5 ms·

If people get one thing and only one from this thread, it should be this: the vast majority of popular work on BPD (e.g., Stop Walking on Eggshells, mentioned b

If people get one thing and only one from this thread, it should be this: the vast majority of popular work on BPD (e.g., Stop Walking on Eggshells, mentioned below, and "I hate you, don't leave me", etc.) is based on research that is decades out of date and substantially obsolete. If you want to learn about BPD, start with the research on Dialectical Behavior Therapy [0] and grow from there. Before you write off BPD people or assume you know how this disorder works or what the prognosis is, take the time to read up on more recent work in this field. BPD is one of the least-understood diagnoses in the DSM, and most people who write about it appear completely unaware of the last ~30 years of research on this disorder. [0] https://en.wikipedia.org/wiki/Dialectical_behavior_therapy https://en.wikipedia.org/wiki/Dialectical_behavior_therapy

phkahler 9y ago
>> BPD is one of the least-understood diagnoses in the DSM That's funny because from what I've read, DBT is the only proven treatment for any of the personality disorders and it's used for BPD. My reading suggests that SPD is the least understood, and probably the most common among HN readers (that part is speculation on my part).
- agency 9y ago
  according to the wiki page on SPD[1], it is not currently recognized in the DSM [1] https://en.wikipedia.org/wiki/Sensory_processing_disorder https://en.wikipedia.org/wiki/Sensory_processing_disorder
  - leadingthenet 9y ago
    I think he means this: https://en.wikipedia.org/wiki/Schizoid_personality_disorder https://en.wikipedia.org/wiki/Schizoid_personality_disorder
    - SimbaOnSteroids 9y ago
      The first one has a correlation with ADHD and Autism Spectrum Disorders. Both of which I'd imagine are fairly common among HN readers.
    - googleit 9y ago
      The very first link on google for me is Symphysis pubis dysfunction https://en.wikipedia.org/wiki/Symphysis_pubis_dysfunction https://en.wikipedia.org/wiki/Symphysis_pubis_dysfunction For a second there I wondered why this would be very common on HN.
- azernik 9y ago
  I think GP meant least-understood by the broader public, not least-understood by the professionals treating it.
valuearb 9y ago
I think you overstate the "research" and "work" in this "field". Psychiatry isn't a science, and never will be one by it's very definition. Dialectical Behavior Therapy is just another flavor of the day for a discipline that has embraced unscientific quack theories since the days of Freud, and continues to do that today.
- dm319 9y ago
  > Psychiatry isn't a science This is a common misconception. In fact psychiatry were pioneers of the gold standard clinical evidence - the randomised controlled trial. I suppose if you were being ungenerous you could say that they weren't able yo do much other type of research. Psychiatry is just a specialism within medicine, none of which are science unless you look at the disciplines from an academic perspective. If you want the least evidence-based specialism, you're probably looking at paediatrics, where there is pretty much no evidence for what they do, as it is very difficult to involve children in trials. Another criticism of psychiatry is that there isn't a laboratory test for any of these diseases, but this is an unfair criticism of diseases that can be clearly defined (see criteria) and causes measurable harm (look at the overall survival of anorexia for example). It is also a criticism that can be levelled at many other diseases. If anyone can tell me what lab test you use to diagnose migraine I'd be interested. It's unfortunate that psychiatry have this problem. As a specialty they can do a lot of good for people who would otherwise not live for very long - if you've seen someone having a psychotic episode you'll know what I mean.
  - valuearb 9y ago
    Randomized controlled studies have little to no scientific value. Too easy to report random results, impossible to control for all factors, sample sizes never remotely large enough. Psychiatric theories can’t be falsified, making them not science.
    - ndidoiul 9y ago
      Ok... so here's another tidbit. Meta-analysis was really developed (although not originated) in psychology, attempting to wrestle with replicability issues in much the same way as is the case now. It's really the introspective nature of the human behavioral sciences that drives that as much as the complexity of what's being dealt with. And I'm not sure why you think psychiatric theories can't be falsified. It happens all the time. If it couldn't, this registered replication stuff wouldn't be getting so much attention, because it would be a non-starter.
blueprint 9y ago
> Within DBT it is the capacity to pay attention, nonjudgmentally, to the present moment; about living in the moment, experiencing one's emotions and senses fully, yet with perspective. Fully… except for judgements. Because judgement would be bad? Would a real Buddha have a contradiction in his teaching? The only thing I really have an issue with is the misunderstanding that Gautama Buddha taught mindfulness. The meditation people teach and learn today is completely different from what he taught people. For one thing, he certainly did not teach people to remember the truth of goodness. He did not teach people to abandon or ignore right and wrong because that has a terrible effect on human society in the long run – even though you do not perceive it through your practice of meditation alone. That's why it's important to learn about teachings about enlightenment from a real enlightened being, not from someone who has not achieved it yet. Modern Buddhism exists in the state of people transmitting what they learned from others, with their own thoughts added.
xor1 9y ago
>Before you write off BPD people or assume you know how this disorder works or what the prognosis is, take the time to read up on more recent work in this field. I was raised by a BPD mother (who actually did an incredible job coping with it as an adult, but she wasn't perfect), and I have dated multiple women with BPD (an all-too-common scenario apparently). I found Stop Walking on Eggshells and similar sources (e.g. the BPD articles on http://gettinbetter.com/articles.html http://gettinbetter.com/articles.html) extremely helpful when it came to recovering from my relationships. The first one had all sorts of red flags, but I was inexperienced and desperate. The one after that completely caught me off guard. She had done some DBT, but that only taught her how to conceal and restrain her symptoms. There is absolutely nothing wrong with writing off BPD people. Being in any sort of relationship with one is stressful, draining, and traumatic.

phkahler 9y ago

>> BPD is one of the least-understood diagnoses in the DSM That's funny because from what I've read, DBT is the only proven treatment for any of the personality disorders and it's used for BPD. My reading suggests that SPD is the least understood, and probably the most common among HN readers (that part is speculation on my part).

agency 9y ago
according to the wiki page on SPD[1], it is not currently recognized in the DSM [1] https://en.wikipedia.org/wiki/Sensory_processing_disorder https://en.wikipedia.org/wiki/Sensory_processing_disorder
- leadingthenet 9y ago
  I think he means this: https://en.wikipedia.org/wiki/Schizoid_personality_disorder https://en.wikipedia.org/wiki/Schizoid_personality_disorder
  - SimbaOnSteroids 9y ago
    The first one has a correlation with ADHD and Autism Spectrum Disorders. Both of which I'd imagine are fairly common among HN readers.
  - googleit 9y ago
    The very first link on google for me is Symphysis pubis dysfunction https://en.wikipedia.org/wiki/Symphysis_pubis_dysfunction https://en.wikipedia.org/wiki/Symphysis_pubis_dysfunction For a second there I wondered why this would be very common on HN.
azernik 9y ago
I think GP meant least-understood by the broader public, not least-understood by the professionals treating it.

valuearb 9y ago

I think you overstate the "research" and "work" in this "field". Psychiatry isn't a science, and never will be one by it's very definition. Dialectical Behavior Therapy is just another flavor of the day for a discipline that has embraced unscientific quack theories since the days of Freud, and continues to do that today.

dm319 9y ago
> Psychiatry isn't a science This is a common misconception. In fact psychiatry were pioneers of the gold standard clinical evidence - the randomised controlled trial. I suppose if you were being ungenerous you could say that they weren't able yo do much other type of research. Psychiatry is just a specialism within medicine, none of which are science unless you look at the disciplines from an academic perspective. If you want the least evidence-based specialism, you're probably looking at paediatrics, where there is pretty much no evidence for what they do, as it is very difficult to involve children in trials. Another criticism of psychiatry is that there isn't a laboratory test for any of these diseases, but this is an unfair criticism of diseases that can be clearly defined (see criteria) and causes measurable harm (look at the overall survival of anorexia for example). It is also a criticism that can be levelled at many other diseases. If anyone can tell me what lab test you use to diagnose migraine I'd be interested. It's unfortunate that psychiatry have this problem. As a specialty they can do a lot of good for people who would otherwise not live for very long - if you've seen someone having a psychotic episode you'll know what I mean.
- valuearb 9y ago
  Randomized controlled studies have little to no scientific value. Too easy to report random results, impossible to control for all factors, sample sizes never remotely large enough. Psychiatric theories can’t be falsified, making them not science.
  - ndidoiul 9y ago
    Ok... so here's another tidbit. Meta-analysis was really developed (although not originated) in psychology, attempting to wrestle with replicability issues in much the same way as is the case now. It's really the introspective nature of the human behavioral sciences that drives that as much as the complexity of what's being dealt with. And I'm not sure why you think psychiatric theories can't be falsified. It happens all the time. If it couldn't, this registered replication stuff wouldn't be getting so much attention, because it would be a non-starter.

blueprint 9y ago

> Within DBT it is the capacity to pay attention, nonjudgmentally, to the present moment; about living in the moment, experiencing one's emotions and senses fully, yet with perspective. Fully… except for judgements. Because judgement would be bad? Would a real Buddha have a contradiction in his teaching? The only thing I really have an issue with is the misunderstanding that Gautama Buddha taught mindfulness. The meditation people teach and learn today is completely different from what he taught people. For one thing, he certainly did not teach people to remember the truth of goodness. He did not teach people to abandon or ignore right and wrong because that has a terrible effect on human society in the long run – even though you do not perceive it through your practice of meditation alone. That's why it's important to learn about teachings about enlightenment from a real enlightened being, not from someone who has not achieved it yet. Modern Buddhism exists in the state of people transmitting what they learned from others, with their own thoughts added.

xor1 9y ago

>Before you write off BPD people or assume you know how this disorder works or what the prognosis is, take the time to read up on more recent work in this field. I was raised by a BPD mother (who actually did an incredible job coping with it as an adult, but she wasn't perfect), and I have dated multiple women with BPD (an all-too-common scenario apparently). I found Stop Walking on Eggshells and similar sources (e.g. the BPD articles on http://gettinbetter.com/articles.html http://gettinbetter.com/articles.html) extremely helpful when it came to recovering from my relationships. The first one had all sorts of red flags, but I was inexperienced and desperate. The one after that completely caught me off guard. She had done some DBT, but that only taught her how to conceal and restrain her symptoms. There is absolutely nothing wrong with writing off BPD people. Being in any sort of relationship with one is stressful, draining, and traumatic.