Ameri's condition Further Defined

This is an accademic description of Ameri's condition.

Ameri is, today, in the antenuated, or weakened, cycle of this condition. She may seek to get a tattoo or a body piercing. She may thwart attempts to provide shelter or travel home by finding a puppy with which she will not part. In the opposite phase of this cycle, which emerges under stress, are to be found the extreme acts of self inflicted wounds even unto death.

Abstract: Borderline Personality Disorder (BPD) is a diagnostic category that has been used with increasing frequency in the United States over the last decade. The attention given to the disorder, the adherence to the construct in the face of significant problems with reliability, the emotional salience with which the term is used, and the culturally specific assumptions upon which it rests, point to cultural aspects of this clinical disorder. This study begins to examine the disorder from an anthropological perspective by exploring by means of a life history method the experience of ten patients diagnosed with BPD. The techniques of grounded theory were used to identify common themes and issues in the narratives that resulted. While the clinical description of this disorder emphasizes an instability of identity, the study participants conveyed a coherent and stable identity. Also, contrary to reports of emotional instability, they had a stable dysphoria and their behavior was less impulsive than it might appear to others. Recurrent references were made to feelings of estrangement, the importance of social validation, and the wish for asylum. They had an ever-present wish to be dead, since death offered asylum, but they distinguished this from active suicidality. The depth of their despair and the constancy of their thoughts of self-harm were kept hidden from their clinicians to avoid involuntary hspitalization. Other conflicts in the therapeutic relationship were also identified. The experience described by the study participants is more congruent with other descriptions of despair than with the clinical description of BPD. Similarly, the grouping of behaviors recognized as BPD can also be found outside of the clinical domain - as a pejorative description of those economically marginal. It is suggested that the professional description reflects tensions felt by most within U.S. culture, but experienced more acutely by those who are marginal, and reflects a strong reaction that emerges from a fear of succumbing to these tensions. Like most culturally specific disorders, or disorders reflecting the distress of those who feel powerless, there are elements of rebellion in BPD and the response to it may be to render the actors powerless by declaring them mentally troubled. With BPD, as with other culturally specific disorders, the cultural expectations are not directly challenged, only the individual failure in meeting them.

Miller, Sharon Glick, April 1993 - BORDERLINE PERSONALITY DISORDER: AN ANTHROPOLOGICAL PERSPECTIVE

The author is now a PHd in a clinical practice.