Introduction

This chapter will explore the complex and intergenerational trauma that many women with psychiatric diagnoses such as borderline personality disorder experience. We propose that labelling responses to trauma as mental illness often results in further trauma, in stigma and psycho-emotional disablism. Practice responses and the reactions of other people can then contribute further to the distress experienced. However, if individuals’ responses to trauma are understood as psycho-emotional adjustments that open up possibilities for alternative reactions on the part of services and communities, that are empowering, build strengths, reduce further risk-taking and boost resilience. The work of Thomas (1999) and Reeve (2004) on expanding the concept of the social model of disability, provides a useful starting point for unpacking this complex interaction.

The social model of disability challenges the medical model as ‘an artificial and exclusionary social construction that penalises those… who do not conform to mainstream expectations of appearance, behaviour and/or economic performance’ (Tregaskis, 2002, 457). Those who experience mental distress may be seen as transgressing all of these expectations, as a result both of the impact of their perceived impairment (for example, depression, anxiety or psychosis) and the behaviour often associated with it (such as withdrawal, lack of self-care, self-harming or talking to voices). While the social model challenges exclusionary social structures, Thomas (1999) called for its extension through a social relational model to take into account impairment effects and the psycho-emotional effects of disablism.

Carol Thomas defines disability as a ‘form of social oppression involving the social imposition of restrictions of activity on people with impairments and the socially engendered undermining of their psycho-emotional well-being’ (Thomas, 1999, 60). For her, psycho-emotional disablism involves ‘the intended and unintended “hurtful” words and social actions of non-disabled people (parents, professionals, complete strangers, others) in inter-personal engagement with people with impairments’ (Thomas, 2007, 72). Donna Reeve’s chapter in this book (Chapter Seven) uses this notion to analyse the complex interplay between impairment, mental distress and disablism. In this chapter we build on her work by exploring complex trauma as a form of psycho-emotional disablism, particularly for women. The concept of psycho-emotional disablism is useful here because of its emphasis on forms of disablism and distress that are often unrecognised.