Borderline: The Biography of a Personality Disorder

Borderline personality disorder, defined today as a “pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity,” was misunderstood long before its 1980 addition to the DSM, contends Fordham University assistant psychology professor Kriss (The Gaming Mind) in this stimulating study. According to the author, the disorder has remained elusive partly because of the medical establishment’s reluctance to acknowledge links between societal power imbalances, trauma, and mental illness. Meanwhile, BPD’s prevalence in women—who represent roughly 75% of diagnoses—further drove its stigmatization. Kriss details how the condition is unfairly typified in popular culture by “wild, promiscuous people... who abuse substances, threaten suicide and fly into rages,” when for many, the borderline experience is a subtler, “chameleon-like” one, and often leads sufferers to slip through the cracks of established diagnostic and treatment practices. While the history of the disorder’s “status as an outlier” from fifth century BCE to 1885 (before the birth of psychoanalysis) is dispatched in a single, breakneck chapter, on the whole this is an enterprising and in-depth exploration of who decides what it means to be ill, how mental illness is framed in cultural narratives, and who gets shut out of those narratives. It’s an ambitious reassessment of an understudied condition. (Apr.)