New ways of supporting child abuse & sexual violence survivors in relation to the ‘personality disorder’ construct

Content note: mentions of childhood sexual abuse

Sitting in a consultation room with a psychologist and receiving the diagnosis of Borderline Personality Disorder at first felt like a huge relief. There is a problem, a problem with a name, and problems can be fixed.

My name is Jodie, and that isn’t how I feel any more. Little did I know I was about to face years of re-traumatising mental health stigma and further institutional abuse. See, I was a childhood sexual abuse victim, and I know that even the label victim can be contentious, but that is what I was – a victim. An adult who was supposed to love and care for me, and keep me safe, instead shattered my world.

Like many other abuse survivors, I kept quiet, buried it right into the back of my mind and got on with my life. The problem was that while I thought it was buried it was in fact leaking out, into my behaviours, into my relationships and into every single day of my life. I now know that I was having a totally normal reaction and response to childhood abuse. But I didn’t know that it was “normal” when I was going through numerous psychological assessments, and painstakingly going over the circumstances of my life that had led me to be sat in that room, receiving that diagnosis. I am not relieved with the diagnosis now, now I am angry.

After I was ‘diagnosed’, I was given mood stabilisers, antidepressants, beta blockers and diazepam and told to wait to be seen by a therapeutic service on the ‘borderline personality disorder’ pathway. The waiting list was 3 years. The relief I first felt started to disappear as I was faced at every turn with stigma, or offers of yet more medication. I began to feel like a shadow of myself, I felt unheard and uncared for – an echo of my childhood experience. Everything I felt was attributed to “being BPD”. The message was loud and clear: “this is your fault”, “you need to change”. Not one therapist, nor my GP, nor my health visitor wanted to acknowledge the abuse, other than to tell me it was “common” for children who had been abused to “develop BPD”. The therapeutic intervention I received focused on addressing certain behaviours, and concentrated on interpersonal relationships and the role I played in relationship’s fracturing. There was no space for the abuse I suffered, or the acknowledgement that my behaviours, and experiences in relationships were a reaction of abuse. No one asked me about my experiences of abuse which added to the deep shame I already felt about it. Being questioned in therapy on whether my emotions “fit the facts”, with all the focus on my behaviour and no room was given to allow me to talk about my trauma.

Eventually, I found a network of other survivors and through developing a peer support group, together we use our voices, to hold space for each other and for our experiences, where there is no shame and no blame amongst us for our experiences or how we have developed and coped. I refuse to be ashamed of my experiences anymore, the shame lies solely with the perpetrator. I refuse to take the blame for my emotional distress, the blame lies solely with the perpetrator. The experience of being able to talk about what happened to me openly is therapeutic.

I started back in university, where I found other academics and researchers who were survivors. I started to see that the diagnosis of BPD was so common amongst survivors but that most of us felt further harmed by this label. So, we joined forces to advocate for the development of a totally separate pathway for therapeutic support for survivors of abuse and sexual violence in the NHS, without having to accept that our personalities are disordered and to put an end to the dynamic of “blame” and to shift the focus from “what is wrong with us” to “what happened to us” in therapeutic spaces. This survivor-written report provides a kind of mandate for an alternative way to provide mental health services for us. It talks about why ‘personality disorder’ as an idea and the treatment pathways that surround it can be so harmful for us. In the report, we’ve been able to state clearly what we need and how this might be achieved. You can access the report here: New Ways of Supporting Child Abuse and Sexual Violence Survivors: a Social Justice Call for an Innovative Commissioning Pathway.