Title

Challenging the Discourse of Untreatability for Borderline Personality Disorder: A Call for Comparative Research

Document Type

Article

Journal/Book Title/Conference

Social Science and Medicine

Volume

146

Publisher

Elsevier

Publication Date

12-1-2015

First Page

223

Last Page

224

DOI

10.1016/j.socscimed.2015.10.026

Abstract

A diagnosis of Borderline Personality Disorder (BPD) often signals the quintessential “difficult patient” status to clinicians, with at least one scholar arguing the condition itself was created to name and group difficult patients. While patients who are deemed difficult are often dispreferred for care, does this have an impact on their overall status as medicalized patients who have successfully achieved a sick role? This study relies on (n = 22) in-depth interviews with mental health clinicians in the United States from 2012 to evaluate how they describe patients with BPD, how the diagnosis of BPD affects the treatment clinicians are willing to provide, and the implications for patients. My findings suggest patients with BPD are routinely labeled “difficult,” and subsequently routed out of care through a variety of direct and indirect means. This process creates a functional form of demedicalization where the actual diagnosis of BPD remains de jure medicalized, but the de facto or treatment component of medicalization is harder to secure for patients.

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