Written by: Sarah Angelone
Edited by: Shivani Shah
Misrepresentation is no stranger to Hollywood. In an industry that aims to produce engaging content, misinformation is not a primary concern. What matters is viewership, and this often perpetuates the misconceptions we see in day-to-day life through dramatized media, made for the sole purpose of intriguing viewers. The lack of authenticity present in cinema spreads false information surrounding a plethora of topics, especially mental health. This phenomenon inherently fosters the stigma that we often see surrounding various mental illnesses. One disorder that is severely impacted by this false representation is Borderline Personality Disorder (BPD).
Borderline Personality Disorder is a Cluster B Personality Disorder characterized by five of the following symptoms: fear of abandonment, unstable relationships and self image, impulsivity, suicidal behavior, intense moods, feelings of emptiness, intense anger, and dissociation (American Psychiatric Association, 2013). The disorder is primarily defined by long-term patterns of unstable emotions. There is no known conclusive cause for BPD, however, it is typically induced through experiences of severe childhood trauma and genetic predisposition. Though the symptoms of BPD are inherently intense, the disorder is grossly sensationalized in the media, perpetuating the stigma surrounding the disorder.
Typically BPD is a label slapped onto any “crazy” character in a TV show or movie series. Though yes, the disorder could apply to the individual in the show or movie, when the sole representation of BPD is the examples of extreme cases, the minority, the stigma is strengthened. Borderline personality disorder itself is symbolic of both internalizing and externalizing psychopathology. Internalizing disorders describe symptoms that are “...relatively difficult to observe,” whereas externalizing disorders are represented by “...highly observable” symptoms. Internalizing processes show someone taking their emotions out on themself, for example, thinking negative things about yourself because you’re angry. Externalizing processes show someone taking their emotions out on their environment, like punching a hole in the wall when you’re upset. As previously mentioned, BPD is conducive with both internalizing and externalizing processes (M. Reynolds, 1998). Typically the stigma associated with BPD representation in television only demonstrates the external expressions of the disorder as opposed to the heartbreaking internal conflicts that co-occur. This sheds a negative light on mental illness as only the negative behaviors are displayed and exaggerated. Without including internal conflicts such as anxiety, low self-esteem, suicidal ideation, and abandonment issues, these characters are often dehumanized and intentionally portrayed as “crazy” and heartless, despite those outlooks being lightyears from the truth.
A typical example of this misrepresentation occurs in a popular TV series, “My Crazy Ex-Girlfriend”. The show follows Rebecca Bunch, who is diagnosed with BPD, and her journey navigating her emotions regarding an ex-lover. Though the internal conflicts of BPD are properly represented, the show heavily dramatizes her external expression as she engages in extremely erratic behavior that is incredibly rare in individuals with BPD such as murder, breaking-and-entering, and arson. BPD is rarely displayed in the media as it is, so the scarce representations that are provided must be accurate and work to destigmatize the disorder rather than encouraging negative perceptions. The internal conflicts portrayed in the show properly represent the internal struggles that one with BPD would face, which makes that aspect of the series phenomenal for representation and relatable for those with the diagnosis. However, the external behaviors ostracize those with BPD and continue the misunderstandings behind the diagnosis.
Proper representation is vital for destigmatizing Borderline Personality Disorder. BPD is suspected to affect ~2% of the entire population, which is over 5 million people. Out of the 5 million people struggling with BPD, 8-10% typically die by suicide (Valliant). Millions of people are impacted by this disorder, thus, helping these individuals feel understood instead of ostracized should be a priority, and that starts with education. Stigma comes from misinformation, and to understand the disorder, overcoming ignorance is vital. This can begin with the media accurately educating and representing the matter of BPD. The stigmas today even affect mental health providers. In a study done by Randy Sansone in 2013, the majority of mental health professionals were shown to “harbor negative feelings…and attitudes toward patients with BPD,” demonstrating a clear bias and stigma even in mental health providers that is likely due to internal biases reinforced by the media (Sansone 2013). The severity of this stigma stems so deep even into the individuals who are most educated on the subject. Thus, the stigma must be tackled.
A big issue in therapeutic settings includes the refusal of many psychological providers to diagnose a patient with BPD, as they are aware of the severe stigma that comes with the disorder. This diagnosis becomes a label of shame for the person with BPD as a result of the decades of stigma surrounding the disorder. Diagnosis is so important for those struggling with mental illness to work towards treatment, and the stigma affecting BPD is so severe that many patients cannot receive a diagnosis. The first step to destigmatizing BPD is to create accurate media representation that helps educate the general population about the disorder.
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Chapman, J., Jamil, R. T., Fleisher, C., & Torrico, T. J. (2024, April 20). Borderline Personality disorder. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK430883/
M. Reynolds, W. (1998). Children & Adolescents: Clinical Formulation & Treatment. In Comprehensive Clinical Psychology (Vol. 5). Elsevier Science. https://www.sciencedirect.com/referencework/9780080427072/comprehensive-clinical-psychology#book-info
Sansone, R. A., & Sansone, L. A. (2013, June 1). Responses of Mental Health Clinicians to Patients with Borderline Personality Disorder. https://pmc.ncbi.nlm.nih.gov/articles/PMC3719460/
Valliant, M. (n.d.). National Education Alliance for Borderline Personality Disorder. https://www.borderlinepersonalitydisorder.org/most-accurate-article-on-bpd-we-have-recently-read-kudos/
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