Shrink Rap News: Brandon Marshall, the NFL, and borderline personality disorder

“He’s an articulate and charismatic male football player,” he said. “This takes it out of the realm of something that’s about weak people.”

The special did not talk about whether Marshall was taking medications – it was implied that he wasn’t – or if he has continued in treatment. We think of borderline personality disorder as being resistant to treatments, and certainly not as a disorder that can be fixed with 3 months of treatment. It was noted that Marshall has some unusual assets in addition to his charismatic personality: He has a vocation he loves and is good at, and he has supportive relationships. A clip was shown of an appearance he and Michi had made on “The View,” where he credited her support as being key to his success.

As psychiatrists, there is a delicate balance when treating patients with personality disorders. On the one hand, we want them to take ownership for their behaviors in the hopes that they will be able to gain some control over them. To balance this, however, personality disorders can be as crippling as any illness we treat in psychiatry, and the prognosis for some people is dismal. While it may be helpful to have a diagnosis and an explanation, it’s not beneficial if the patient sees himself as the victim of an untreatable condition. The television special on Brandon Marshall did a wonderful job of presenting this disorder with a balance – as a problem that happens to people, perhaps because of their difficult childhoods – but one that the individual can learn to take control of in an empowering way.

We might imagine this remains an ongoing struggle for Marshall, not one that was treated and fixed. I, however, enjoyed watching an NFL production with a positive spin on what we think of as being such a devastating psychiatric disorder.

Dr. Miller is a coauthor of “Shrink Rap: Three Psychiatrists Explain Their Work” (Baltimore: Johns Hopkins University Press, 2011).