Talk:Borderline personality disorder

Study implication is not warranted

The cited study cannot imply anything about the usefulness of family members information on BPD as long as the opposite causality is reasonable to assume - or at least this limitation needs to be explicitly stated; citing from the study:

"These data are cross-sectional and we are unable to determine direction of effect from our correlations. We are, therefore, unable to know whether more knowledge leads to poorer emotional well-being or whether family members who are more depressed, distressed, and burdened are those that feel most motivated to learn what they can about the illness." — Preceding unsigned comment added by 133.1.239.222 (talk) 04:41, 19 May 2016 (UTC)

New source

Hello,

There is a cochrane review on psychological therapies for people with borderline PD. It concludes that psychotherapies are beneficial. This citation could be added as an additional supplement to the section on treatment.

best, Jogunk07 (talk)Jogunk07

New Image: painting by Edvard Munch

There is a prevailing consensus to OPPOSE the inclusion of the Munch image in this BPD article. The depiction of mental disorders or psychological states in art is highly subjective and not always identified by the artist's intentions. Any alternate image proposed for BPD would seem to need a stronger basis in reliable sources identifying it as BPD in order to be used in the article. Fountains-of-Paris (talk) 20:55, 25 January 2016 (UTC)

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

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Edvard Munch: Young People on the Beach (Jugend am Meer) (1904). A painting that is part the Linde Frieze, a series commissioned by Max Linde. According to the art historian Nicolay Stang the painting shows the “inability to make contact with one another” thus being consistent with a major symptom of BPD (see main text). In modern times, Munch has been diagnosed by psychiatrists as having had BPD, including by an authority in the field, James F. Masterson.

For comparison from Major depressive disorder with this caption: Vincent van Gogh's 1890 painting Sorrowing old man ('At Eternity's Gate')

Not sure what it has to do with BPD? Doc James (talk · contribs · email) 13:30, 16 December 2015 (UTC)

Here the answer: The image was greeted with a warm welcome on the German sister site some months ago and has not been met by one single objection since. Young persons are the major group of those affected by the disease. Here, on the painting, they are - each on their own - sitting at the border between land and sea and looking out. Munch is known for his psychologically inclined paintings. I hope this is sufficient for an explanation. Could you please reinstall the image? You would do a service to many of those affected.--Saidmann (talk) 14:39, 17 December 2015 (UTC)

That is insufficient support IMO. Doc James (talk · contribs · email) 14:40, 17 December 2015 (UTC)

What kind of "support" would you like to read? By the way, there is an equivalent case in Major depressive disorder. Here the painting by van Gogh has been there for a long time. How can you accept the van Gogh but reject the Munch? In both cases there is an equally indirect connection between disease and painting. But that's what paintings are all about. They are indirect, but thought provoking. To use such paintings is established practice in WP, and IMO a good practice.--Saidmann (talk) 14:52, 17 December 2015 (UTC)

Van Gogh was depressed and this painting is about depression. Doc James (talk · contribs · email) 14:55, 17 December 2015 (UTC)

Nobody can see on the van Gogh painting that the artist was depressed. It is not even mentioned in the legend. Many painters suffered from depression. Can this be a reason to put up any of their paintings? No, the reason why the van Gogh is established in Major depressive disorder is the content of the painting. If you are still certain that you must revert the edit, I will present the issue in front of a panel of experts.--Saidmann (talk) 15:08, 17 December 2015 (UTC)

Yes you are more than welcome to get a third opinion. Doc James (talk · contribs · email) 15:09, 17 December 2015 (UTC)

agree w/ DocJames--Ozzie10aaaa (talk) 16:17, 17 December 2015 (UTC)

If you can find an WP:RS specifically associating this work, or at least the period in the artist's life, with BPD, then a carefully captioned image might be ok. This is probably possible. But just adding it as it was is not ok. Johnbod (talk) 17:26, 17 December 2015 (UTC)

Sorry, I do not understand this. In Major depressive disorder there is nothing in the caption of the van Gogh painting that might link it to depression. Nor is there anything in the text. There is not even anything in the Vincent van Gogh article that says that the artist himself suffered from the disease. And there is no knowledge about such a connection, either. The van Gogh painting has been in Major depressive disorder for at least four years. The only relation to the subject of the article lies in the image itself, nowhere else. And this relation is an indirect one, as in almost all paintings. I see no difference whatsoever between the van Gogh case and the Munch case. The service of these paintings, as placed in the articles, lies in widening the views of the readers. I can see no negative effects.--Saidmann (talk) 18:25, 17 December 2015 (UTC)

WP:OTHERSTUFFEXISTS Johnbod (talk) 18:29, 17 December 2015 (UTC)

OK, this essay suggests that the rationale of precedential value may be valid in some contexts but not in others. Anybody can agree with that. I think it is valid here, and as yet nobody has given a reason why it might not be valid here.--Saidmann (talk) 18:39, 17 December 2015 (UTC)

I have previously seen Munch's The Scream used to characterize both depression and schizophrenia, so I am not surprised to see another Munch painting here.

I am not convinced that Youth at the Sea is a suitable representation for borderline personality disorder.

Incidentally, I am also not convinced that van Gogh's Sorrowing old man is a suitable representation for major depressive disorder. There is no evidence to show that the painting is intended to convey that implication. Indeed there is evidence that van Gogh had bipolar depression, not major depressive disorder. (I am aware that the article has passed FAC.) However the connection between van Gogh's painting and major depressive disorder is certainly less tenuous than that between Youth at the Sea and borderline personality disorder. Axl ¤ [Talk] 22:15, 17 December 2015 (UTC)

I have now followed Johnbod's suggestion to describe and reference the connection between the painting and BPD in the caption. See above. I hope that the new caption will now resolve the issue.--Saidmann (talk) 17:46, 19 December 2015 (UTC)

What ref supports "The painting shows a typical symptom of BPD: feeling "empty" and "lost". " Doc James (talk · contribs · email) 17:54, 19 December 2015 (UTC)

Feeling "empty" and "lost" is quoted from the article. I have added a (see main text). I also replaced "shows" by "suggests".--Saidmann (talk) 18:02, 19 December 2015 (UTC)

The painting shows young people hanging out at the beach. Who says they are empty or lost? Doc James (talk · contribs · email) 18:13, 19 December 2015 (UTC)

Images do not speak. But they can suggest something. The young people are not only "hanging out", but they also show no signs of interaction. They all look isolated, even though close to each other. The van Gogh does not say "sorrowing" either. That may be a suggestion. The man may just be tired. But - objectively - the image has the inherent quality to possibly suggest "sorrow". Likewise the Munch has - objectively - the inherent quality to possibly suggest feelings of "empty" and "lost".--Saidmann (talk) 20:15, 19 December 2015 (UTC)

Sources speak about images. This source says [1] that this old man painting is showing deep depression. Doc James (talk · contribs · email) 03:13, 20 December 2015 (UTC)

The source you referenced is a book about hair loss. The author does not reference his association. He might have picked it up in WP. It appears nowhere else in the literature.--Saidmann (talk) 12:34, 20 December 2015 (UTC)

A reference has now been added to the caption concerning the subject of the painting.--Saidmann (talk) 19:01, 20 December 2015 (UTC)

Because all issues of the discussion are now resolved in the latest version of the caption and no further issues have appeared for more than 48 hours, it would seem appropriate to apply the updated version.--Saidmann (talk) 11:38, 22 December 2015 (UTC)

Try a RfC. This is not enough "According to the art historian Nicolay Stang the painting shows the “inability to make contact with one another". It does not say it shows young people with the symptoms of borderline personality disorder. Doc James (talk · contribs · email) 18:33, 22 December 2015 (UTC)

The art historian was not a psychiatrist. He said what the subject of the painting was. Also, in 1972 the term BPD was not yet in use. The art historian does not diagnose people on a painting, but describes a situation of difficulties as shown on a painting, which clearly is symptomatic for BPD. This is the closest connection that can be found between a painting and a mental disorder, and it is much stronger than the one in the van Gogh case. The image is now one of the best referenced ones you can find in WP. The van Gogh is not referenced at all.--Saidmann (talk) 19:55, 22 December 2015 (UTC)

What a great and evocative image. I agree that it shouldn't be placed prominently on this article. I would however would support its placement in eg the "Society and culture" section, where as you state an attempted and sourced depiction of BPD would be of benefit. Another article which may benefit is something like Loneliness. --Tom (LT) (talk) 19:50, 23 December 2015 (UTC)

• Comment. The description near the top of this discussion includes the phrase "sitting at the border between land and sea". I can't tell if this is relevant while I don't understand why the condition is so named. If I heard someone say "Steve has borderline personality disorder", I would until today have thought they meant "Steve almost has a personality disorder, maybe, not quite". The article does not give any explanation for the name, but says "There is an ongoing debate about the terminology of this disorder, especially the suitability of the word 'borderline'"; and gives two references: the first is not currently accessible, and the second does not, as far as I can find, discuss the nomenclature. If I ever learn why the word "borderline" is in the name, I may feel qualified to !vote here. Maproom (talk) 09:42, 24 December 2015 (UTC)

The answer is in the history section. The original idea of Hughes (1884) was that there were symptons falling on a borderline between sanity and insanity. In the definitions of recent decades the term - and thus the old idea - was kept, despite modern diagnostic criteria.--Saidmann (talk) 14:50, 24 December 2015 (UTC)

Thank you for the explanation. I didn't see it in the History section (which I did not think an obvious place to look for it). In my view, now, the picture should be omitted, as the "border" allusion is spurious. Maproom (talk) 23:35, 24 December 2015 (UTC)

Sure I could see putting it in the history or society and culture section. Doc James (talk · contribs · email) 23:12, 24 December 2015 (UTC)

First, I agree that the painting makes a very powerful impression. — Preceding unsigned comment added by A whiter shade (talk • contribs) 00:29, 30 December 2015 (UTC) But I also feel its place would rather illustrate Loneliness, as Tom (LT) suggested. It might be an interseting idea to include a subcategory like https://en.wikipedia.org/wiki/Category:People_with_borderline_personality_disorder or a reference to it. The best picture for this purpose is actually not one by Munch (who, surprisingly, is not on the list), but by Van Gogh: His famous Self-Portrait with his bandaged ear: https://en.wikipedia.org/wiki/Vincent_van_Gogh's_health#/media/File:Vincent_Willem_van_Gogh_106.jpg. which is an alternative to this: https://de.wikipedia.org/wiki/Selbstverletzendes_Verhalten#/media/File:Auto-Mutilation.JPG. In any case, I would very much appreciate some illustration. Have some nice last days in 2015! --A whiter shade (talk) 01:23, 30 December 2015 (UTC)

I agree with Tom (LT) that "inability to make contact with one another" is a symptom of further disorders, as well. So it may not be specific enough here, and a painting showing this trait may not be the best choice. Therefore I took a very specific trait of BPD - idealization and devaluation of others in personal relations - and selected paintings by Munch that have been associated with just this BPD trait in the professional literature. I assume that this solution will be widely considered appropriate for the opening section of the article. Thanks to all for the discussion leading to this outcome.--Saidmann (talk) 18:27, 13 January 2016 (UTC)

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The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Therapy or psychotherapy

Doc James I changed therapy to psychotherapy. Seemed sensible. Was reverted. Have not reverted again. Let's get this consistent across articles. My logic is that linking to the therapy article, is too broad for readers. I see that it is simpler, but in this case it may be more beneficial to readers. Psychotherapy is very commonly understood worldwide. Can you outline your reasoning please Doc James and I will apply this consistently in future to other related articles.Charlotte135 (talk) 00:33, 20 May 2016 (UTC)

I changed it so that therapy links to psychotherapy. Psychotherapy is often simply referred to as therapy. Doc James (talk · contribs · email) 00:41, 20 May 2016 (UTC)

Okay, I'll go with that. I changed it from therapy to psychotherapy at the DBT article too. Can you please make that link there as well and I'll revert back to therapy. Thanks.Charlotte135 (talk) 00:47, 20 May 2016 (UTC)

Done [2] Doc James (talk · contribs · email) 00:52, 20 May 2016 (UTC)

• . doi:10.1002/14651858.CD005652.pub2. 
• Nicolay Stang: Edvard Munch, J. G. Tanum Forlag, Oslo 1972, ISBN 978-8251800105, p. 177.
• James F. Masterson: Search For The Real Self. Unmasking The Personality Disorders Of Our Age, Chapter 12: The Creative Solution: Sartre, Munch, and Wolfe, p. 208–230, Simon and Schuster, New York 1988, ISBN 1451668910, p. 212-213.
• Tove Aarkrog: Edvard Munch: the life of a person with borderline personality as seen through his art, Lundbeck Pharma A/S, Denmark 1990, ISBN 8798352415.