Well, I can't agree with your comment on it not existing.. I work in a fantastic PD Service, work heavily with people with BPD, work for a BPD charity, and advocate for people with BPD.. Oh, and have BPD myself! Borderline Personality Disorder doesn't mean you're borderline as to whether you have a PD or not. When it was originally name, it was thought you were "borderline psychotic" if you had BPD. I woudl also re-word that the patient was being manipulative (which people with BPD can be, VERY manipulative) because she was mentally ill (though, technically, someone with a PD isn't mentally ill.. so confusing). The MH system in this country though rewards manipulation. I'm not an "acting out" BPD type, so when I was hospitalised, I sat in my room quietly smoking and self harming. No one one the ward knew I was self harming as I chose not to tell anyone, and was discharged 3 days later (in a worse state than when I arrived!). yet, the woman in the room next door to me, who was loud, shouting she would self harm, loudly breaking mirrors in order to self harm etc got all the attention. Is this right? No, not at all, but shout loudly, and you will get attention from the doctors / nurses. I'm lucky that I now work for a very forward thinking service, who has learned these things, and thus doesn't reward such behaviour. It doesn't "punish" it as such, but you will receive more help if you don't act out. You're lucky you don't have to live with this disorder. Very lucky. When your "wise mind" is saying "huh I shouldn't be doing these things to these people", but the "BPD mind" is saying "sod it, do it anyway, it won't bother them".