Some reflections:

1. Is BPD real? As I expected, a number of comments question the diagnosis and consider it possibly harmful. How is this as an alternative ? Forget the label. Do you have ANY way of assessing for yourself, about you, whether you are growing more wise, more mature? Do you see how it might be useful for you personally, not in the context of the mental health system, to have some way of discerning - non judgmentally with compassion, love and care, the extent to which people you're involved with or may be involved with are likewise growing in wisdom, maturity, etc? As a psychologist who entered the field PASSIONATELY anti-diagnosis, I came to a middle ground. I still think the diagnostic system is weak, conflicted, outdated, and overly pathologizing, and when I wrote psych evaluations I ALWAYS made great efforts to minimize the readers' attention to the required diagnostic section. But if you don't take it too literally, it can have its uses - in its rightfully very small place.

2. What do you do about it, and if you grant the usefulness of the label, how do you deal with relationships with people who are - let's be careful with labels - "BPD-like"?

For this I don't have a final answer. A family member, for whom my wife and I have taken responsibility after their mother passed, has been (wrongly, I think) labeled BPD. I never got a handle on how to see her compassionately until I realized her mother was correct in describing her as having a varying maturity level, from teens to toddler (she's now in her late 60s).

This gave me tremendous help in seeing her compassionately (the family, against my advice, has over many years easily spent several hundred thousand dollars trying to placate her needs, always to no avail).

I have come to see that her requests are really hardly any different from that of a normal 7 year old child. This also makes it easier for both my wife and myself to adhere to appropriate boundaries which in the moment (just as with a 7 year old) may seem overly strict.

I hope this helps anyone struggling themselves with BPD or with a friend. Mindfulness, combined with CBT or DBT, by the way, is a godsend!