20 Comments
Jan 27, 2022Liked by Athena Walker

Afterthought: I wonder if there is also Borderline BPD? The lacking a consistent and integrated sense of identity thing is not something I have experienced, and the 'splitting' only at a low level. I suppose it makes sense that anything with diagnostic criteria will have some people at the margins.

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Jan 27, 2022Liked by Athena Walker

If only these terms were as clear in everyone's head as they are in this article. And then replaced altogether.

I will look up Elinor Greenberg's writing.

From what you say, borderline psychopaths would be fascinating to hear more from, with that complex and individually varied interplay between the emotional and the psycopathic traits. People who straddle two worlds- cultural, psychological, neurotypes, gender, all areas really- can have a great insights and a lot to say.

I would add two comments to the BPD treatment list. Medication can be of help not just for the comorbid conditions. There's the familiar story of people quickly going off their antidepressants because they hate that their feelings are dampened just too much. Well, some of those old fashioned heavy meds will do that. And while you might not want to take them for a lifetime, the partial numbness can for quite a while be a blessed relief for someone with BPD. Brain and body healing can occur, the patient can get a hopeful glimpse of an undreamt of possible existence with less pain, and then in time, all the practical steps can be taken to improve things. Also, it is a boon if a patient is lucky enough to have or find an important relationship with a safe person who will not compound the patients emotional deregulation with their actions and responses, but is prepared to work with them.

I had not considered the sexism angle for BPD diagnosis. I made me think of an opposite example, the atypical borderline who acts inwards more than outwards, where meltdowns do occur but much of the time the patient seems composed. (And half the time the meltdowns occur because of the cumulative strain of maintaining this composure while in turmoil!) For many women, who have been trained since childhood to be nice, accommodating, a good sport, and to behave a certain way to men/perform femininity, I believe that could result in a misdiagnosis of simple depression. The therapist may misjudged the severity of the problem if they haven't enough wild material to go on.

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Feb 12, 2022·edited Feb 12, 2022Liked by Athena Walker

Diagnostic criteria based on purely outsider's (doctor's) observation can create much misunderstanding too. We definitely need the insider experiences taken into consideration as well. That is why I appreciate Elinor Greenberg's work. Although I'm not an expert, PCL-R seems to only list mostly shallow observations of test founder(s), based on prison population, but not the inner experience of actual psychopathic people. There is a similar case with schizoid pd, that I think I may be most familiar with. Also its name might raise confusion with schizophrenia while they are very different concepts. Different root causes and mechanisms. I think the psych field isn't that good at looking for root causes yet, or just starting, I hope. We could save many misdiagnoses and mis-treatments with it. Mismedication isn't an affordable thing, knowing the horrible side-effects of psychiatric drugs.

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If you look into the PCL-R you really don't even see very many psychopathic traits even in the factor 1 section. Who says psychopaths have to be pathological liars? I would think that if anything when psychopaths lie it's for some kind of calculated gain or reason. In reality the PCL-R is a clusterfuck of ASPD, NPD, BPD and HPD traits. The poor behavioral controls, impulsivity, promiscuity, short-term marital relationships, that all makes sense for BPD and of course someone can have antisocial traits with BPD that's how it often works with a lot of cluster B disorders, there's overlap. True psychopaths could never meet the whole criteria for BPD or NPD unless there was some kind of masking involved.

BPD as a "female psychopath" is horseshit, if anything HPD is a better representation but even then it's a reach. 50% of HPD is dually diagnosed with ASPD but this idea that one disorder is "female" and the other is "male" is absurd. Female psychopaths are harder to spot just like males with BPD are harder to spot.

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Jan 29, 2022Liked by Athena Walker

Ok, I wasn't sure.

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Jan 28, 2022Liked by Athena Walker

Ok so he didn't have the MRI?

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Jan 28, 2022Liked by Athena Walker

Didn't X Fallen have an MRI done that confirmed that his brain showed that he is a psychopath? That he was born that way.

So isn't he a psychopath, but just on a lesser or lower end of the spectrum?

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deletedDec 18, 2023Liked by Athena Walker
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