The postmodern condition
The 20th century in the Western world, inter alia, was characterised by the demise of the patriarchal system which has brought about a devolution of power, the rise of feminism, a redefinition of roles and the need for individuals to adhere to sometimes diametrically opposed societal demands. This century was tarnished by the horror of the dehumanising cruelty of the Second World War and left people questioning human beings’ assumption of their integrity. Furthermore, the stability and predictability of the modern era have been juxtaposed with the ‘chaos’ inherent in scientific and philosophical thought. This has shaken the foundations of how we understand our world.
Could it be that in view of the above, certain hallmarks of psychological adjustment, and in some instances health, will have to be reconsidered? Examples of such hallmarks are the notions of:
an invariable, unified self—previously posited as the ideal—may be too rigid to adjust to an ever-changing and ambiguous context;
emotional control - generally viewed as essential to maturity—may be a handicap in accessing vital creative energy necessary to survive in a rapidly changing and alienating society;
containment of psychological pain - in the service of maintaining a semblance of individual or group functioning—in a hypocritical society, finds expression in adrenaline-seeking behaviour and in drug and alcohol abuse;
the sanctity of marriage—as a cornerstone of social relationships—may be too limited to accommodate the diversity of our current society.
Does this mean that fragmentation, multiple selves, variable mood and non-contiguous relationships may well be an appropriate, albeit extreme, adaptation to an ever-changing and mercurial context? Furthermore, if the postmodern assumption of multiple truths holds, then the idea that a self can reflect many facets, all of which are valid, makes sense. As a result, “a multiphrenic condition emerges in which one swims in ever-shifting, concatenating, and contentious currents of being” (Gergen, 2000, p 80).
In the light of the above and if it is plausible that, as Gergen (2000, p 24) postulates, each period presents its own particular illness, its mal du siècle, one can rightfully ask what the malady of our time is. More specifically, are there particular processes in contemporary society that foster a particular response to living? And, does this mean that there is a condition that in some way mirrors the dynamics of the current era? If so, could it be that the more sensitive individual would be vulnerable to the mirroring of the fragmented nature of our current society and as such become a carrier of the inherent confusion and pain that transformation has brought about? Similarly, as "interpreters' of societies" mental illnesses, psychiatrists are also part of the context in which they make their interpretations. Could it be that their "lenses" are both receptors and creators of what is happening in society?
Borderline personality disorder: A mal du siècle?
During the middle of the previous century, theorists and clinicians began identifying clusters of symptoms that developed into a category referred to as borderline personality disorder (BPD). BPD was included in the DSM-III in 1980 (Wirth-Cauchon, 2000). In brief, this diagnosis refers to individuals experiencing psychological pain as a result of a perceived existence in a marginalised "no-man’s land" - a land that is experienced as empty and unstable. This is mirrored in a fragmented feeling of self with unclear ego boundaries and defective in its organisation and structure (Wirth-Cauchon, 2000). Until fairly recently, BPD was a broad wastepaper basket category that clinicians assigned to a variety of conditions they were uncertain about.
In its 27-year history, BPD has received enormous attention and thousands of articles and books have been published on this syndrome (Bjorklund, 2006). It has been described in different sources as one of the most controversial diagnoses in psychology today, as well as an amorphous concept that has been misunderstood and misused. BPD has become a widely used category and the “best evidence indicates that about 11% of psychiatric outpatients and 19% of inpatients meet the criteria for BPD” (Borderline Personality Disorder Research Foundation). An unanswered question regarding this category is the apparent 75% gender bias towards women (Skodol & Bender, 2003). In line with the thinking expressed in this article, it may be that because the role of women has changed so dramatically, it would consequently be inevitable that they would be the major receptacles of the difficulties that change and uncertainty have brought about.
ollowing the notion of returning mental illness to the fold of society, and if BPD reflects the current maladies affecting society, is it reasonable to ask whether aspects of a "borderline response" to life and the world in any way mirror what is happening in a broader societal context? If so, can this in any way can be construed as an "adaptive" reaction to a depersonalised, uncertain and rapidly changing world? The outrageousness of this question is more plausible when the modern health/pathology binary, inherent in the understanding of the DSM category of BPD, is juxtaposed with a contextual description.
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