The memoir The Buddha and the Borderline tells the story of Kiera Van Gelder’s courageous journey receiving treatment for borderline personality disorder (BPD). BPD is a personality disorder defined by the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) as “a pervasive pattern of instability of interpersonal relationships, self-image, affects, and marked impulsivity” (American Psychiatric Association, 2000). BPD is a personality disorder and thus cannot be diagnosed until after the age of 18 when using the DSM-IV-TR’s diagnostic criteria. This does not imply, however, that BPD is an illness that restricts itself to adulthood; although the age of onset varies from individual to individual, BPD-like symptoms or features are usually evident in adolescence and sometimes even observed in childhood. In her memoir, Gelder states that she was diagnosed with BPD at 30 years of age but she later goes on to describe the symptoms of mental illness she experienced her entire life, including symptoms of depression and anxiety, mood swings, self-injurious behavior, suicide attempts, extreme self-image issues, binge eating and purging, and drug abuse (Gelder, 2010).
Perhaps one of the most puzzling facets of BPD, as in other mental disorders, is where and how it originates. One of the most common myths about BPD is that all of its sufferers are victims of abuse. While this is false, it is true that individuals with BPD are more likely to report experiencing traumatic events during childhood, the most common being physical and sexual abuse and seeing domestic violence (Herman, Perry & Van der Kolk, 1989). Gelder describes her own history of trauma toward the end of the memoir, in which she was manipulated into carrying on a sexual relationship an older male babysitter for years, beginning around the age of five. She ends her confession by saying:
“There’s no way I could have foreseen that becoming this child lover would trap me in an endless cycle of unmet need and desperate attempts to secure more love, each time offering myself to others in ways that only brought more secrets and shame […]. […] look at me now: a woman in her thirties who still longs to be touched so that I can become yet another imprint. I want to cry for that little girl now, but I can’t. I turn to Taylor at night hoping he can be lover, father, doctor, and friend all at once, but of course that’s an impossible dream” (Gelder, 2010, p. 138).
This is an example of a phenomenon in developmental psychopathology known as traumatic sexualization, which is when “a child’s sexual knowledge and behavior are shaped in developmentally inappropriate ways”, often as the result of sexual abuse (Mash & Wolfe, 2013).
A more exact description of a possible developmental pathway for BPD emphasizes a dynamic interrelationship between a traumatic childhood, a vulnerable temperament, and a triggering event (Zanarini & Frankenburg, 1997). A traumatic childhood is a very...