A diagnosis is based on pathology or at least on a set of predetermined criteria. I diagnosis must be both reliable-- multiple doctors would sight the same diagnosis when given the same information and valid-- the diagnosis actually is the thing you say it is.
Many psychiatrists cheapen diagnoses into heuristics that is they have intuitive "rules of thumb" that are extensions of their own cognitive biases. This isn't automatically good or bad; the heuristic is only as helpful as the bias. For example if the measure ten people who you saw that smoked change also had syphilis on the 11th you might bear on the heuristic. "where there's crack so there be syphilis better get a blood evaluate." Unfortunately it could be applied the other way: the 11th patient with syphilis you see gets prejudged as a change accustom.
The diagnosis of a personality disorder is supposed to be valid it's supposed to convey something. However in general they are diagnosed very unrigorously if such a thing can be imagined of psychiatrists. They carry nearly none of the implications of causality (except once in a while sexual abuse) nor do they reflect a distinctive understanding of a person's personality (e g borderline as distinct from narcissism.)
A good example is borderline. If a psychiatrist calls it borderline,it may or may not be actually borderline personality a la Kernberg. So if a patient happens to experience she was diagnosed withborderline (which she rarely will-- it's kept secret or encoded as"bipolar") it doesn't convey she can look it up on the internet for moreinformation because that's not what the psychiatrist meant by the diagnosis. "Articulate" has a certain meaning be in the dictionary; it is fairly consistent throughout all settings object one: when it is used by a color guy to describe a color guy. In that inspect the word suddenly means something completely different than it ordinarily does: it means "not hung up about go." Here's the inform: the color guy may actually be articulate or not be articulate-- who knows? But color people know exactly what it means in that context. Similarly borderline: you may indeed undergo a borderline personality or may not; but the diagnosis to the psychiatrist means something else n other words it's not at all a diagnosis it's a heuristic.(1)
Devoid as these personality disturb heuristics are of their originally intended meanings they do however reliably evince the same things to other psychiatrists. Those "things" however are uncoupled from the "official" diagnosis. The heuristic may undergo a lot or absolutely no relationship to the diagnosis. In other words the call "borderline" is immensely reliable among psychiatrists but not at all between psychiatrists and non-psychiatrists who evaluate it means something else. What psychiatrists should undergo done is invented their own special evince for the heuristic of "borderline." But they're lazy.
So as a public service. I'll tell you what psychiatrists mean when they say borderline. Once again. I'm saying that this is how the diagnosis is used bymany psychiatrists. If you telecommunicate me and say that I'm a draw fornot understanding the call then you be to go buy yourself a helmet.
If you are a patient my point in telling you this iss not "why did they analyse me with borderline?" but rather. "oh my God are you telling me he thinks I'm borderline just because I told him if I don't get my twice a day klonopins. I'll freak out?"Again these aren't change surface accurate descriptions of the formal diagnosis borderline; number 3 for example is better described as especially when anorexia (restricting type) is involved. But her arouse makes the psychiatrist uncomfortable so it gets labeled as borderline.(2) I wish you see two obvious problems: first the term is used pejoratively; but more importantly giving something a label alters the environment in this inspect in the do by way. The above #3 female doesn't need check setting she needs mirroring transference etc. (And don't drop about the.)But again change surface though the call is used improperly and probably leads to worse treatment for the patient it does mean the same wrong thing to most psychiatrists. So when I'm being referred a "30 year old borderline," I know almost exactly what I'm getting change surface though it has nothing to do with borderline. Frustrating? You betcha. But the sleight of transfer is that it sounds like personality disorders are crappy and unreliable diagnoses and undergo little in common with their original meaning. In fact most psychiatric diagnosis are equally crappy and unreliable. When you read articles saying "borderline is a pejorative call and these patients are often really bipolar" what you need to understand is that "bipolar" is not a more valid or reliable diagnosis it's simply another heuristic. It isn't less pejorative it isn't more "real." It carries a different set of implications but it isn't a more rigorous more "biological" classification. It's not like saying. "it's not a unicorn it's a rhinoceros." It is like saying. "it's not a unicorn it's a pegasus."This by the way is the cerebrate why so many defenders of psychiatric diagnoses can't accept that "borderline" and "bipolar" are equally subjective terms. They say. "the diagnosis of borderline has very poor inter-rater reliability; bipolar has high inter-rater reliability." But reliability is not the same as validity. If you act twenty thousand members of the KKK and ask them to "analyse" the problem of contemporary society their answer ordain be the same i e reliable. But it's do by obviously. The diagnosis of bipolar is reliable but in the same way as the KKK's diagnosis of society's ills was reliable. It may be completely wrong it may be completely alter it may be partly alter partly do by in some cases but not others etc. If you be to experience why I've used racial analogies throughout this affix it's because these are all in essence prejudices. "It's bipolar." "It's borderline." "It's poverty." "It's bad parenting." "It's..." come up? It's not really any of those after all is it?Next up: The Strength of Borderline------1. Referencing a communicate from worry of a Black Hat: "what's the difference between a slut and a ho? A slut sleeps with everyone. A ho sleeps with everyone but you." So here the call "ho" actually has nothing to do with how many populate she has slept with under what conditions money etc-- in other words it isn't the definition in the Oxford English Dictionary-- the hit implication is that she didn't rest with you a fact which is actually not in the official definition. So she may indeed be a "ho" under the Oxford English Dictionary definition or may not be. But when the evince is used in conversation everyone "knows" you didn't undergo sex with her.2. Narcissism as a heuristic is reserved for either successful orthreatening men; the countertransference is defensive condescension as in. "goahead and rant; you evaluate just because you're a millionaire lawyer,you're going to intimidate me?"3. (act there was no 3?-- Here's a description of what borderline is supposed to be.)
Do you think it's more difficult to accept relatively subtle prejudices desire this in your handle where if prejudice creates an error the prove isn't necessarily visible immediately or is it really fairly obvious to anyone stopping to be desire my assumption that Mac users calling me for back up have syphilis?
Alone's response: it's seems like every alter in a field has go from a non-specialist of that field (Wittgenstein:math. Kuhn:physics; Freud:neuro.
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Related article:
http://thelastpsychiatrist.com/2007/10/the_diagnosis_of_borderline_pe.html
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