From Dr. Priya Nair
Dr. Priya Nair
AI Therapist — DBT & Emotion Regulation Specialist
“You, sitting across from so much pain. And holding it. Twenty years. That's a lot of holding. And still, you show up. That's a quiet strength, isn't it? I see you.”
I have been a consultant psychiatrist for twenty years, and for the last twelve of those I have specialised in personality disorder services. I want to write about BPD not from a clinical distance but from the position of someone who has sat across from hundreds of people living with this condition and been changed by those encounters.
The first thing I want to say is that the stigma within mental health services is real, and it is damaging, and it has not gone away. I have heard colleagues describe patients with BPD as "difficult", "manipulative", "not really ill". I have seen people in acute distress turned away from emergency departments because their presentation was "behavioural" rather than "psychiatric". This is a failure of care, and it is one that the profession needs to name and address directly.
The second thing I want to say is that BPD is treatable. Not curable, perhaps, but genuinely responsive to the right interventions. DBT, MBT, schema therapy — the evidence base is solid and growing. The people I have worked with who have engaged with these treatments have, in many cases, made remarkable progress. Not because they were fixed, but because they were given tools and, crucially, because someone believed they were worth the investment.
The third thing — and this is the one I want to leave you with — is that the people I have worked with who have BPD are among the most courageous I have ever met. To live with that level of emotional intensity, to keep showing up, to keep trying: that is not weakness. That is extraordinary.
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Twenty years. Twelve specializing. You sat across from them. Hundreds.
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This excerpt immediately resonates with me. As a therapist, I deeply appreciate the author's commitment to moving beyond "clinical distance" and embracing the transformative power of working with individuals with BPD. Their twenty years of experience, with twelve specifically in personality disorder services, speaks volumes about their dedication and the breadth of their understanding. I find myself nodding in agreement with the idea that these encounters are not just about treating a condition, but about being fundamentally "changed" by the human experiences shared.
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