Démanteler la construction diagnostique du trouble de la personnalité limite : une analyse critique du discours

Titre original en anglais : Dismantling the Diagnostic Construct of Borderline Personality Disorder: A Critical Discourse Analysis

Cobbaert, L., Maloney, E., Harding, K., & James, S. (2026). Dismantling the Diagnostic Construct of Borderline Personality Disorder: A Critical Discourse Analysis. International Journal of Mental Health Nursing, 35(2), e70241-e70241. https://doi.org/10.1111/inm.70241

Date de publication: 25/02/2026 Ajout dans AutiHub: 06/07/2026 Type: Article Langue de l’article: Anglais

Cette publication est intégrée dans AutiHub via :

Auteurs

Auteur·ices des publications
4
Auteur·ices de la publication identifié·es comme autistes
2 / 4 (50,0 %)

Résumé

Le trouble de la personnalité limite (TPL) est largement présenté comme un diagnostic psychiatrique objectif décrivant une détresse émotionnelle et relationnelle. Toutefois, les travaux féministes, décoloniaux, sur la neurodiversité et dirigés par l'expérience vécue montrent que le TPL a émergé au sein d'épistémologies coloniales, cis-hétéronormatives, misogynes et neuronormatives qui moralisent la détresse et régulent l'identité, l'expression de soi et l'accès aux soins. Cet article examine de manière critique le TPL en tant que construction diagnostique et technologie de gouvernance qui produit des préjudices iatrogènes par l'injustice épistémique, l'exclusion structurelle et des interprétations moralisées des besoins. Il explore comment le diagnostic discrédite les savoirs issus de l'expérience vécue, justifie le retrait des soins et masque les déterminants sensoriels, culturels et structurels de la détresse, et examine les implications pour la pratique infirmière en santé mentale. Une analyse critique du discours a été menée à partir de la littérature psychiatrique, de documents de politique publique, de textes diagnostiques historiques et de travaux sur l'expérience vécue, en considérant le langage et la catégorisation psychiatriques comme des technologies de pouvoir façonnant la crédibilité et la réponse clinique. L'analyse montre que le TPL fonctionne moins comme une description clinique que comme un cadre réglementaire maintenu par des normes genrées, coloniales et cis-hétéronormatives. Les récits dominants sur la dépendance, la théorie de l'attachement et l'expression émotionnelle masquent les traumatismes, les différences sensorielles et la violence structurelle, tout en légitimant des pratiques coercitives et excluantes. Les infirmiers et infirmières en santé mentale sont placés en première ligne dans la mise en oeuvre de ces logiques, éprouvant souvent une détresse morale. Le diagnostic de TPL manque de légitimité épistémique, culturelle et éthique. Son utilisation continue compromet la sécurité thérapeutique et la confiance. Une transition de réduction des préjudices s'éloignant de la construction du TPL est nécessaire, en donnant la priorité à la sécurité relationnelle, à des soins tenant compte des dimensions sensorielles et adaptés sur le plan culturel, à l'humilité épistémique et au leadership de l'expérience vécue.

Borderline personality disorder (BPD) is widely presented as an objective psychiatric diagnosis describing emotional and relational distress. However, feminist, decolonial, neurodiversity and lived experience-led scholarship demonstrates that BPD emerged within colonial, cisheteronormative, misogynist and neuronormative epistemologies that moralise distress and regulate identity, self-expression and access to care. This paper critically examines BPD as a diagnostic construct and governance technology that produces iatrogenic harm through epistemic injustice, structural exclusion and moralised interpretations of need. It explores how the diagnosis discredits lived experience knowledge, justifies care withdrawal and obscures sensory, cultural and structural determinants of distress and considers the implications for mental health nursing practice. A critical discourse analysis was conducted across psychiatric literature, policy documents, historical diagnostic texts and lived experience scholarship, treating psychiatric language and categorisation as technologies of power shaping credibility and clinical response. The analysis shows that BPD operates less as a clinical description than as a regulatory framework maintained through gendered, colonial and cisheteronormative norms. Dominant narratives of dependence, attachment theory and emotional expression obscure trauma, sensory differences and structural violence, while legitimising coercive and exclusionary practices. Mental health nurses are positioned at the frontline of enacting these logics, often experiencing moral distress. The BPD diagnosis lacks epistemic, cultural and ethical legitimacy. Its continued use undermines therapeutic safety and trust. A harm reduction transition away from the BPD construct is required, prioritising relational safety, sensory-informed and culturally responsive care, epistemic humility and lived experience leadership.

Bibliographie citée par cette référence

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Vue d’ensemble de l’inclusion dans la bibliographie

Ces indicateurs décrivent la bibliographie citée importée pour cette publication. Les métriques de références citées utilisent le total des références citées comme dénominateur. Les métriques d’auteurices cité·es indiquent si elles utilisent toutes les occurrences d’auteurices cité·es ou seulement les occurrences rattachées à des auteurices déjà intégré·es à la base de données AutiHub. Ils utilisent les rattachements mis en cache entre les auteurices cité·es et les auteurices intégré·es à la base de données AutiHub. Dernier calcul : 16/08/2026 11:31.

Références citées
187
Nombre total de références citées intégrées pour cette publication.
Références citées avec un·e auteur·ice identifié·e comme autiste
6 / 187 (3,2 %)
Occurrences d’auteur·ices cité·es identifié·es comme autistes
6 / 550 (1,1 %)
Parmi les occurrences rattachées à des auteurices intégré·es à la base de données AutiHub : 6 / 30 (20,0 %). Auteurices cité·es distinct·es identifié·es comme autistes : 5 / 512 (1,0 %).
Occurrences citées rattachées à la base AutiHub
30 / 550 (5,5 %)
Auteurices cité·es distinct·es rattaché·es : 29 / 512 (5,7 %)
Occurrences rattachées, non identifiées comme autistes
24 / 30 (80,0 %)
Parmi les seules occurrences rattachées. Sur l’ensemble des occurrences d’auteurices cité·es : 24 / 550 (4,4 %). Auteurices cité·es distinct·es rattaché·es, non identifié·es comme autistes : 24 / 29 (82,8 %).
2 entrées de bibliographie citée n’ont pas pu être entièrement enrichies à partir des métadonnées DOI.
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