QUESTION:
Dear Dr. Heller,
I currently live in the UK. I'm seeing a psychiatrist who has decided I have BPD. I and my friends disagree but he doesn't seem to want to listen at all. He comes across as being very judgmental. It will be quite hard for me to get a second opinion. Do you have any advice?
ANSWER:
I don't know your psychiatrist, but if he really is judgmental and doesn't
listen, you have a problem - even if his assessment of you and your diagnoses is correct.
There's a wonderful saying that making judgments says nothing about the person being
judged, only of the person doing the judging. While the obvious answer is to get a second
opinion, there are other things you can do as well.
1) Go over the criteria yourself honestly and objectively. I have found
for most patients the answer is obvious. Try to come up with examples.
2) Bring a copy of the
official criteria
with you,
find out which ones he believes you fit and why, and have a discussion with him if you
disagree.
3) Discuss the criteria that you believe you fit with your closest
friends, to find out why they disagree.
With very rare exception I don't make the diagnosis unless the patient agrees it
clearly fits him/her.
