Re:BPD and conflicting diagnoses

Just an opinion, intended in addition to the other responses, (which I have no problem with) ...

1. Diagnosis is _mostly_ the concern of clinicians for their purposes and its value or problems are not intended to be obstacles to your accomplishing your goals. However it *can* be of value to you. Take what is of value to you from it to guide your path. Don't get locked into it. Don't let the heavy politics around mental health issues dissuade you from learning more about your own options. Use the diagnoses as a starting point, not a form of confinement. Think of *multiple* diagnoses as *multiple* different opportunities or starting points to improve your life rather than as conflicting hypotheses to choose between. If they don't suggest a positive course of action, then their relevance to you is limited.

2. Diagnoses are rarely mutually exclusive, especially on different axes. People can fit multiple syndrome patterns at once to different degrees because they are dealing with different ways of looking at a whole complex human life. There are criteria established to help distinguish similar but distinct syndromes, but they can be arbitrary. They have improved over time however.

3. The cluster associated with what has been sometimes known as "Borderline personality" is a very distinctive one that is infamously difficult for other people to deal with, not just clinicians. It is frequently comorbid with other syndromes, and the quibbles over the name are just politics. Freudians originally thought, erroneously, that BPD was somehow on the "border between neurosis and psychosis," hence the name. It isn't important.

A good practical guide for understanding BPD patterns of behavior and the effects on people around the sufferer is:
"Stop Walking on Eggshells," by Mason and Kreger. Also helpful are: Kreisman and Straus' "I Hate You - Don't Leave Me," and Santoro and Cohen's "The Angry Heart."

It doesn't by any means require that you buy into a clinical diagnosis of BPD to get some insight from these sources. The practical advice they offer is of some more general value as well in dealing with difficult people or dealing with people under particularly difficult conditions. In fact,that would be my biggest complaint,that they often offer such general advice.

My best to you and my hopes that you have reliable support around you from friends and loved ones.

kind regards,

Todd

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