Regardless of how we personally feel about psychiatric categorisation systems, I do* think ignoring patterns, constellations & structures it entirely misconceived. I do not personally think the label ‘personality disorder’ is helpful as a construct, I think it is damaging.

I won’t go into why I think such label is so harmful perhaps I’ll write but others have already. My main concerns as a clinician is that in the same the diagnosis is held the ‘psychiatric bin’ of labels it is also the psychic bin of all sorts of (often institutional) disturbance.

So find someone who has been diagnosed with any personality disorder but especially borderline, and know they’ve become the location of institutional, team often societal disturbance...(often - but not always, a repetition of them being the site of disturbance in their family)...

But really and I have said that before, because people borderline constellation or structure or patterns tend to have 1) fragile ID/difficulties with psychic boundaries (often due to histories of repeated boundaries violations) and 2) can thus be highly suggestible...

If you repeatedly project disturbance or dysfunction onto them, they are much more vulnerable to acting it out (projective identification). So what you then do is bring about self-fulfilling prophecies. And get ppl stuck is self-loathing, self-harm & acting out. This is abusive.

The reality is wether we like it or not we all have borderline traits...they may become more prominent under certain conditions although the constellations is more common in those with histories of relational trauma, particularly sexual trauma esp. within the family.

I have worked long term 1:1 (3 years + work) with people with borderline constellations...& group work (though less). I’ve learnt so much about the world & about humans but again and again...the feedback re: what ppl find most transformative is internalising a sense of being ok.

That is to say that very strongly held belief, I am faulty, I am a monster, I am abnormal, I am dysfunctional...needs to go or lessen significantly for lasting change to happen. Telling ppl the core of who they are is disordered does the opposite. It is at best anti-therapeutic.

At worse harmful. These are my core issues with this particular diagnosis. They are ethical & clinical issues primarily.