Keir Harding Profile picture
Oct 27 25 tweets 13 min read
And we are here (late!) To the @rcpsych GAP conference. So far we think we've spotted @lovebillybragg and @SameiHuda. Looking forward to an interesting day #rcpg #rcpsychgap2022
Some talk about the long term plan. Years ago "personality disorder" wouldn't have got a mention... #rcpsychgap2022
Up next is @Shrink_at_Large on Changing the Srory around PD #rcpsychgap2022
The pros and cons and diagnosis

"Do better than a thorn in the flesh" #rcpsychgap2022
Does a diagnosis get in the way of the credibility of those it is given to?

#rcpsychgap2022
google.com/amp/s/www.huff…
The borderline pattern collapses the model of the ICD-11 @Shrink_at_Large
The problem with borderline is it links to such a powerful prototype (cartoon?) of manipulative, attention seeking etc...

Is that useful and what does it hide? #rcpsych2022
3/4 people will get a personality disorder label of some description (mild/moderate/severe/difficulties), which is a problem if it links to that prototype/cartoon 🤔

#traumanotpd #rcpsychgap2022
So we need to remember the huge levels of trauma in the lives of those diagnosed with "bpd" (or bpd pattern) #rcpsychgap2022
So what else is hidden in the BPD pattern? Well, there's a lot of ASD around #rcpsychgap2022

Can we see past that cartoon/stereotype?
Do we just need a new name?

1 Personality is not a neutral term.

Others reaction to "personality disoder" ramps up shame.

#rcpsychgap2022
2 You stop being believed

"If you wanted to kill yourself you would have" etc

#rcpsychgap2022
Attempted solutions to manage distress are seen as symptoms of illness/a disordered personality

#rspsychgap2022

Credit to @RRowanOlive
"BPD" reaches back in time and rewrites our history, validating the worst things people have ever taught us #rcpsychgap2022
It is a closed system, everything is understood as bpd. Silent = attention seeking or communicative = manipulative

#rcpsychgap2022
So why isn't there more change? We've been going on about this for years... #rcpsychgap2022
The @rcpsych position statement says great things about relational working, but this diagnosis undermines relationships

#rcpsychgap2022
The thorn in flesh course...

#rcpsychgap2022
The status quo is maintained by the idea that good care is dependent on the diagnosis of personality disorder

It's not just "bad staff". This term allows the pathologisation of difficulty/discomfort

#rcpsychgap2022
Some solutions 👇

#rcpsychgap2022
There's a question along the lines of "but how do we help," is SCM the answer?

In some ways it's a brave question but in others it shows how unprepared services are for helping people who have survived neglect/abandonment and abuse #rcpsychgap2022
If EUPD/BPD doesn't exist how do we account for people benefiting from DBT/MBT?

Those therapies aren't diagnosis specific and offer things helpful to many people. Why can't we offer them without people having to accept a PD label? #rcpsychgap2022
And that is my @Mental_Elf audition over.
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More from @Keirwales

Oct 26
First ever visit to the Freud Musuem which had a lot less objects taller than they were wide than I was expecting.
THE couch (what is that throw covering? 🤔)
Read 6 tweets
Oct 25
Good Morning. Its my birthday today (46 🤮) and I've done something rash and impulsive.

I've entered the London Marathon on behalf of the National Society for the Prevention of Cruelty to Children. @NSPCC

justgiving.com/fundraising/ke…
Everyone I work with has experienced some form of childhood adversity and this is a charity that is very close to my heart.
If you could give anything that would be amazing. If you could join the 1% club and donate 1% of my target (£22) that would be fantastic and you can tell me to do something for you. Videos, songs, embarrassing things... your choice, all for £22.
Read 4 tweets
Aug 15
TW selfharm, suicide, restriction

At the @BIG_SPD conference in June I was live tweeting the session on Funded & Forgotten looking at OOA placements. As I couldn't live tweet the bit me & @HoppyPelican did, this is it in it's glory 🧵👇
The abridged version is "people deemed as NEEDING a specialist placement can be supported in the community"
There were 2 other presentations
We cannot emphasise enough the efforts we went to to ensure we had consent to share this narrative, but they wanted this experience shared and it was their idea to share it.
Read 29 tweets
Jul 11
My letter to @theCAMH on the subject of diagnosing 14 year olds with "personality disorder" its behind a paywall but some 'highlights' include....
"publication after publication recognises the persistent negativity mental health staff project towards those they perceive as having disordered personalities. Whatever we have done to change this since No Longer A Diagnosis of Exclusion (NIMHE 2003) is not enough"
"Studies show that up to 84% of people who have been given this diagnosis have survived trauma (Zanarini et al 2000), although in this debate it was 100% of the lived experience contributors"
Read 8 tweets
Jun 26
Just finished this from @JDaviesPhD

It really gripped me and spoke to aot of thoughts I've had over the past few years about pathologising understandable distress.
I remember thing about people experiencing domestic violence being admitted to hospital and medicated and this really shook my ideas about what mental health services were for
The things that I'll try to remember from the book are...

People treat others worse if they think they have a biomedical disease rather than are responding to distressing events.

This totally mirrors my work experience.
Read 10 tweets
May 11
For #BPDawarenessMonth let's put a different answer out there to the question:

"What is BPD?"

There's some other threads on this subject on twitter today, but this one is a bit different...
These are the criteria. To get a diagnosis you need to tick 5/9
But you're probably thinking "if someone has criteria 1-5 and another person 5-9 they have the same diagnosis while only sharing 1 characteristic!"

You might also think "who gets to decide if my anger is appropriate?"
Read 29 tweets

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