Is BPD a Genuine Diagnosis or a Dismissive Label?

Curt and Katie chat about whether (or not) Borderline Personality Disorder is a useful diagnosis. We look at the difficulty in differential diagnosis, the huge overlaps with other diagnoses, and the harm caused by misdiagnosis and dismissal of these clients. We also explore whether BPD is just complex PTSD in disguise. We don’t come to total agreement, but we get a little bit closer on how we can move past the harmful elements of the BPD label. 

Transcripts for this episode will be available at mtsgpodcast.com!

In this podcast episode we explore the diagnosis of Borderline Personality Disorder

After reading an article that suggests that there is no clinical utility to the BPD diagnosis, we decided to dig into whether or not BPD is a diagnosis worth using. We struggled to get this episode recorded as we started from a place of deep disagreement. We were able to get to a helpful conversation, we think.

Why is Borderline Personality Disorder controversial?

·       It is heterogeneous

·       There are a lot of rule outs and overlap with other diagnoses

·       There may not be clinical utility in using this diagnosis

·       There is bias and judgment related to having this diagnosis

·       There is a lot of harm from misdiagnosis

What are the problems and challenges in diagnosing “BPD?”

·       Overlap with autism, psychosis, complex or chronic trauma and others

·       Must look at the causes rather than solely the symptoms

·       The ongoing complexity of how trauma interacts with other elements of a person’s experience and personality make it hard to tease out what is really going on

How is Borderline Personality Disorder distinct from Chronic PTSD?

·       First you must understand the relationship between PTSD and Chronic or Complex PTSD

·       A theory is that Chronic PTSD has more relational avoidance than BPD

·       Another theory is that BPD has an absence of sense of self, which CPTSD does not

·       There is literature that shows that not all patients with BPD have trauma history

Should BPD remain as a recognized diagnosis in clinical practice?

·       We’re still not sure and don’t completely agree

·       At the very least, it needs to be renamed

Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:

Our Linktree: https://linktr.ee/therapyreimagined

Modern Therapist’s Survival Guide Creative Credits:

Voice Over by DW McCann https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano https://groomsymusic.com/