The term actually originated specifically because it is not psychosis, and it is not neurosis, but contains aspects of each.
But even those aspects are vague and can mix and match.
For example, any form of self-harm is associated with BPD. Anything from the eating disorder I had as a teenager, to drinking a bottle of wine three times a week because my migraines and fibro were undiagnosed and untreated, to choosing partners who mistreat me—all “qualify” as “symptoms” under the dx.
No family or cultural context allowed.
Similarly, black and white thinking can be produced under sleep deprivation, as a recent article produced by practicing psychologists that’s critical of the term notes. An awful lot of us were sleep deprived for years. So-do we need therapy, or rest? Perhaps a break from the consequences of cortisol overload?
I absolutely think that “having a dx” can feel extremely relieving for many folks. DBT, especially for people who have not had mindfulness training in the past, is also quite useful. For us, and possibly for many people. However, I think that what is missing from the entire conversation, as I noted in my article, is the context.
BPD is associated so often with severe trauma as to be a stereotype, particularly with sexual trauma. The distinction between BPD/CPTSD vs CPTSD alone may well be the presence of meaningful intervention from a different adult than the abuser, or the absence of additional factors like further marginalization or chronic illness. However, what seems most notable to me is that the BPD pattern in essence can develop in anyone in response to unresolved trauma, at any time—I’ve seen these symptoms in someone who was recently physically assaulted, for example, and in another person who was being bullied—but they are stigmatized so heavily that these people rarely seek treatment. More, if they do not happen to be marginalized women, they are unlikely to be identified for their behavior patterns. Whereas marginalized women, once stigmatized, rarely recover.