Suppose you polled therapists and asked them what the most controversial diagnosis is in the current version of the DSM. Many of us would likely say Borderline Personality Disorder, and it would certainly be in almost everybody's top three.I’ve been wanting to do an episode on BPD for a bit because there is something about this controversial diagnosis that allows us to explore the challenging and consequential nature of psychiatric diagnosis itself.To guide us in this exploration, I've had the privilege of inviting Dr. Awais Aftab, a leading authority in the field. His extensive work on philosophical, ethical, and scientific issues related to diagnosis makes him the perfect person to delve into this complex topic with. Awais Aftab, MD, is a psychiatrist in Cleveland, Ohio, and Clinical Assistant Professor of Psychiatry at Case Western Reserve University. He led the interview series "Conversations in Critical Psychiatry" for Psychiatric Times, which explores critical and philosophical perspectives in psychiatry, with a book adaptation forthcoming from Oxford University Press. He is a senior editor for Philosophy, Psychiatry, & Psychology and has been actively involved in initiatives to educate psychiatrists and trainees on conceptual and critical issues. He blogs at Psychiatry at the Margins.In the conversation, we dig into whether Borderline Personality Disorder is “real” and what that means, how it relates to the philosophical concept of epistemic injustice, how context influences the utility of a diagnosis, and more.Listen to the full episode to hear:How treatment of people diagnosed with Borderline Personality Disorder frequently illustrates aspects of epistemic injustice/justiceThe ways that clinical setting and context influence the use, or misuse, of BPD as a diagnostic label and how that impacts patientsHow quantitative psychology is influencing how we conceptualize personality disordersWhy a BPD diagnosis can be intensely valuable for some clients, and how it helps guide cliniciansWhy we can’t chalk up all psychopathology to traumaHow calls for testimonial justice from psychiatric patients should serve as a corrective force to excessive skepticism of patient narrativesLearn more about Dr. Awais Aftab:Psychiatry at the MarginsX: @awaisaftabLearn more about Riva Stoudt:Into the Woods CounselingThe Kiln SchoolInstagram: @atherapistcantsaythatResources:Borderline Personality and Self-Understanding of PsychopathologyEpistemic injusticeThe epistemic injustice of borderline personality disorder, Jay Watts, BJPsych InternationalA Metaphysics of Psychopathology, Peter ZacharPeter Fonagy

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“What did the council decide on item 42?” — answered with the speaker and the moment.

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