PD In the middle

So, I work in a service which has the term “personality disorder’ in its title. And…this feels risky…but I’m not advocating to change it. Not because I like the term. I don’t. I think it’s rude (at best), abusive, stigmatising and re-traumatising at worst.

I’m passive about it not because I like it or believe in it but because I feel in the middle of two camps: This is crude. I know it is more nuanced than this but, for simplicity…Those in the first camp argue that no service and no intervention which uses the term has any value or credibility. People in this camp hate the term for very good reasons and are alienated by the services which use it.

The second camp defends the term because it has validated their distress and provided relief by opening doors. Or because it makes sense to them, because it fits with a medical framework that situates distress as ‘disorder’, as intra psychic failure, as non normal. Potentially as something you can fix, recover from, take pills for. A chemical imbalance that can be treated. They may like it because it is part of an expert professional lexicon that validates them.

I agree with those in the first camp but I don’t belong there. I’m glad there are people in the second camp who have been helped but I don’t belong there either.

Now, I know language is important. I know it can create and uphold structures that oppress and abuse as much as it can create art and song. I know language has the capacity to make bad things happen and to stop better things from happening. I know language frequently works to serve those in power and that efforts to change damaging discourses are bold and brave and radical and important.

But, I believe language will continue to be weaponised while workers are afraid, incompetent, ashamed and traumatised themselves by the work that they do. I’ve heard so many terms over the years (“it’s behaviour”, “she’s sabotaging”, “he’s kicking off”) that work to position the user of the service as malign, as other, as disordered, infantile, malicious, hateful. So many words – some good ones, some powerful, useful words (not all stupid words like ‘personality disorder’) – all used damagingly, sometimes cruelly, always thoughtlessly.

Emotion makes us thoughtless. It doesn’t matter who we are. When we’re afraid or ashamed we act badly, carelessly, instinctively to protect ourselves often by controlling or hurting another. And when we work for organisations that are unable to process and manage anxiety, cultures emerge which sanction and support those practices. Words are routinely used in a way that damages other people by obscuring the personal meaning of their circumstances, denying the trauma they have experienced, refusing to allow them to be known and understood. In this way workers, professionals are validated and safe – we are different, sane, sorted. Inured to the traumatic stories that people have to tell.  We can confidently locate the ‘problem’ within the users of our services and hide behind words that protect us  from the realisation that we are the same. That ‘there but for the grace of God’…. That what we see before us are entirely rational responses to a society which has failed to protect, failed to rescue from or condemn abuses that we find unbearable. A society we belong to and which is overwhelming to change.

So, no..I’m not advocating to change the term. When the paradigm shift that I am advocating for finally happens, the term will change. Or it will not longer have any power, will no longer be used to hate. This is where my activism is focussed – in working to notice and name the defensive practices which serve us as workers and the anxious organisations we work for at the expense of our clients. In working to make it safe for workers to be afraid, to not know, to be inexpert. To be more authentically human and kind.



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