This weekly roundup thread is intended for all culture war posts. 'Culture war' is vaguely defined, but it basically means controversial issues that fall along set tribal lines. Arguments over culture war issues generate a lot of heat and little light, and few deeply entrenched people ever change their minds. This thread is for voicing opinions and analyzing the state of the discussion while trying to optimize for light over heat.
Optimistically, we think that engaging with people you disagree with is worth your time, and so is being nice! Pessimistically, there are many dynamics that can lead discussions on Culture War topics to become unproductive. There's a human tendency to divide along tribal lines, praising your ingroup and vilifying your outgroup - and if you think you find it easy to criticize your ingroup, then it may be that your outgroup is not who you think it is. Extremists with opposing positions can feed off each other, highlighting each other's worst points to justify their own angry rhetoric, which becomes in turn a new example of bad behavior for the other side to highlight.
We would like to avoid these negative dynamics. Accordingly, we ask that you do not use this thread for waging the Culture War. Examples of waging the Culture War:
-
Shaming.
-
Attempting to 'build consensus' or enforce ideological conformity.
-
Making sweeping generalizations to vilify a group you dislike.
-
Recruiting for a cause.
-
Posting links that could be summarized as 'Boo outgroup!' Basically, if your content is 'Can you believe what Those People did this week?' then you should either refrain from posting, or do some very patient work to contextualize and/or steel-man the relevant viewpoint.
In general, you should argue to understand, not to win. This thread is not territory to be claimed by one group or another; indeed, the aim is to have many different viewpoints represented here. Thus, we also ask that you follow some guidelines:
-
Speak plainly. Avoid sarcasm and mockery. When disagreeing with someone, state your objections explicitly.
-
Be as precise and charitable as you can. Don't paraphrase unflatteringly.
-
Don't imply that someone said something they did not say, even if you think it follows from what they said.
-
Write like everyone is reading and you want them to be included in the discussion.
On an ad hoc basis, the mods will try to compile a list of the best posts/comments from the previous week, posted in Quality Contribution threads and archived at /r/TheThread. You may nominate a comment for this list by clicking on 'report' at the bottom of the post and typing 'Actually a quality contribution' as the report reason.
Jump in the discussion.
No email address required.
Notes -
https://www.redalyc.org/journal/778/77876376007/html/
That's a systematic review that should serve as a good point to start. I don't think you're actually going to get canceled for saying this in professional circles, but then again, I have little reason to say this to an actual BPD patient in clinic.
My condolences about your SIL, but the good news is that DBT is surprisingly effective. I'm still grateful to @Throwaway05 for telling about that years ago.
@wsgy
Like many diseases states BPD is thought to essentially be a "two hit" problem - genetics loads the gun by giving you a predisposition to emotional lability in response to stresses and some life event fires it. Usually this is little t trauma or big T trauma. For more complications on this, see the discussion about C-PTSD.
Anti-Social PD and true sociopathy seem to be somewhat similar,* and for a hilarious and more medical example you can see "cigarette smoking pulmonologist" phenomena (lung cancer is a genetic phenomena and you can't fire the gun if it's not loaded).
Childhood sexual trauma is about as big T Trauma as you can get.
Once impacted by the disorder BPD individuals are more likely to continue to receive and deliver IPV for all the usual reasons including poor choices in partners, ongoing poor coping skills, the presence of mental illness (often with morbidity) and substance use.
With respect to Human's comment on DBT - in many ways BPD is one of the better diseases to have. With appropriate life course and engagement in therapy you can smother the disease state and it goes away. Period (compare with say Bipolar). Historically the more maverick individuals would prescribe a dick (with appropriate male partner) and if the dick puts up with the BPD long enough it dies on its own. This is....old fashioned, but a kernel of the wisdom remains, the natural progression of cluster-b personality disorders (aka persistent teenage brain) is to eventually develop an adult brain, you just need enough of your life to be remaining by the time you get there.
Modern social trends have....presented some problems, but the increase in prevalence in therapy is a counter balance.
Individuals in medicine usually think BPD is worse than it is in aggregate because we spot it media/celebrities when it's quite severe, and when it's noticeable in patient populations its usually severe (especially if your only major experience is IP and you only see the worst of the worst).
If you work enough non-psychiatry outpatient clinic and look closely you'll see a variety of personality disorders with a variety level of function just going about their business getting general medical care and living their lives.
Not every patient is belligerent, suicidal, and homicidal.
*Bad outcomes in development is a problem for all sorts of shit. TBH I'm very annoyed at your preceptors not talking ACE and the impact on development at some point in Psychiatry or Pediatrics.
More options
Context Copy link
More options
Context Copy link