Tuesday, October 7, 2014

The Stigma of Mental Health Diagnosis: On the Word 'Borderline'



In mental health, diagnoses are important. For example, consider the word 'borderline'. It means just that. For example, the perimeter of one country is the same as another, but not one or the other country. It delineates both, but there is nothing definitive in terms of territory. Borderline does not fit into the realm of either hither or yon. This might also signify displacement.

Where black meets white in terms of color, there is a gray borderline. Where night meets day, there is a borderline and it can be a gray area, too. In mental health, the gray area can depict the realm of the unknown or in terms of a whole person, the unknown realm of the mind, soul, body or spirit. Maybe it is not gray at all, but more akin to the realm of rainbow colors. 

Instinctively, we seek to label 'borderline' as something, anything or whatever.  Without a name, it is useless. It cannot be defined or can it? It is not one, not the other. There is no 'is' about it, much less 'is not'. It is the 'almost' or 'not quite' region.

Should we medicalize it or perhaps medicalize everything? That way there can be a diagnosis, but it still remains vague and non-inclusive.

Magnify it. Whatever you choose to magnify grows. If it gets large enough, it might have a name too. Everything big has a name.

Put it in the mental health realm, but it is not mental health or mental illness, either.

Assign some characteristics to it, whatever suits your fancy. At least that way, it is in a box. Boxes are containers and things fit into them. Borderline fits into a box perhaps, by virtue of its perimeter or perimeters. Or does it?

There is a fine line between 'borderline' and 'split'. One is not the other; the other is not the one. There is no division in 'borderline'. It has unity, even if only as a single, stable or unstable black line or maybe it is white. Better still, it can be gray or rainbow colors.

Maybe 'borderline' fits better in a circle. Everything that is outside of the border is not in the circle or part of the 'borderline'. Or is it? Everything inside the circle is not part of the 'borderline', either. Or is it? 

Isn't the 'borderline' part of both the outside and the inside? Maybe it is simply the uniting factor.

Is the secret, the unifying-dividing power of the 'borderline'? It can be labeled this and that, but not this and not that. Joining and separating. Uniting and dividing? Joining and separating? Holding everything together and keeping it apart?

Just more evidence of a complex whole.

One can only ask what this means in terms of a mental health diagnosis. From a wholistic/holistic perspective, it might even make sense.  



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