Never good enough--part 1: Shame or borderline personality disorder?

This paper takes a deconstructive approach to the historical, clinical, and social context of the diagnosis of borderline personality disorder (BPD). This is undertaken by providing an overview of pertinent literature, an examination of the diagnostic criteria, a discussion of the development of the shame affect, a discussion of women's narratives and a reinterpretation of the symptoms of BPD as an overwhelming shame response. An argument is developed that shame is an integral but neglected feature in the experiences of mental distress that are characteristic of BPD. This discussion is supported with evidence of shame in narrative quotes from women with a diagnosis of BPD. There are striking similarities between what is currently pathologized as BPD and an overwhelming shame response. Recognizing the influence of shame may assist mental health nurses to provide mental health nursing care that best meets the needs of women experiencing these symptoms.