Ramblings on Self-Image and Diagnosis

This afternoon, I was discussing y treatment plan with my psychologist. I heard her saying something about diagnosis and treatment being complicated by a combination of autism with axis II symptomatology. “Axis II,” I thought, “that’s personality disorders. Have they finally gotten to diagnose me as BPD?” And yes, they have. And instantly the DID and PTSD diagnoses went out the window. Not only that, but BPD, not Asperger’s, is my “main diagnosis” now.

What does this mean? I anticipated it for a long time. In fact, I’ve always doubted the diagnosis of DID. When initially diagnosed, I was too overwhelmed by some of the consulting psychologist’s questions to answer them with the nuance they required. Like, the psychologist asked whether we are aware of what happens when another alter is out. I said no, but the real truth is that we could not have known, since if we lost time, we would only find evidence later and not know that an alter had been out unless we’d had soome awareness of that alter.

I have a very unstable self-image, which goes with both DID and BPD. In addition, I need concrete qualifiers for myself, which I theorize could be an autistic feature. This gets me to identify myself not with abstract characteristics like creative, intelligent or whatever, but with the labels I’ve been given. I’ve gotten better over the past year or so at identifying myself with neutral labels like crafter and blogger.

At the same time, I still do have characteristics that are more abstract. I am not just an autistic, a crafter and a woman. I am not just a dissociator or a borderline. Yet what I am in terms of these labels, fundamentally impacts how people see my characteristics. Like, borderlines are generally assumed to be manipulative attention-seekers. If I’m seen as manipulative when a vulnerable alter is out, for example, that means my needs won’t be listened to. In contrast if I’m seen as vulnerable when I’m manipulating, I won’t unlearn to manipulate. Furthermore, my poor self-image may not alter the core of my mental problems – whether that be a drive to manipulate or emotional vulnerability or both or soomething else entirely -, but it sure alters the way I perceive this core.


2 thoughts on “Ramblings on Self-Image and Diagnosis

  1. I don't understand how professionals would suddenly discredit diagnoses of autism, which is physical disorder not a mental disorder, and PTSD, which is the specific result of an incident, for BPD. Your diagnosis is not who you are, but how you are treated by a medical/mental health system. Even though you say you will be influenced by this change, at your core essence of your person, you remain the same and still deserve to be treated with dignity and fairness. You are valuable and valued. And you give value to the world.


  2. FYI. Now that the DSM-5 is out, there is no more axis two. All personality disorders were moved to the same category as other mental illnesses. One diagnosis is no more or less important than any other. Make use of the labels that are helpful in your treatment and let the others go. Thanks for the post and the thoughts.


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