Dismantling the Diagnostic Construct of Borderline Personality Disorder: An Abolitionist Perspective

This paper presents a perspective grounded in critical psychiatry and decolonial epistemologies, synthesising interdisciplinary scholarship and lived experience testimony to interrogate the diagnostic construct of borderline personality disorder (BPD) as a site of iatrogenic harm and epistemic violence. Clinical discourse commonly positions long-term therapeutic engagement as a risk factor for “dependence,” framing care recipients as the locus of complication. Rather than accepting this premise, we locate harm within systemic, relational and epistemic practices embedded in psychiatric culture. We argue that conditionality, pathologising interpretations of support needs and punitive framings of self-advocacy produce iatrogenic harm, whereas consistent and validating therapeutic relationships foster safety and autonomy. Using a decolonial theoretical lens, this work critiques the misogynistic origins of the “dependence myth” and traces how Western attachment theory has been universalised to pathologise kinship forms outside nuclear family models, particularly in Indigenous, Black, migrant and collectivist communities. We further highlight how sensory processing differences are neglected in BPD discourse despite their significant role in self-injury, suicidality and embodied distress, calling for an expanded framework beyond relational psychodynamic explanations. Diagnostic bias toward sexually and gender diverse people is examined as a continuation of psychiatry’s historic regulation of gender and sexuality through personality pathology paradigms. Ultimately, we contend that the BPD construct functions less as a neutral clinical category and more as a colonial, cisheteronormative, and neuronormative governance technology that produces pathology through stigma, epistemic control, and carceral logics. Reframing BPD as a diagnostic instrument of social regulation rather than a disorder located within individuals opens space for care grounded in relational justice, cultural flexibility, sensory attunement, human rights, and epistemic humility, rather than the castigating of Western social nonconformity and the enforcement of compliance with normative behavioural conditioning.