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A couple of thoughts from me:

Some on here have suggested that Borderline Personality Disorder should be renamed something else. I hear what you guys are saying, but how long would it be before the new name simply became a term of abuse like the old one? Would it simply result in the nurses on the acute ward moaning about “another bloody Emotional Dysregulation Disorder” instead?

If we’re going to persuade the powers that be to pump money and resources into services for people with personality disorders, I think there’s a good case for putting those resources into CAMHS. Admittedly I would say that because I’m a CAMHS nurse, but the best window of opportunity for treating the PD is when it’s forming in a child or adolescent, and we still have a chance to redirect them down a different road.

Alternatively, since Early Interventions in Psychosis teams are increasingly in vogue, perhaps we should look at having Early Interventions in Personality Disorders teams too, working with an age range of, say, 14 to 21, and giving them a few intensive years of psychotherapy during their formative years.

Finally, I’d just like to give my thanks to Lou and Disillusioned for giving their own personal insights on the suggestion that PDs are untreatable and that people with PDs can’t recover. As their testimonies show, both of those suggestions are simply bollocks.

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After all - everybody has a personlaity and that doesn’t stop most people getting appropriate help. The problem with personality disorder is that we get confused about what we’re supposed to be doing.

I have worked with many people with borderline and other personlaity disorder diagnoses. The task is always the same - work on the problems and not the personality type.

For what it’s worth

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Thanks for your postive responses.

Personally, I would welcome a change in the BPD label.

Especially when I’ve never been admitted to a secure unit, have a Univerity degree, a reasonably successful career and have spent a lot of time working with special needs adults in a professional capacity. I
As you can imagine, this label could have potential implications for my career, which are much more negative than ‘Bioplar’ or ‘Severe depression’ could ever be.

It

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Neither seems a particularly easy option, but Len Bowers has done research on what kinds of nurses work most successfully with people with PD in secure hospitals and also into what they do that enables them to work so successfully. This could inform staff training. I certainly found it useful to reframe some of the behaviour that I found so very challenging to work with - like you say, pesky, think of it as survival mechanisms. But then, I often had a sneaking admiration for some of our BPD patients, particularly the more rebellious ones.

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I think that the problem is with having a label or a frame of reference imposed on one from above - I’m talking about the many many more people I’ve met who’ve been diagnosed with BPD who have been told they have BPD, who do not agree, who do not find it a useful way to conceive their distress, but who nonetheless carry that diagnosis because the system for helping people in distress happens to have the medical model at it’s foundation. This simply does not allow for people to frame their experiences in any of the myraid of different ways that would suit them better. It’s not the existence of the medical model that I’m opposed to, just it’s dominant position in mental health care.

It should be one of many options for people to understand themselves as disordered and needing fixing, but in fact it is the only one. And, though I have met some practitioners who work very skillfully in this framework and utter the phrase borderline personality disorder with the deepest respect for the person they are discussing and their experiences, unfortunately I have met many more who throw the term around as a short-hand off “pain in the ass”. It is associated with all the hopelessness of not being able to fix what’s perceived as broken, and the helplessness that this arouses in practitioners. When practitioners turn this outwards and project their own difficult feelings onto the people they’re working with, BPD simply becomes a good way to blame people for being miserable and for making others miserable, and to wash ones hands of them. So I don’t really see it as much of a choice personally not in the current climate.

Personality disorder has been seen as a “waste-bin” diagnosis by critics in the sense that it is the box into which patients who don’t fit into any of the other boxes have been thrown. As such, the presentation and experience of people thus classified can vary so immensely that it can hardly be considered a valid concept.

It may not be possible to wish BPD away (or the rest of the psychiatric classification system), but that’s no reason to stop trying to! The campaign for the abolishion (sp?) of the schizophrenia label (CASL) are working on it for schizophrenia, but why stop there?

Shrink, the problem with your argument that conceptualising it as a disorder will lead to the possibility of treatment and the benefit and improvement is that this is not a “disorder” with a great “recovery rate” is it? Being diagnosed with BPD is much more likely to mean “hopeless case” to the person and those around them then “good potential for recovery”. It means you’re broken in a way that either can’t be fixed or would be too expensive and take too long to fix because you are SO BADLY broken. Besides which, just because a doctor has diagnosed a personality disorder does not mean that the treatments available for personality disorders are what the person needs. It’s really not everyone labelled BPD that needs constant confrontation about their impact on others, extra-strong boundaries all the time, not to be given too much attention in a crisis, no medication ever because they’re not ill, and hours and hours of sitting in highly charged group settings. Some people might just need some love, warmth, nurturing, holding, hugs, yoga, gardening, meditation, children, animals, friends, therapy, moderate medication, a flexible and meaningful job, a creative outlet, and some periods of respite. That’s not about “fixing” what’s broken, it’s about learning, understanding, living and growing.

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I agree with you to some extent. I think most people who suffer from a mental illness are desperate to find out what’s wrong with them and actively seek a diagnosis.

However, I was devasted when I found out I had been diagnosed with a personality disorder. In my opinion, it is the worst possible diagnosis, and carries so much stigma with it, that the diagnosis was a trauma in itself. For a while, I was actually convinced that I was bipolar, and in some ways, I would still prefer this label, because it implies a ‘proper illness’ and not an attention seeking waster who takes up valuable bed space.

I would prefer “Emotional Regulation Disorder” or similar, because words do matter. Especially when a future employer/midwife has a peek at your medical notes and thinks “axe” “Broadmoor” and “foster Care.”

It’s bad enough having horrible things happen to you as a child/adult and nearly destroying yourself to cope with the trauma. It’s worse to end up with a label that confirms your worst thoughts about yourself, and perhaps this is not entirely the label’s fault.

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I’m having a blonde moment. What is the meaning, here?

We all agree that people who have such a label, diagnosis, explanatory framework, symptom cluster (or whatever you wish to call it) have valid experiences and experience distress.

If, through being distraught, you reckon it’s a disorder and merits help, then that’s the model of an illness with the possibility of treatment and benefit and improvement. Sure, you acn use different symptom cluster and resolution models but the concept’s the same. Things ain’t right, fix it, get better. This is one benefit of conceptualising it as a disorder.

If, through being distraught, you reckon it’s a normal and expected emotional state to be in, which most of use would be in if we’d the same past life experiences, so it’s nothing to do with illness and health care and psychiatry ’cause it’s all just the natural, normal state of affairs, is this better?
“You’re not ill, phew! You’re still here? No no, you can go home, now . . . ”

I could get on to nosological validity of diagnostic labels but I’ll not. Rather than categorising it as an entity or diagnosis or label, I’m much more interested in why this is seen as a bad thing?

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I also think it perhaps does some disservice to people who may be bewildered and traumatised by their own behaviour/thoughts/feelings and its sequelae to assume that nobody would want to make sense of that in terms of a disorder. It may work for you to dismiss it altogether, but some people might like a diagnosis to hang onto. For some people, it may be enormously helpful to think in terms of a disorder rather than conceptualise your behaviour/thoughts/feelings as the result of some inner failing or the failings of others.

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Mr Ian, do you mean by the second part of your answer that that is the way you believe “people with BPD” think?, I’m not very clear.
Since (I believe) we all have self- and other- destructive tendencies, or at least we all do things that we know aren’t really good for us, or don’t do things that are, aren’t we all on some kind of bordeline continuum? Who gets to decide at what point along that continuum someone is classified as having a “disorder”. And why would they want to do that?

Any other answers?

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The extent to which they will destroy their world around and within themselves as a form of ‘coping’ - if it’s going to go to shit - may as well do it yourself and at least have some control over it.

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