a plan for when these triggers arise, so that they don’t overwhelm you and you don’t react in a way that’s out of alignment with your values and that you regret. What are some of your triggers in this relationship? What resources can help you through them?

Some people find it helpful to keep a list of reassuring statements for those moments; for eg. taking time for themselves doesn’t mean that they don’t care about you. Others also keep reassuring messages from their FP themselves for these moments and other things that remind them that their FP still cares about them.

Deliberately taking the time to cultivate your life outside of them. Admittedly, this can be difficult, but it’s really helpful to force yourself to regularly carve out time without them, with or without other people. Figuring out your likes, engaging with your interests and your culture, creating, writing, reading, connecting with communities with shared identities and interests — in whatever ways you can — can be so helpful in maintaining your relationship with this person by building a deeper connection with yourself, one that exists outside of your relationship with them. These things can also help to make it easier for the times when you have to be apart.

It also helps to share your time among others — other friends and people you know. These interactions don’t all have to be deep and meaningful, but it helps not to make your FP the only person that you interact with on a regular basis.

Communicate with them about what capacity they have to support you, and what kind of support they can offer. Sometimes the type of support that you need from them isn’t within their capacity to offer or isn’t something that they know how to offer. Sometimes, the support that people offer us isn’t what we want.

Instead of expecting them to know what you need, openly communicate with them about what kinds of support you need in different situations, so that you can prevent moments of misattunement that may make you feel as though they don’t really care for you and that may place unspoken, unfair expectations upon them.

Also having honest conversations after these moments do occur can help to address and repair potential ruptures in the relationship.

Being able to label that this is an FP attachment is also a major step towards working on it. Are you able to tell if this is an FP attachment? What tends to signify this to you? How do you act around an FP? How do you feel around them, what do you expect from them? How do you feel when they’re not around?

Extend compassion to yourself for not being where you’d like to be as yet. There may be a lot of shame and self hate for continuing to have an FP attachment — but you’re literally not doing anything ‘wrong’ for feeling this way.

Not only that, but self-compassion is much more likely to help engender any change that you would like to see than self-hate is. It’s okay to give yourself grace. FP attachments can be really hard, but, with time, they can get a lot easier.

Many of you know that taking a critical, anti-oppression lens to the psychiatric diagnosis of borderline personality disorder is something that I spend a lot of my time doing. In light of the people who still believe that all people diagnosed with BPD are terrible, dangerous people and who chose to share comments that this “anti-oppression stuff” is just to distract from that, I wrote a short list of what bringing an anti-oppressive lens to this diagnosis means to me.

This is by no means an exhaustive list.

1. Acknowledging multiple ways of sense-making of these experiences beyond the biomedical model

There are endless ways of making meaning of these experiences and traits, some culturally-based, some spiritual, some sociopolitical. Even the neurodiversity paradigm is an alternative to the moralising and hierarchical nature of the pathology paradigm that defines all of these traits as ‘disordered’ and in need of curing.

There are so many other ways of understanding and making sense of our experiences and traits, and an anti-oppressive approach to this diagnosis, to me, involves de-centering psychiatry’s authority as the ultimate or only way of understanding our experiences.

2. Recognition of healing as a relational process as well, instead of emphasising hyper-individualistic approaches to healing

While the importance of relationships is incorporated into aspects of BPD recovery, such as a recognition of the significance of peer support, recovery often remains overwhelmingly individualistic. This is in conjunction with the fact that we can actually interpret many of these experiences and struggles in the first place as the result of living in a hyper-individualistic culture, and this diagnosis as potentially a pathologising of more collectivist values.

Even traits like shame and self-hate, that tend to be considered as individual struggles and are often offered individual forms of recovery, can be seen as relational struggles.

3. A recognition that many ‘BPD symptoms’ can also be responses to ongoing systemic traumas

Closely related to the first point, I thought this deserved to be noted on its own, because once there’s a BPD diagnosis involved, too many practitioners treat responses to ongoing systemic traumas as the result of internal or past issues. How do we talk about ‘symptoms’ like identity struggles, low self-worth, shame and self-hate without talking about white supremacy, for example? How do we talk about dissociation without the ways that capitalism depends on our disembodiment? Bearing a BPD diagnosis does not divorce us from the impacts of the world around us.

4. A recognition that a lot of the ways that recovery from BPD is defined is by ability to conform to oppression and to partake in oppressive institutions

As Bruce M.Z. Cohen writes, “dominant norms and values of society are normalised and deviations from them are pathologised“. The struggles and experiences of people with BPD are real, but much of how ‘recovery’ is defined is by ability to partake in oppressive systems and to conform to values that uphold these systems. I believe that an anti-oppressive approach to BPD should allow for definitions of recovery to be a collaborative process.

5. An understanding that perceptions of these traits, such as ‘emotional dysregulation’, are not neutral and vary based on a person’s social location

What is considered ‘emotional dysregulation’ is not neutral. Here is an excerpt from a post that I wrote for Instagram: “Many of you know that I’m not a fan of the term ‘emotional dysregulation’, considered to be a core feature of Borderline Personality Disorder. It’s vague and elusive and does not account for raced and gendered perceptions of emotions, nor how the subjective interpretation of emotions is used as a tool of oppression […] Can we move past the idea of ‘regulation’ as a standard, neutral concept? Can we consider its limitations, its harms, its subjectivity, its culturally-bound definitions?”

6. De-centering DBT and Western Eurocentric forms of healing as the ultimate or only forms of healing

These are not the only means of accessing healing and recovery, however these terms are defined, and even when they are extremely useful components of our healing process, they may not be the only or main factors that contribute to healing. Recognising the significance of other forms of healing is also a way of honouring the spiritual and healing traditions of other cultures, many of which have been extracted from their cultures of origin and appropriated into the Western psy-disciplines.

7. Moving beyond destigmatising efforts alone to questioning how the devaluing of these mental differences and different ways of being is beneficial to the dominant social order

Destigmatising efforts alone without structural change still leaves us vulnerable to harm, particularly the most disadvantaged of us. In what ways is this socially-constructed hierarchy of bodies, minds and ways of being actually beneficial to the dominant social order?

I don’t believe that an anti-oppression approach to this diagnosis is optional, but that it’s necessary — it can help to deepen our individual healing and to get us closer to a future where these forms of suffering stop repeating themselves at such a large scale. We can move beyond individual healing, and, by applying an anti-oppressive lens, hopefully use our struggles and experiences as portals for collective change.

If you’d like to see more of my work, you can follow me on Instagram here and here, and sign up to my mailing list. If you’re a mental health worker and would like to shift the ways that you may have been taught to view people diagnosed with BPD, you can consult with me 1:1.

Content warning brief trauma mention.

Feelings of emptiness have driven so many decisions that I deeply mourn. Decisions that have caused me further trauma and that have impacted my health.

I’ve let go of the belief that things could have ever gone any differently, that I could have, should have done things any differently. Because I didn’t have the tools that I have today, I didn’t have the resources or the abilities that I have now, and those decisions were made at a time when they were all that I had to hold onto to survive.

This isn’t an exhaustive list by any means, but hopefully it can inspire some ideas that can help you survive instances when those feelings of emptiness get to feel insufferable.

Some trauma survivors attribute their feelings of emptiness to an inability to feel safe. We all deserve to be and to feel safe. It’s a basic human need. Chronic trauma, including the ongoing traumas that many of us are still enduring, can strip us of our ability to feel safe, and feeling unsafe can make everything feel absolutely colourless and meaningless. Finding ways to establish a sense of safety again is a foundational part of healing from trauma.

Some people also attribute them to a sense of purposelessness and a lack of a sense of identity.

I also believe they have a lot to do with disconnection and not just from one another, but from the rest of the natural world. It’s not a coincidence that some folks associate their sense of emptiness with feelings of loneliness. This disconnected way that we live, expecting one romantic partner to fill all of our needs for connection, disconnected from the rest of the natural world, it’s hard not to feel empty.

One thing that has helped me to cope in the moment is to label it. When it feels overwhelming, labelling that I feel a sense of emptiness and identifying where exactly I feel it and what it feels like has been helpful in containing it and in reminding me that I’m just experiencing transient sensations.

Also, challenging the belief that this feeling is never going away by remembering all of the times I’ve felt this way before and that it’s never lasted has helped. That’s one thing about feeling overwhelmingly empty. It always feels like it’s going to last forever and that belief in those moments has only made me feel worse.

Movement has also been helpful and can help to bring my focus to other parts of my body that have more pleasant or neutral sensations. Depending on my capacity at the time, this can be as simple as just getting up and walking from one room to another. Some people have shared that exercise in those moments and going for long walks have helped them. Movement also helps me to shake off that sense of immobility that can come with feeling unbearably empty.

Grounding techniques that involve the sense of touch have also helped to shift my focus to different, more tolerable sensations in my body. For example, I may shift my focus to the feeling of a really soft blanket or to something with a really distinct texture.

Many of us have also been very disconnected from our cultures, whether through colonialism or other means. Reconnecting to your culture in some way can help with a lost sense of self, and I always strongly recommend this to Indigenous peoples.

I’ve also just come to see emptiness as a compass, noting in what situations I feel it the strongest and around whom. I haven’t lived in a lot of safe places, and I remember one day, as we were nearing my-then apartment, that sense of emptiness just growing in me, becoming more and more intolerable, and it occurred to me that this was something worth listening to.

There isn’t always a lot of power we have to make environmental changes, but interventions that always focus on ‘curing’ or ‘regulating’ us out of our distress can miss the opportunity to see it as a form of communication that the issue isn’t internal but external. Is there any action that you can take towards making external changes, in your individual environment, for eg. to get yourself away from an unsafe place? Or from people who treat you poorly? Or a relationship that isn’t really for you?

And on a collective level, what actions can you take to transform the systems that are impacting our safety and wholeness? Justice-oriented work can give us a sense of agency in the face of all that’s making us feel hopeless, in the face of the discrimination, violence and deprivation that are denying many of us wholeness.

Being around nature when possible has also helped. I’ve also started collecting images of the world that bring me peace and looking at them whenever I feel unsafe or unbearably empty, and it helps so much to bring me back to a sense of peace.

Remember, it’s a human need to feel connected to the earth. I think one of the most life-changing things for me has actually been changing my relationship to the land from one of dominance and extraction to connection, which is our current dominant mode of relating to the land, and instead understanding it as also vibrantly alive and deeply interconnected with my own survival.

Many Indigenous peoples have had very different relationships to the land than we have currently and I encourage us to reclaim those relationships and see how it impacts that sense of emptiness you feel.

Art is another thing that has helped me to survive these feelings and that, even amidst some of the worst circumstances of my life, has made my life feel worth living. Writing, reading, music, photography have all brought a sense of purpose and beauty to my life. I think that even if we never show it to anyone else, art is also in its own way a form of connection.

Trauma also makes our world smaller and art can help us remember that life still exists far outside of the things that have happened to us and, even if temporarily, it allows us to dream again. It’s no surprise that many people have shared that things like music and writing have helped them.

People have also shared that thrills like roller coasters have helped them. So have horror movies. As with any coping mechanism, I think it’s just important that we weigh any potential consequences and make sure that we’re not seeking thrills in things that can harm us or others.

And, lastly, rewatching TV shows. Someone specified that the predictability can be grounding and comforting. I keep a list of my comfort series and movies and I rewatch them so regularly, especially when I need to feel safe. I also believe that getting caught up in someone else’s world can help us to feel a sense of connection.

I’m a big fan of making lists, and listing the things that help you when you feel empty– and adding and removing things from this list over time as necessary– can help in moments when we really need them but can’t recall them. Safety plans can be a type of document that we use to list our survival resources.

It can also be helpful to create a sort of hierarchy of resources. There are those that we can draw on often, because they’re not only accessible but they also come with minimal consequences.

And then there are those that we may not want to draw on as often and we can list those as more of ‘emergency’ resources for when things get really bad. At least, doing things this way has helped me.

What are some other things that you do when you feel empty that help you? Feel free to share below!

Content warnings: abuse, ableism, involuntary institutionalisation, victim-blaming, murder, gun violence, trauma.

To begin with, this isn’t an essay on the many ways that the psychiatric diagnosis of “Borderline Personality Disorder” is disastrously harmful.

It would take much more time for us to get into the extents of the harms of this diagnosis and how complicit it is in allowing for interpersonal and institutional violence. This essay only offers some brief insights into some of the issues with this diagnosis, but more than anything, it’s really a reflection on the complexities of what it means to engage with a thing that can be both a catalyst for healing for some and an incredible weapon in one — very often for the same people.

Rejecting and criticising this diagnosis is not new at all. It’s been heavily criticised since its inception and even labelled the “dustbin diagnosis”.

There have always been advocates who have fought for its removal from the DSM, on the grounds that it is nothing more than a tool of patriarchal control to pathologise women who deviate from social norms, and as a way to contribute to the oppression and revictimisation of abuse victims — including those who have been victimised by the healthcare system.

And these incidences are not hard to find — in fact, they’re tragically overwhelming.

There are endless stories of people (often people from already oppressed communities like trans and POC) being victimised by the healthcare system in their country, and then being labelled as “borderline” as a way for clinicians to justify their mistreatment and harm. Because, of course, once a person bears a diagnosis of BPD, people are much more willing to accept their mistreatment. Bearing a psychiatric diagnosis somehow makes people more deserving of inhumane treatment than “normal” people do. We’re okay with medical abuse and neglect when they’re “borderline” — which can really mean so many things, including a person whose care needs are considered “too much” by a system that is designed for profit, not people.

In the years that I’ve had my Instagram account, I’ve spoken as much as I could, from as many angles as I could, on the problems with this diagnosis — as I could because I’ve still had to be careful as a person living where I do in the Global South with the extent of what I say.

Still, I’ve spoken on some of the ways that it’s used to depoliticise and individualise the impacts of systems of oppression, including colonialism and white supremacy, by labelling them as “symptoms” of a “mental illness”.

I’ve spoken about the elusive nature of the concept of “emotional dysregulation”, and how dangerous it is to assume that there is such a thing as “emotional regulation” and to pathologise deviance from it, when the subjective interpretation of emotions has been and continues to be used as a tool to control oppressed populations. This makes a psych diagnosis that contains “emotional dysregulation” as a core feature a powerful weapon.

I’ve spoken about how this diagnosis is used to further oppress survivors by decontextualising their experiences and actions from their abuse. In a society where there is often just no winning at all for survivors, no matter what, the diagnosis of BPD plays a key role in this by allowing society to divorce survivors’ responses to their abuse from the abuse that they endured, often giving abusers a free pass — including within the legal system — and shaming and villifying survivors for how they were changed by the abuse they endured.

Yet, even with all of that, there are people who have found meaning and healing through this diagnosis, and not just white people, who tend to dominate the destigmatising movement, but people from all types of backgrounds have claimed this diagnosis and found understanding through it.

I once had a conversation with someone who shared with me a feminist critique of the diagnosis and said that they agreed with all that was said, but that they still needed resources for healing anyway. I’ve thought about that conversation a lot. There are so many conversations I’ve had with people over the past year in the forms of what do we do with this diagnosis while it continues to exist? Do we ignore it? Do we refuse to use it at all, so as not to unintentionally lengthen its life or validate its construction? Do we use it with a constant reminder of its problematic nature?

I’ve yet to find definitive answers in any movement, and I’ve come to believe that there isn’t one definitive answer to this problem. I think that’s just the way they’ve set this up.

For one, this diagnosis often offers the belonging that many folks have been deprived of, and that can make it so magnetic to those who, for the first time in their life, have only ever found belonging with others labelled borderline as well, based on shared experiences — including the experiences of being oppressed and harmed through this diagnosis. We’re all wired for belonging, and if bearing this diagnosis is one of the few ways you’ve ever been able to feel like you belong somewhere, it can be really hard to give this up. Even if it can be used against you.

It can also be very validating. For many people, receiving this diagnosis is the first time in their life they’ve ever found validation for their suffering.

Many trauma survivors (which, according to various statistics, constitute a large portion of people with this diagnosis) have had their suffering treated as if it weren’t “real” or as if it weren’t “enough” to be taken seriously. Ironically, bearing this diagnosis often also leads to people holding those same views towards the bearers anyway — literature has shown cases of practitioners withholding care from people because they have a BPD diagnosis and are, therefore, considered to be exaggerating their suffering. This often forces people with BPD diagnoses to “perform” their suffering in large ways to be taken seriously and given the care they need.

Regardless, it has given a lot of folks validation. A large portion of people with BPD diagnoses are trauma survivors, and we live in a world that does everything but validate the experiences of trauma survivors.

Too tired from the physiological impacts of chronic trauma to work the 40+ hours a week that capitalism demands, or have a nervous system that finds the sensory environments of most workplaces to be too hostile to tolerate? You’re just lazy or spoiled.

Can’t remember the exact details of your trauma and didn’t immediately react to it the way that people believe you should have? You’re just making it up.

People often diminish trauma and hold very narrow definitions of what trauma can be. Where I live, trauma often remains confined to the realm of war violence and “major”, exceptionally violent events, like gun violence, and your experiences must be truly extreme to even be considered as traumatic.

And, yet, even with events like these, this invalidation still occurs.

I was a witness to a murder once. It was so incredibly traumatic that, for months after, I just couldn’t sleep. I kept waking up in the middle of the night with this distinct feeling that someone was waiting outside with a gun to finish the job. It made no sense in the light of day, given that the perpetrators never even saw me, but eventually this recurring night-time fear left me too sleep-deprived to go to work and I asked them for some time off.

When I told a friend at the time (they’re no longer a friend, in part due to their constant ableism) that I was taking time off work because I was so tired from the impacts of this trauma, they told me that I was “lucky” and that they wished they could take a vacation from their job, too. It was not a vacation. I was deeply suffering from PTSD and the only time that I felt safe enough to sleep was during the day. I didn’t bother to defend myself in that conversation. I just sighed and let it go.

I think that, at every turn, trauma survivors find invalidation in our society.

Society, then, gives a survivor this label that finally validates their suffering — even if it does so in incredibly problematic ways — and it’s the first time that many finally feel as if their suffering and their experiences are real. And that they actually deserve the care that they’ve been seeking and have been chronically denied.

I am absolutely angry at the ways that this diagnosis has historically been complicit in causing immeasurable harm. It was used by my abusers to deny the abuse that I endured by citing my diagnosis as “proof” that they were actually the victims, and, in turn, they attempted to have me institutionalised in a place widely known for its horrifying abuse. And, of course, this diagnosis makes all of these things possible. It decontextualises the impacts of abuse by pathologising victims as “disordered”, and many aspects of the ways that this diagnosis is constructed easily fuel the belief that people bearing this diagnosis are violent (for eg “inappropriate anger”).

This is only one of the ways that this diagnosis has personally caused me harm. And, still, I don’t see it as my place to tell anyone not to use this diagnosis if it brings meaning to them — and I find it especially uncomfortable to dictate to people from oppressed communities what they can and can’t do with this diagnosis — people who often offered the least autonomy and agency in our society.

I do, however, believe that we should constantly revisit our use of it, and recognise how we may unintentionally be contributing to its harms. How might we be perpetuating narratives around this diagnosis that have been used to harm people? How does the language that it uses or what we’ve been taught “causes” it harm groups of people? Constant revision — that’s what I commit myself to now.

There are people who have reclaimed the diagnosis the way that they’ve reclaimed the word “mad”. There are people who reject it and who police others’ use of it, too (these are often white people, infuriatingly enough, unilaterally leading movements again without involving the leadership of the most disadvantaged).

There are people who have had it weaponised against them by their abusers and by ableist healthcare providers and who still use it.

I also think that, as long as this diagnosis exists and continues to cause harm, ignoring it won’t help and doesn’t make sense. People are going to continue to use it to search for resources, community and understanding, for themselves and for their loved ones, and I prefer that they find resources that are anti-oppressive in nature — that don’t individualise and medicalise all of their suffering, and that advocate for anti-carceral approaches to care.

I don’t believe that there is one simple approach, and I don’t believe in movements where decisions are unilaterally made by a few people and then imposed onto others.

But what can we do differently if we’re committed to using this diagnosis to help people to feel less alone and to offer them the tools that have helped us to survive? How do we do that, how do we reach out to one another and offer the things that can help keep the other going, while also holding space for the ways that our meeting place is a site of harm and violence and oppression? A thing that can facilitate healing (where applicable) and a weapon in one.

I think we do it with constant revision, with a commitment to learning and sitting with the ways that others can experience immense, unimaginable harm at the hands of this diagnosis that we don’t, a commitment to learning about the history of this diagnosis and of psychiatry and its relationship with capitalism and colonialism. And to being in conversation with one another, especially those who who are more disadvantaged and vulnerable than we are.

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Psychosis is considered a common part of the experiences of people with ‘Borderline Personality Disorder’* and can appear in the form of hearing voices that others don’t and experiencing paranoia. These experiences can be quite intense for many and very distressing.

There are also many harmful beliefs that have long circulated about what we consider to be ‘psychosis’, beliefs which have had strong social and political motivations, and which can cause harm to multiple groups of people. A white mental health practitioner with a large Instagram account who does work around BPD advocacy, recently made a post that perpetuates some of these common beliefs. Because specificity is necessary here, here is a direct quote from their post:

If BPD psychosis is stress-related and resolves on its own, is it a big deal? (TW suicide).

Any amount of psychosis can be potentially dangerous, because it can make people act in unpredictable or unsafe ways. Additionally, we know that people with BPD who experience more psychotic symptoms, tend to struggle with quality of life more, have more co-occurring disorders, and be at higher risk for suicide.

To begin with, I don’t expect perfection in our BPD advocacy and I don’t want to invoke perfectionist tendencies in anyone. It’s unrealistic to expect that we’re always going to say the right thing and make the right points, or that we won’t unintentionally say things that can cause harm.

But this post forms part of a larger pattern of their continually depoliticising these struggles and differences, and I want us to investigate the values and beliefs that underlie these types of narratives and consider — where do they come from? Who benefits from them? Who do they harm? I also want us to understand that there are many other frameworks through which to see these experiences and that these frameworks are not only very important, but some are also much older.

Here is a short list of my major points of contention with this post.

Firstly, statements like this leave no room for people to determine their own relationship to their experiences.

One of the main things that I take issue with around this post is the fact that it decides for people what their relationship to ‘psychosis’ should be. While I use the word ‘psychosis’, I recognise that it is only one way of understanding these experiences of unshared reality and that it is not used by everyone to define their experiences.

I know that these experiences can be absolutely distressing and they can cause a lot of damage in interpersonal relationships. It can be so challenging not to know what’s real and what’s not in your relationships. To have paranoid beliefs that challenge your ability to trust the people in your life.

But for some people, experiencing reality differently is a neutral experience, and, for others, it’s welcomed. Hearing voices and experiencing hallucinations are not inherently distressing experiences, and there are multiple ways of sense-making of these experiences that go beyond the framework of ‘psychosis’ and we don’t get to impose our beliefs onto anyone else about what meaning they should make of their experiences, and whether they should seek to get rid of or ‘cure’ themselves of their differences.

It isn’t harmless for us to promote ideas around only one way of being, one way of having a mind and one way of experiencing reality. It isn’t harmless for us to promote hierarchies of human beings. In fact, our society is already constructed around them.

This is also very in-keeping with the ways that people with BPD tend to already have their treatment goals unilaterally decided for them by practitioners, with little to no input as to what they would like changed and what recovery means to them.

Psychosis and danger are already overly-conflated.

Psychosis is already heavily conflated with danger, and this puts people, often Black and Indigenous people, who experience it, or who are perceived to be experiencing it, at risk in multiple ways. One such way is the risk of police violence in places like the United States, where many of the victims of police violence have been Black people with schizophrenia and bipolar.

The perception of people suffering mental illness as violent and dangerous is another reason police are called. Officers are the only people often perceived by the public to be able to deescalate mental health crises.

-How Mental Illness Affects Police Shooting Fatalities

Not only is this association between psychosis and danger harmful, but what is considered to be psychosis is not a fixed, static state. I have known of people who bear a BPD label, for instance, who have had their beliefs around their mistreatment invalidated as a form of ‘paranoia’.

One notable example of the subjective interpretation of ‘psychosis’ in history is the way that ‘psychosis’ was used as a tool to undermine the civil rights movement in the United States. There are also trans people who have had their gender invalidated as a manifestation of a delusion. So, when we conflate danger and psychosis, I’m curious as to what exactly we mean by ‘psychosis’, because what is interpreted as psychosis has historically been subjective — and this subjectivity has been used to oppress people.

BPD is already overly-conflated with danger and harm.

The BPD label itself is also already overly-conflated with causing harm to others. What are we doing to people with this diagnosis when we add yet another layer to that by insisting that psychosis can also make them dangerous?

It’s a form of cultural oppression.

I say this as someone who will probably never outlive my grief for what colonialism did to me and my ancestors. When you talk about people with ‘psychosis’ being innately harmful and that experiencing ‘psychosis’ is a way that no one should want to live, I hear that you don’t care that many cultures have had different forms of meaning-making of experiences labelled ‘psychosis’ for a very long time, or that many have actually had their cultural beliefs oppressed through the label of ‘psychosis’. When you talk about psychosis in ‘any amount’ being a problem, you forget that many of us have had our cultural and spiritual beliefs oppressed as forms of ‘psychosis’ — and ideas that ‘any amount’ of ‘psychosis’ is an issue can be used to promote harm and eugenics under the guise of ‘care’.

There are many contributing factors to low quality of life for people with BPD and for people with psychosis.

Finally, to their last point that “people with BPD who experience more psychotic symptoms, tend to struggle with quality of life more”, there are many factors that can contribute to this outside of the individual. For example, while I’ve spoken about why people with BPD may struggle to work through an anti-capitalist lens, these statements naturalise capitalism and attribute folks’ low quality of life entirely to their mental and emotional struggles and differences.

They also ignore the fact that many people with a BPD diagnosis are people of colour, trans people, and people who otherwise face heavy discrimination and oppression in ways that can contribute to a lower quality of life.

As eating disorder therapist, Stacie Fanelli, recently wrote in a post on Instagram, “referring to the way someone naturally exists as harmful puts blame on the individual, not the systems that fail to accommodate them and this allows those systems to continue sidestepping calls for change.”

There is no one ‘right’ way to have a body or mind or to experience reality, and it is particularly damaging when white practitioners working in a field that was borne out of and sustained through the colonial oppression of other cultural and spiritual ways of being and understanding the world promote these ideas.

Psychosis is not a static, fixed, objectively-defined state, but has been subjectively-interpreted to oppress groups of people — and when we add that psychiatric incarceration remains acceptable as a form of care, we can see how this conflation between danger and psychosis can be used as a tool of social control.

If you are a person with BPD and you find that getting rid of your ‘psychosis’ isn’t entirely a goal of yours — that’s valid. If you have a different relationship to your experiences, that’s also valid. You should have a say in determining what recovery and healing mean to you.

Not all differences are in need of ‘curing’. Not all differences equate to distress. And all differences absolutely do not equate to harm and danger — not only that, but this narrative in itself is what often leads to harm, and, most often, to the most vulnerable and disadvantaged.

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*(I use the term BPD as the name of a psychiatric diagnosis, not because I believe that anyone’s personality is ‘disordered’, and with a recognition that this diagnosis has caused immense harm to many people bearing it (particularly multiply-oppressed peoples), and that it is a limiting, one-dimensional and often extremely harmful way of making meaning of these experiences. At the same time, I recognise that there are people who have found meaning and validation through this label, and I believe that people should have the right to self-identify in ways that make sense to them.)

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