Paper short abstract:

Borderline Personality Disorder is typified by an unstable, incoherent sense of self. At the same time, BPD is understood to be a chronic, incurable condition. Diagnosis, then, is a temporal practice. This temporality is paradoxical in BPD, shaping--and sometimes foreclosing--recovery.

Paper long abstract:

In Western psychiatric practice, Borderline Personality Disorder (BPD) is typified by an apparent lack of a stable or coherent sense of self. Living intensely within the immediacy of the present, sufferers' mood states, affects, perceptions, and personality dimensions shift and change rapidly, producing a sense of acute disorientation, dysregulation, and distress. The result is a fundamental disruption of intersubjectivity, hinging on "a peculiar atemporal mode of existing" (Fuchs 2007). At the same time, from a psychiatric perspective, personality disorders like BPD are understood to be stable and persistent patterns of relating over time, chronic conditions that can be managed but not cured. A diagnosis of BPD therefore "fixes" the client in a particular subjective space in ways that sit in stark contrast to the everyday lived experience of the condition. How are these differing reckonings of temporality in BPD—a condition that is both atemporal and chronic—negotiated by people with BPD? And what are the implications for how we think about mental illness? Drawing on clinical and ethnographic work with women diagnosed with BPD, this paper considers how notions of chronicity and dysregulation in BPD produce paradoxes wherein clients must figure their subjectivities across varying and conflicting temporal landscapes. In so doing, I argue for a reconsideration of how processes of diagnosis shape the ontology of psychiatric conditions.