A Comparative Critique of Borderline Personality Disorder (BPD) in the Plot of the story Guide to dying with medicinal herbs

Examining physical and psychological disorders in literary works through the lens of clinical symptoms is an approach that can open new horizons for readers. However, such research have not received much attention in Persian literature. This qualitative study analyzes the components related to borderline personality disorder in the story Guide to Dying with Medicinal Herbs by Atiyeh Attarzadeh, utilizing the diagnostic criteria outlined in the DSM-5. The results indicate that six criteria from the DSM-5—namely, efforts to avoid abandonment, unstable interpersonal relationships, impulsivity, recurrent self-harm, feelings of emptiness, and paranoid ideation—can be identified in the main character of the story. Furthermore, focusing on this disorder in the protagonist enhances the story's believability by elucidating the motivations behind various events. Therefore, this approach not only deepens the understanding of the behaviors and mindset of individuals with borderline personality disorder but also enriches the reading experience of literary texts.
Introduction:
Nowadays, comparative studies have experienced significant transformations worldwide, focusing on the connections between literature and other type of arts and sciences, including medicine. The interaction between fictional literature and medical texts, as well as the role that familiarity with language and literary works can play in conveying clinical teachings and medical ethics, is a crucial matter that needs to be addressed. Research in this field can increase the appeal of literary works and enhance audience engagement while broadening readers' perspectives.
Methodology:
In this article, the author examines borderline personality disorder in the novella The Guide to Dying with Medicinal herbs by Atiyeh Attarzadeh using a qualitative method and a comparative approach to clinical signs and narrative structure. The author aims to provide precise and sufficient evidence for their claims. To align the symptoms of the disorder in this literary work, the latest edition of "Summary of Psychiatry: Behavioral Sciences / Clinical Psychiatry" serves as the foundational reference. The author seeks to answer the following questions: What diagnostic criteria related to "borderline personality disorder" are employed in the narrative? How does the text of this story engage in a referential exchange with the signs present in clinical psychiatry texts?
Results and Discussion:
The results indicate that the main character in the analyzed narrative exhibits symptoms consistent with the clinical criteria for Borderline Personality Disorder (BPD) as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) by the American Psychiatric Association. These symptoms appear to be influenced by environmental and physical circumstances following exposure to traumatic events. Table 1 illustrates the alignment of six symptoms associated with this disorder as depicted in the narrative.
Additionally, alongside the description of clinical symptoms, the narrative effectively outlines the biological and environmental factors contributing to the emergence of this disorder. These factors include trauma from losing eyesight, abandonment by the father, the severe emotional distress of the mother in response to her husband's infidelity, and neglect of the child's needs. This demonstrates the author’s skill in creating realism and believability, fostering a connection between the reader and the text, which enhances its impact. Notably, the author employs evocative language to depict the internal and mental states of the afflicted individual, creating a metaphorical representation of their physical and psychological conditions.
The study of this narrative is significant because it employs descriptions that align with clinical criteria for diagnosing Borderline Personality Disorder (BPD) while using literary language to depict the inner experiences and mental states of the affected individual. This approach can foster a deeper understanding and improve interactions with individuals suffering from this disorder, making it particularly beneficial for those who work with such patients. These readings not only familiarize readers with contemporary narrative literature but also aim to enhance comprehension and engagement, especially for those who interact with these patients in various capacities.

Conflict of Interests: The author declares no potential conflicts of interest concerning the research, authorship, and publication of this article.
Ethical Considerations: The authors of the present study take the responsibility of being honest and following ethical issues in using all the references.
Funding: There was no funding support.

Conclusion:
Investigations suggest that the causal relationships among events in the text align with the etiological frameworks proposed by researchers in psychology. Various theories and models regarding the etiology of borderline personality disorder and its associated characteristics have been presented in specialized literature, all emphasizing the interplay of biological and environmental factors. In The Guide to Dying with Medicinal Herbs, at least six out of nine clinical signs of borderline personality disorder, according to clinical diagnostic sources, are identifiable in the narrator or main character, as shown in Table 1. It appears that neglecting the main character's need to develop interpersonal skills and restricting their social engagement leads to ongoing and unrelenting suffering, resulting in conflicting emotions regarding loneliness. At times, this loneliness is comforting, while at other times, it is distressing. Additionally, throughout the story, two experiences related to abandonment become pivotal for the main character, with the mother being central to both narratives. Through vivid storytelling, the author effectively underscores the importance of connection with others and the need to escape loneliness in the protagonist's life. The journey depicted in this story represents the most significant event experienced by the main character, fundamentally altering their relationships with others. Throughout the narrative, the dual emotions of love and hate, fear of loneliness, and dissatisfaction with life circumstances are repeatedly illustrated through the character's words. The character's actions and their portrayal are appropriately influenced by one another throughout the story. The causal relationships inferred by readers from the end to the beginning reveal traits of the main character. Notably, characterization is achieved indirectly; readers gain insight into the main character through their actions.
Some researchers have utilized narratives that describe illnesses to enhance the learning of clinical topics for medical students. Others argue that studying these narratives benefits both practitioners in the field and the general public by promoting a better understanding of patients. Consequently, examining these narratives—due to their alignment with clinical diagnostic criteria and their use of literary language to convey internal emotional states—can effectively deepen our understanding of individuals suffering from these conditions. Such readings not only familiarize readers with contemporary fiction but also aim to improve understanding and interaction, particularly for those who work with these patients.