The 7 Types of Stigma & How They Apply to Borderline Personality Disorder (BPD)
Merriam-Webster Dictionary defines stigma as "a set of negative and unfair beliefs that a society or group of people have about something." Many of you, especially those who have experienced it, may be aware that Borderline Personality Disorder (BPD) carries a heavy stigma.
BPD is a mental health condition that is characterized by emotion dysregulation, fear of abandonment, and self-harm and/or suicidal behavior - among other things. It's important to remember here that BPD is treatable. Here at Online DBT Skills, we teach Dialectical Behavior Therapy (DBT), one of the evidence-based treatments for BPD.
There are many ways in which this stigma affects people with BPD. In fact, there are 7 types of stigma in general. Let's explore the different types and how people with BPD (and their loved ones) may experience them. I hope this helps you understand and contextualize your experience and know you're not alone.
Public Stigma
This type of stigma is when the general public has a particular view of a mental health diagnosis that is negative. This is what fuels discrimination. If you've ever googled BPD and seen auto-fill options like "are borderlines evil," that's a result of public stigma.
Self-Stigma
Self-stigma is when someone with the mental health condition internalizes the public stigma associated with that condition. If you have BPD and are worried about "manipulating" others or experience shame that you might be a bad person due to your diagnosis, that's self-stigma.
Perceived Stigma
This type of stigma is when folks with the diagnostic label fear that they will run into discrimination (as contrasted with experienced stigma, when discrimination has occurred). If you've ever felt afraid to go to the emergency room for mental health or even other reasons because you worry you'd be treated poorly for simply having a BPD diagnosis, that's perceived stigma.
Label Avoidance
Label avoidance is when someone avoids seeking mental healthcare in order to avoid being diagnosed with a stigmatized label. If you think you have BPD, but you've avoided going to therapy or other treatment because you don't want that on your health record - that's label avoidance.
Stigma by Association
This type of stigma is when someone connected to a person with the stigmatized diagnosis, but who doesn't have the diagnosis themselves, is affected by the stigma. An example of this if is a friend of someone with BPD is criticized for supporting or associating with the person with BPD when neither person did anything harmful.
Structural Stigma
Structural stigma is when discrimination against people with mental health conditions becomes institutionalized. For example, policies that result in fewer employment opportunities for people with BPD or other mental health conditions.
Health Practitioner Stigma
This is when healthcare providers let the stigma negatively affect the services and care they provide to folks with those diagnoses. You may have heard doctors assume a patient with BPD is lying about substance use without any evidence or therapists try to avoid taking on borderline clients at all costs. These would both be examples of health practitioner stigma.
These types of stigmas exist outside of just BPD. They can show up with a variety of mental health labels as well as in other areas of medicine and life. However, BPD is associated with a particularly intense stigma. Remember: we all make mistakes and a mental health diagnosis is an explanation for our actions, not an excuse. But we haven't caused harm simply by just existing with a diagnosis - that's stigma.
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