Dr Dan Warrender

The 'conceptual black hole of borderline personality disorder': how can BPD be not real mental illness but too unstable for therapy, described as not personality disorder but treated as only personality disorder, and also, borderline of what? Open access: doi.org/10.1080/016128…

Read the draft carefully. Now re-read it even more carefully. Read it again. Now submit. Now reveal a typo in the first sentence.

Everyone can speak with some authority about the particulars of their own experiences (even as we recognize our state of self-ignorance and capacity for self-distortions), but if we are interested in *generalizable knowledge*, there is no substitute for a community of truth-seekers interested in meticulous observations, creative conjecture, open critique, and error correction. The idea that any single person has some unique access to truth is a fantasy.

As over 200 patients are shipped out of St Andrews Hospital I want to thank @PrivateEyeNews and @drphilhammond for shining light on the inadequacies of of private locked rehab placements and the fear in the nhs that drives their use.

All those “my therapist told me something” tweets

Published today in the international journal of nursing “Perhaps the most significant omission in the clinical and academic discourse on BPD is the failure to acknowledge that the diagnosis itself generates tremendous harm.” onlinelibrary.wiley.com/doi/10.1111/in…

Among philosophy books that attempt to “say something useful about the real world,” this is the best I’ve read in a long time. Big picture idea that addiction isn’t a brain disease is good. But page by page, there’s a lot to think about.

When you submit your paper to a journal This is how reviewer 1 and reviewer 2 treat it

PhDs take a long time, stress you out, and don’t guarantee a job, but nothing beats the first time you hear, “oh, so not a medical doctor?”

“It used to be that a socially avoidant woman would come for therapy saying something like, ‘I’m a painfully shy person and I need help learning how to deal better with people in social situations.’ Now a person with that concern is likely to tell me that she ‘has’ social phobia—as if an alien affliction has invaded her otherwise problem-free subjective life.” People talk about themselves in acronyms oddly dissociated from their lived experience: ‘my OCD,’ ‘my eating disorder,’ ‘my bipolar.’ There is an odd estrangement from one’s sense of an agentic self… and consequently one’s possibilities for solving a problem.” —Nancy McWilliams (Diagnosis and Its Discontents: Reflections on Our Current Dilemma, 2021)

It's up to those who claim ADHD is ‘genetic’, ‘neuro’ or a ‘chemical imbalance’ to demonstrate this is the case before we can accept any of those propositions. As a scientist my only job is to scrutinise studies to see if such claims have been supported - and they haven't

Once you download 10,000 pdfs, you win academia

Academia offers no material rewards of any kind. But if you’re especially lucky, you can cultivate a mutual professional hatred that transcends time and space.

This is my entire education and entertainment strategy on Twitter

@DoctorPerin There is a lot in there you could talk about. A twisted tale of love and revenge.

@dan_warrender I watched Oldboy so long ago I’d need to see it again

My producer wants to do a podcast series where we psychoanalyze a different movie each week for a month or two. He’s reading me a list of movies he thinks is relevant. What would you want to see?

@DrGipps @DoctorPerin Excellent choice!

@DoctorPerin Lars and the Real Girl

One of the things I'm most looking forward to this year, is having been selected to deliver the annual Skellern Lecture. I plan on discussing how MH nursing may be constrained by ideas of 'nursing', and the relationship with psychiatry. Learn more: skellern.info

Remember this guy the next time you are arguing with someone on the internet

When people diagnosed with 'borderline personality disorder' are told they are "too unstable for therapy", this harms their self-concept, and also seems to rather bizarrely demand that people get well before they are treated. Explore further, open access: tandfonline.com/doi/full/10.10…

“All people have a personality; it is a mistake to conflate personality styles with ‘disorders.’ Unfortunately, the DSM, from 1980 on, has led many clinicians to make just this mistake. To include personality styles in a taxonomy of ‘disorders,’ the framers of DSM-III described personality styles in their most extreme and pathological forms. As a result, many clinicians learned to ignore personality entirely, unless a patient meets criteria for a specific DSM-defined personality disorder. Some now equate any clinical reference to personality with pathology. As a result, clinical understanding of personality has generally devolved rather than evolved.” —N. McWilliams & J. Shedler, Psychodynamic Diagnostic Manual, 3rd edition (PDM-3)