Identity Expansion once diagnosed with a disorder (or any illness)

[waverider]

The following is an excerpt  from one of our LESSONS

PERSPECTIVES: Telling someone that you think they have BPD

We are all familiar with the often defensive reaction, but how many of you have experienced Identity Expansion once a diagnosis has been accepted and is this an across the board trait of your pwBPD? I know it is a big issue with my wife who is a bit hypochondriac in this way over many things, and now wears her BPD as a label, almost like its a free VIP pass. Even though hardly anyone knows what BPD is when she bandies it around

Identity Expansion

There is a second reason, however that may keep a treater from disclosing a diagnosis.  Lets say for example through discussion with the treater it is agreed the client meets the minimum of 5 of the 9 symptoms for Borderline Personality Disorder [1].  Now lets say the client suffers from confusion and is lacking identity. Now we have a troubled client that is relived to meet the newly official diagnostic criteria to open a pathway toward individuality (upgrades to identity).  Of course the client is excited to learn more about herself and studies all of the symptoms for a diagnosis of borderline personality disorder.   Through research the client finds there are 4 more symptoms that she has managed to keep ‘in check’ but now realizes she has some latitude, a more extensive range to express her newly discovered identity.  It is as though she has received a license to be complete, however maladaptive that may be.  The reasoning maybe, “An maladaptive identity is better then no identity at all.”   Now we have a treater that is frustrated with the extra symptoms that the client had previously been able to manage.   So now what?  

Does this make you hold back on what you know about the Disorder in case they start adapting traits as "normal and to be accepted'? I know I hold back for this very reason, in case I am handing her a character script.

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[Notwendy]

This is interesting. My mother has been fully invested in hiding a diagnosis, or the idea that anything isn't right with her. However, she has done this with other pieces of information that she learned in therapy over the years. One thing to consider is that she was in therapy before the diagnosis of BPD was known, and there wasn't much information about it. I would imagine they would have called it some kind of neurosis back then.

Sometimes, after an episode of dysregulation ( she tends to deny them, but in the case that it is hard to do that) she will offer some kind of "psychological" explanation for it. At one point, after an episode when my father was ill, her "reason" for her behavior was that it was somehow because she didn't process her own parents' death at the time- many years ago. Offering these "psychological" explanations served as her way of normalizing her behavior (that wasn't normal ).

It also extended beyond her. But in this case, it served to make our normal behaviors "not normal". She used to tell me things about myself when I was a kid, that I see now may have been projections from therapy. She would tell me I was "afraid of abandonment" which, surprisingly ( considering I was raised by a BPD mother) I was not. It is eerie to hear her speak of a friend or relative with some psychological issue, because what she says they are doing are things she does herself.

[waverider]

I guess rather than projecting, it is a kind of absorbing, in order to have an alibi. I can't hide it so i will justify it mindset. The disorder then becomes a tangible entity onto which they can then project/deflect blame and responsibility.

I believe it has been one of the hindrances to my wife being properly diagnosed for a long time as she has adopted prior proposals and so has "acted out" OCD etc. Here own mother does not really believe in mental illness, say its "all in the mind" (knind of weird logic there), and so my wife always wants a "label" to validate herself as having a real problem.

There are similar issues when therapist delve into past events as these are then portrayed as post traumatic triggers causing the issues of today when really I see them as past rewrites used to illustrate the feeling of today.

[Notwendy]

I also think this could be in addition to a cultural trend to have a diagnosis for behaviors. While I believe the condition of ADHD is real, it is sometimes used as an explanation of bad behavior, and absolves parents and child of responsibility to deal with it. I know this comment can be disputed by those affected with ADHD, but I  have seen the term used loosely. The child's inability to sit still can be attributed to ADHD, but regardless, pulling the dog's tail needs to be addressed with and without ADHD. ( and in this case, the dog doesn't care what caused the behavior, he will eventually bite them anyway if his tail is pulled)

So for instance, my mother has BPD, but if she rages at her kids, that behavior is something to deal with, with or without BPD.

[waverider]

If a term becomes well known it can be overused, and in effect diminish the issues of those genuinely affected. OCD is a good example of this. In real terms it is a disabling anxiety disorder based around illogical fears. However it is readily used by people to simply describe that they have a fad, or reoccurring passion about something, hardly the source of debilitating anxiety.

Is Identity Expansion closely related to Idealization?