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Mental Disorders

by Dana Becker
Westview Press, 1997
Review by Christian Perring, Ph.D. on Dec 31st 1997

Through the Looking Glass

Dana Becker's book Through the Looking Glass is one of the relatively few books on borderline personality disorder. It's an impressive work, and Becker shows a commanding knowledge of the psychiatric literature on BPD, to which she refers often -- there are over 23 pages of bibliography. Sometimes she makes it hard to see the wood for the trees, given the detailed discussion of many different books, papers and experiments relevant to the topic, but her text repays detailed study. Although she voices some doubts of the objectivity of the diagnosis and explains some of the arguments for doing away with the category altogether, she ultimately works with it. Her main aim is to make sense of the disorder, by showing how the symptoms can be seen as a result of female socialization. Of course, Becker is aware that not all women have BPD, and but she is not particularly concerned to explain why some women are more prone than others to develop the disorder.

Becker proceeds according to the standard feminist methodology. First she recaps the history of female insanity in 26 pages, focusing in issues connected with BDP, especially the parallels between BDP now and hysteria in the nineteenth century. She goes on to set out one of the standard criticisms of psychiatry; that psychiatric diagnoses are not objective, but rather reflect male bias and act as a form of social control. Becker is largely in agreement with past feminist scholarship, although she is not closed-minded about it: she leaves much room for uncertainty and unresolved issues. She also points out that there is a great deal of confusion within psychiatry as what should count as borderline personality disorder, or whether it should be classed as a personality disorder at all. She shows that Freudian and post-Freudian theory are of not much help in sorting out these difficulties.

Turning to the more empirical literature, she addresses the often held view that BPD is strongly linked to a history of sexual or physical abuse, and it is here that her approach starts to differ from the most common feminist approach. Her examination of the data suggest otherwise, and it is "more than likely that there is no cause and effect relationship between sexual and/or physical abuse and borderline personality disorder" (p. 69). Similarly, the relationship between BPD and Post Traumatic Stress Disorder is confused, because of the variation in criteria used to identify both conditions in studies looking for links between them. Given these difficulties, Becker argues that it would help to approach the classification and understanding of BPD through a wider social context, with special attention to women's socialization.

Getting the Message Across About Women's Experience

Becker's central thesis is that the lives of those with BPD is similar to all female experience. She goes on

... by understanding this kinship, we can come to accept how the socialization of women brings us all somewhat closer to the "border" that is now called borderline than we might imagine. To reach that understanding, we must know that BDP is not one disorder but an aggregate of symptoms; to understand how that collection of symptoms is a "female" one, we must further explore how female experience is shaped by training in dependency and the inhibition of anger and we must look at the reciprocal relationship of these two (119).
Becker uses this approach to give a better understanding of the experience and behavior typical of those with BPD, such as unstable sense of self and self-destructiveness. She suggests that in modern society, women have a "looking glass self," which is to say that they tend to see themselves as others appraise them, especially in sexual ways. They become unable to experience their true selves. Acts of self-destructiveness may be attempts to avoid the anxiety that would come from acknowledging the essential sadness, aloneness and fear that so many women feel.

The great virtue of Becker's book is that it connects together a wealth of psychological and sociological work on the development of women's experience through adolescence, and she uses this to illuminate the psychological and social understanding of the symptoms of BPD. Her ideas are sophisticated and thought provoking.

For the full review of Dana Becker's Through the Looking Glass, click here.