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It was about 8 in the morning when my mom woke me up. The sun had just risen and the air was still cool. I was thirsty but I had to get going, my parents were waiting downstairs. I threw on something comfortable and I knew it was going to be a long day. I remember when I got my hair done a couple months ago. It wasn’t the usual braider I go to, but a different lady named Carrie at the salon. She was so warm and welcoming, like a batch of freshly baked cookies. I knew of Carrie because she goes to the same congregation as my family, but I never really spoke to her until that day. I had a lot on my mind that day, college was tough and I was having trouble with my best friend. I didn’t really feel like talking to anyone but Carrie made the words slip out from my mouth. As she braided my hair she reminded me of what kindness feels like.

I was about to have all four wisdom teeth pulled out and god when I tell you I almost broke down into a full blown panic attack. I was so nervous before the surgery, especially about the IV being inserted in me. I was panicking and the surgery team noticed, which made me panic even more. One of them started to say something and I flinched knowing I was probably going to get told “you’ll be fine you’re worrying for no reason”, but instead I smelled those freshly baked cookies again. The nurse’s kindness reminded me of Carrie’s, his sweet loving words comforted me just like her’s. His empathy was like hot chocolate on a cold winter day and I knew I was in good hands.

Soon after I got knocked out by the anesthetic. The surgery went well and the recovery wasn’t too bad. What I remember the most was how well the surgery team, surgeon, and post-op team treated me. Not once did I feel dismissed or judged by them. They listened to all my concerns and made sure that my recovery was excellent. Kindness and compassion goes a long way in healing people, whether it’s in a hair salon or in a doctor’s office.

Girl Interrupted: Connecting the Coming of Age Film to

the Struggles of Young Women with

Borderline Personality Disorder in the 21st Century

Young women with Borderline Personality Disorder (BPD) have a difficult time forming and maintaining interpersonal relationships. BPD is a formal diagnosis and the causes of the disorder are not clear however researchers link it to social, environmental, and genetic factors. Borderline Personality Disorder mainly affects young women and is reflected in research across multiple different studies. For example, in Hessel’s study “Borderline Personality Disorder in Young People”, a sample of 341 young adults aged 12-26 were studied, and “the final sample consisted of 214 females”, meaning that more than 50% affected were females (Hessels 2022). In another collection of studies on young people with BPD, it was found that “21 of the 39 studies had samples that were predominantly female” once again over 50% affected being female (Runions 2020). Although it is not clear why women are disproportionately affected by the disorder, it is clear that it poses a major issue for them. The symptoms of BPD include emotional volatility, chaotic behavior, and insecure self image. The symptoms of the disorder are associated with “instability in interpersonal relationships”, “impairments in theory of mind”, and “feelings of loneliness” (Runions, Hessels, Liebke 2020, 2022, 2017). These symptoms manifest into social dysfunction negatively affecting their interpersonal relationships, causing many young women with BPD to experience high levels of social isolation. Due to the nature of the disorder, young women with Borderline Personality Disorder are highly stereotyped and stigmatized because of their diagnosis.

Although previous research highlights the problems with interpersonal relationships among women with BPD, questions remain on how to respond to the overarching problem relating to stigma. Many people who do not have the disorder cannot recognize nor empathize with the struggle young women with the diagnosis face. Young women with BPD are often blamed, misunderstood, and dismissed for their dysfunctional relationships yet hardly understood or empathized with due to stigma.  This creates a toxic environment for those who are affected by the disorder causing them to experience “clinical relapses…triggered by interpersonal events such as conflicts” (Navarro-Gomez 2017)  therefore resulting in them being stuck in a cycle of unhealthy relationships.

In order to address this issue, a study displaying representations of Borderline Personality Disorder in film and media can be used to understand the diagnoses better in young women. “Girl Interrupted” is a memoir turned film, available on Amazon Prime, that follows Susanna, an eighteen year old woman diagnosed with Borderline Personality Disorder. The film documents Susanna’s 18 month stay at a psychiatric hospital shortly following a failed suicide attempt. During her stay, she faces strong feelings of loneliness and has dysfunctional interpersonal relationships. Like any film, many characters and plot points are exaggerated for dramatic effect and entertainment, yet the film still manages to display many characteristics of mental illness which are accurate. There are many crucial moments in the film that show Susanna’s diagnosis being dismissed by the people around her, the first and foremost being Susanna herself dismissing her diagnoses at her therapist’s office at the beginning of the movie. Susanna’s parents reject the fact that she has BPD in a meeting with her therapist later on in the film. There appears to be a cultural gap in Susanna’s upper class parents and how they deem those who are mentally ill beneath them. Susanna’s diagnosis challenges their prejudice and they are in denial of their daughter’s diagnosis because mental illness can not affect people of their status. In a pivotal scene in the movie, her boyfriend tells her that she’s “not crazy” and doesn’t “need to be” in a psychiatric hospital, even though Susanna was trying to tell him that she is mentally ill. Even fellow patient and friend to Susanna at Claymoore, Lisa, misunderstood her BPD and encouraged Susanna to partake in reckless behavior, keeping Susanna from healing from it causing her emotional distress, confusion, and self isolation. These examples show different ways of society’s stigma and invalidation towards mental illness, even by those who are mentally ill.  Interestingly enough, Lisa’s illness parallels Susanna’s, however, Lisa plays into societal stereotypes and is not open to the people trying to help her. She did not believe in the system at the hospital due to her internalized stigma, preventing her from getting better. Lisa remains at the hospital unlike Susanna who faces her problems, heals, and gets discharged. A significant part of Susanna’s recovery was that she was able to make healthy connections with the staff at the hospital who validated her diagnoses and made a safe space for her to heal.  This highlights the importance of how an understanding of BPD, or any mental illness for that matter, impacts individuals who are affected by it. An empathetic approach to people with Borderline Personality Disorder helps them foster healthy relationships and gives them room to heal.

The goal of the study is to help the general public gain a better understanding of Borderline Personality Disorder to challenge their negative stereotypes and empathize better with young women with the disorder. The study would show a focus group the film, ask them to analyze Susanna’s character, and then discuss how her disorder affects her relationships. This can help them grasp a better idea of BPD and compare different portrayals to identify the key factors of the disorder leading to dysfunctional relationships. By doing so, displaying the results of what the focus group says can help the public gain a better idea of what BPD is like in young women and how the disorder manifests into their interpersonal relationships.

For the focus group, six to twelve participants will be selected to watch a screening of Girl Interrupted together and answer open-ended questions about the film. The participants will fill out a Google form including a debrief of the study, a questionnaire regarding demographic information pertaining to the study, and an electronic signature verifying their consent to participate before the study. Participants will be selected from the population of undergraduate students at the University of Iowa and will receive a confirmation email a day before the study. The study will be three hours long and participants will be compensated with a free dinner. 15 minutes will be set aside to ask the participants opening questions and for them to grab their dinner before the film. 120 minutes will be allocated for watching the film and 40 minutes will be used after the film to answer discussion questions. During the discussion, a moderator will be facilitating the group and taking notes on everything said. Participants will be identified by a number given to them before the study begins. Participants are welcome to compare the film to other media they have seen related to young women with BPD. The focus group is not intended to educate participants, act as a debate on the disorder itself, or as group therapy for the participants. Participants can however discuss their viewpoints on the film and how it affected their perception of Borderline Personality Disorder.

Anticipated results for this study include a better understanding of Borderline Personality Disorder and how it affects interpersonal relationships in young women. Participants are hoped to have increased empathy, compassion, and recognize negative stereotypes about the disorder. Participants are also hoped to recognize examples of BPD in media and film and determine which examples are stigmatized. However, since only one focus group will be conducted and one example of BPD will be shown, participants may not be able to come to concrete conclusions. Further groups with different sets of people, different types of media shown during each group, and multiple sessions per group must be conducted for the most accurate results in the study.

The results will be published across multiple different social media platforms in order to reach audiences of various demographics. In doing so, an increased sense of understanding and empathy is expected from the published results, therefore changing the public’s perspective on Borderline Personality Disorder in young women and how it affects their interpersonal relationships. Ultimately, in the long run it is hoped that young women with Borderline Personality Disorder are living in a society that understands their disorder and helps them create and maintain healthy, functional relationships.

References

Hessels, Christel J., et al. “Borderline Personality Disorder in Young People: Associations with Support and Negative Interactions in Relationships with Mothers and a Best Friend.” Borderline Personality Disorder and Emotion Dysregulation, vol. 9, no. 1, Jan. 2022, pp. 1–11, https://doi.org/10.1186/s40479-021-00173-7.

This study focuses on positive and negative interactions between individuals with Borderline Personality Disorder (BPD) and their mothers and best friends. The group of individuals with BPD were mainly adolescents from the ages of 12 to 26 with the majority being female. BPD in younger people is generally associated with dysfunctional relationships especially with parents and peers. The study showed the negative interactions with the individual’s mother and best friend were associated with BPD.

Liebke, L., Bungert, M., Thome, J., Hauschild, S., Gescher, D. M., Schmahl, C., Bohus, M., & Lis, S. (2017). Loneliness, social networks, and social functioning in borderline personality disorder. Personality Disorders: Theory, Research, and Treatment, 8(4), 349–356. https://doi.org/10.1037/per0000208

This study focuses on the loneliness associated with Borderline Personality Disorder (BPD) through the psychosocial lens and relates it to social dysfunction. The study was done on 80 women and sought to see if social interaction affects the feelings of isolation caused by BPD. Two groups, a group of healthy women and a group of women with BPD, were tested for loneliness under the same social conditions. Although it was thought that the women with BPD would feel more isolated than the healthy group, both groups reported similar feelings calling for further research. However, increased social interaction was shown to significantly help both groups.

Navarro-Gómez, Sara, et al. “Romantic Relationships of People with Borderline Personality: A Narrative Review.” Psychopathology, vol. 50, no. 3, May 2017, pp. 175–87, https://doi.org/10.1159/000474950.

The aim of this study was to focus on romantic relationships with people with Borderline Personality Disorder (BPD). The study’s participants were mainly women and showed that people with BPD had frequent and unstable romantic relationships. Compared to those without BPD, the relationships people with BPD had were chaotic and did not have healthy attachment styles between the two partners. Although more research needs to be done, the dysfunctional behavior in these relationships can be attributed to BPD.

Runions, Kevin Cecil, et al. “Borderline Personality Disorder and Peers: A Scoping Review of Friendship, Victimization and Aggression Studies.” Adolescent Research Review, vol. 6, no. 4, Oct. 2020, pp. 359–89, https://doi.org/10.1007/s40894-020-00137-y.

This study focuses on adolescents with Borderline Personality Disorder (BPD) and their relationship with their peers. The study’s participants were mainly female with the mean age being between 13-18. BPD was associated with the problematic behavior observed in the study. However further research needs to be done in the study to cover multiple different kinds of peer relationships in youth with BPD.

Generative AI tool ChatGPT was used to aid in drafting this paper. All suggestions were proof-read and revised by the author.