“People diagnosed with BPD overwhelmingly experienced their early lives as involving constant messages that they do not – and should not – fully exist. Here, of course, gender becomes relevant in terms of how children are treated by caregivers and the culturally appropriate strategies available managing developmental challenges. It makes perfect sense that a girl growing up in a context where her physical existence, psychological existence, or both felt constantly threatened might become fearful of being left alone and unprotected. Developing a finely tuned radar for others’ emotional states while also knowing that the person who cares for her one minute might hurt her the next might easily lead to fluctuating attachments and difficulty developing a stable sense of self. Perhaps in an attempt to derive some sense of her material impact in the world or to manage strong affect that was disallowed or invalidated, she might engage in behaviours associated with either intense pleasure or pain. Paranoid ideation and even dissociation could be entirely adaptive skills in a context where damage was not only possible, but likely. In short, all of the symptoms associated with BPD could be viewed as adaptive responses to an environment that tells a child she is forbidden to exist as her own person and that she will encounter grave consequences should she try. What becomes problematic is that, as this girl becomes an adolescent and then an adult, such survival strategies are often misread (for many of the reasons critics of BPD have pointed out) as communicating things quite the opposite of what she intends and a looping effect comes into play. If a person with such strategies happens to come into a clinical setting, she is likely to find that her skills do not translate; they become her undoing (Aviram et al., 2006). What were once survival sills are now deemed ‘frantic’ or 'inappropriate’ or 'manipulative’ or 'paranoid.’ When a person is continuously misunderstood by others (especially those, like therapists or doctors, whose job it is to understand her), when her experiences and attempts to connect are continuously viewed as scheming or inauthentic, it is perhaps not surprising that rage and despair and feelings of emptiness become entrenched. […] She is caught, yet again, in a paradox of existence where to 'be’ in any form, from any angle, renders her inauthentic.”
— Rebecca J. Lester, “Lessons from the Borderline: Anthropology, Psychiatry, and the Risks of Being Human” (published in Feminism & Psychology 23:1, 2013)
