« Last post by experimental on March 25, 2017, 09:45:22 AM »
Well i think diagnoses are real entities/things. I thought that way before i had any adult understanding of what the DSM is or how diagnoses (of anything, from anywhere) are established. I felt and believed in the validity of these categories including BPD as a teenager and before any influence from any psych person. I think it's up to the diagnoser to understand and exercise their judgment about which thing or things someone has, and which ones are valid and meaningful while others are secondary or a spin-off of something. It may well be both, and it'd be irresponsible not to capture it as such. I later found out there are guidelines and much discussion about these things, especially complicated/ambiguous/conceptually-unclear categories. But that doesn't stop it from being valid. So it bothers me when people say diagnoses don't matter or it's the person that counts or docs/pdocs/professionals/experts/Ts don't know what they're doing and undermine all of it. Because it's real and meaningful to me. And for a long time i wrangled these on my own.
And hey i'm not a doctor or diagnoser or whoever else, but I can see things and I expect and will only give time to doctors who can exercise at least an equal level of clarity and clinical judgment. Of which they are qualified for. I agree many people suck at it despite that. And it's a really awful experience for us when they do. But these are meaningful categories and I want to swim away from the current in survivor communities where believing in yourself and your value or uniqueness equals rejecting these categories and the expertise that sits behind that (or should sit behind that). I feel like i'm trying to keep sight of its value and worth. I'm not either a doc of any sort nor someone helped by one (ie able to finally trust one who is wise and competent and great), so i can't be idealising their greatness, and i have my share of cynicism and bitterness. Not that you guys make me feel that way, but it's just conversations i've been in before elsewhere.
It's up to the diagnoser to exercise an appropriate level of judgment about both the diagnosis and its description. It's up to the reader of my records to exercise sensible judgment about complexity in whatever is described, any overlaps or similar terminology, or variations of the same phenomenon under different terminology or descriptors (even my brain injury has a clusterfk of words). Sometimes it's not realistic to expect anyone coming upon my medical record to understand it all deeply, and you could even say that it's only natural NOT to understand it for most medical contexts, but that doesn't undermine what it is. It's a problem of governance or people (and context) or process, which is a different thing, different discussion.
I certainly don't want to minimise or dismiss the destructive impact of many people with BPD. But the category in itself is meaningful to me and I'm glad and happy that it was seen in me in some way because it's illuminating for a number of things. And also cos i have positive associations with the term to begin with.
And i guess im on a 'psychiatric' swing in rebound from old-t's vague anti-diagnoses position to a detrimental degree. and recently getting in touch with the extent of clinical thought in my head sequestered away all this time. so it's the combo of the two leading to these posts. heh.
FWIW i would most probably not meet criteria now anyway, but aged 16-20 if i went to say a hospital during one of my really bad days (as they say you should do but i never did) and was really honest about everything that was going on and my thought process (which i would never have done cos it was far more about hiding everything), it would be easy and understandable to have diagnosed me BPD.