Our expert says:
Borderline Personality Disorder is an unusual diagnosis to be made in South Africa, so although I'm convinced it is a significant and highly troublesome condition, it's hard to find people who recognize it or know how to manage it.
It sounds as though she's been puzzling as well as troublesome, and has received a number of sometimes fashionable but contradictory diagnoses along the way.
Multiple Personality Disorder ( later called DID ), as I have written about in a noted textbook, I don't believe in. It "exists" in the sense of a highly troublesome set of beliefs and behaviours,only when created by a naive and/or exploitative "therapist" who believes profoundly in the condition and wastes masses of time and money effectively training the unhappy person into creating and mimicking the signs and symptoms the "therapist" expects. It very often gets worse with therapy, especially if the "therapist" specializes in this condition ; and surprisingly often is cured when that therapist is sacked and the person either receives no specific therapy for it, or comes to be cared for by a sceptic who deals with the actual problems rather than the "therapist's" fantasies.
People diagnosed with DID are very highly suggestible, and so can become like a psychological chameleon, obligingly producing whatever their therapist is most keen to find. And thus, as you say, may receive a series of different enthusiastic doagnoses.
It is very highly doubtful whether MPD / DID occurs naturally, in the absence of fanatical believing therapists, and the movies and books which provide instructions in how to do this set of tricks. So long as it receives sympathy and attention, the odd behaviours continue.
There is no good evidence whatever ( and considerable scientific evidence against it ) that they actually have any different "personalities" rather than different ways of behaving, in response to the expectations of those around them.
People with Borderline Syndrome are quite inclined to cut or otherwise harm themselves when distressed, and can be rather easily distressed. They tend to have very inconsistent relationships with other people, and tend to flip bewilderingly quickly from idealizing uis as absolutely marvellous, to considering us awful and dreadful.
They easily feel abandoned and unappreciated, even when being lovingly cared for.
They are also extremely talented at frightening and alarming their family or companions ; even cutting itself, can be a small gesture which is highly disturbing to other people.
Although individuals vary and might at times be helped, I have not seen good consistent evidence that any drugs are useful in dealing with either of these conditions.
WHat helps is not easy to find, but psychotherapy ( with some family therapy to help the family react usefully to the crises this sort of person produces so often ) with a highly skilled and experienced psychotherapist, and specifically with one who does NOT believe in MPD / DID, and instead of applying a set of templates and pre-conceptions which such beliefs provide, is prepared instead to assess the changing situations patiently and carefully and without unhelpful pre-conceptions, and to provide more common-sense and practical responses to the actual specific propblems being presented. I haven't seen much on the use of the surrently best supported ( by good evidence ) form of psychotherapy, Cognitive-Behaviour Therapy, CBT ) specifically with DID, but would expect it to be most likely to be helpful.
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