In biographer and journalist Sally Bedell Smith's otherwise thoroughly researched, well-written life of Diana, Princess of Wales, DSM-IV is put to questionable use. "While one cannot say with certainty that Diana had a borderline personality disorder, the evidence is compelling," the author writes. "The most important factor setting the borderline personality apart from those with other disorders is early parental loss—in Diana's case the departure of her mother and the emotional withdrawal of her father for several years following the Spencer divorce." During Diana's lifetime, someone close to Prince Charles consulted both a psychiatrist and a psychologist, who agreed that her behavior "fit the description of the borderline personality in quite extraordinary detail." The effects of Diana's parents' divorce were certainly traumatic and led to lifelong problems with issues of abandonment, anxiety, and insecurity. Diana often wept before and after public engagements due to both her own high expectations for herself and the public's expectations of her. She was prone to mood swings, bulimia, self-mutilation, lying, and inattention. These symptoms could suggest any number of diagnoses other than borderline personality disorder. What useful purpose does it serve, and how much harm may it do, for anyone—psychiatric professional or otherwise—to make a posthumous diagnosis of mental illness? More to the point, is it appropriate?
Throughout Ms. Smith's book, it becomes clear that the British, especially the upper classes, view psychiatry with intense skepticism and disdain. Raised as a member of the aristocracy, Diana was supposed to keep a stiff upper lip—to sort herself out, rather than seek psychiatric help. To his credit, Prince Charles did try to get Diana
