TikTok removed the cluster B boyfriend skit: a debrief

[SurajRajan]

Neurologist here. Please continue posting. You fill a really important and unaddressed vacuum in Medicine, with these explanatory psych videos. If such videos are a "community violation", you could include this "pause-explain-play" review style takes. But you are a good actor, and the nuance you bring to this both as a doctor and as someone who is trying to embody that person, is incredibly powerful. Thanks for your time and effort.

[alternativewalls]

Getting unreasonably angry at the depiction of cluster b is so cluster b

[SeanStrange-ox]

I have BPD. I have been that person. Please, please dont stop making content like this. I wish I had seen this sooner. I might have realized my wild emotions, the intense searing pain I felt throughout my whole body every time I was splitting at my partner, the constantly blaming her for my emotions, that all of that wasn't normal or okay.

I might've talked with a therapist sooner. I might've known to tell them about these enotuonal swings and the outbursts that came with them, the instant "they cant love me" "I deserved to be treated like this" "they're secretly mocking me for feeling this way" thoughts that rushed through my mind when I'd have experiences like those you depicted. The need to be intensely controlling and domineering, to reject what I internally feared was true and demand that she make me feel okay. I might've known I was in the wrong, that I was the instigator, that I needed help. I might've been able to get a BPD diagnosis sooner. I might've been able to get DBT and a therapist with a lot of experience helping people like me, I might've been able to start working on my BPD and learn how to have healthy communication and that I had to stop choosing my own comfort and security to keep from constantly hurting the woman I loved. I might've been able to tell her why I was constantly fighting, why I was so unreasonable, not to excuse it but to finally own up to the reality she had quietly been accepting because she had grown up abused and feared being alone, just like me. I might've been able to do right by her sooner. I might've stopped being abusive sooner. And I might've learned to love myself and realize I wasn't my genuine self, that I lived with PTSD and several other mental illnesses that were buried deep beneath this monster that is DBT.

I resonate with those commenters who fear stigmatization. I've lost friends, even had family turn away from me when I've told them about my diagnosis. Even though I was trying to celebrate progress, that I was getting better, they thought of these horrible societal depictions of BPD that aren't realistic or rooted in reality. I grew up watching those depictions too, I thought I couldn't possibly have BPD because I had seen those depictions and knew that wasn't what my life was like. What you showed wasn't that. What you showed in that skit was a beautiful, succinct, moderate example of what my day to day life looked like FOR MY ENTIRE ADULT LIFE. I didn't feel stigmatized when I saw it, I didn't fear what others would think about people like me when they saw that. I felt seen. I felt like I was looking into a mirror and seeing my past. I sent it to my wife and she cried, and together we cried tears of joy at how much healthier our lives are now that I got the care I needed.

I'm glad it's still up on YouTube. I've struggled for years to explain what my experience was like, what I was doing when I went through these thoughts and feelings of splitting, so others could understand. Your skit didn't spread stigma, it depicted what my life was like before I got help.

Please, dear god please don't stop making content like this. Please make more of it. Maybe have the skit and then follow it up with a critical assessment and show how each element speaks to a different aspect of the diagnoses. You don't need to make it a monolith, you can point out that there's room in between these diagnoses and that there's differences in root causes but you can show how these behaviors are wrong, and speak to how while they might come from mental illness they are still that person's responsibility for owning and recognizing as a problem and getting help for. You can tell others that the victims in this situation aren't helpless, that them asserting how they're being treated wrong and that providing therapy as a solution to be taken seriously could meaningfully repair things. How it won't just get better overnight, but that if they try, patients in loving healthy relationships recover faster and have less remission than those without healthy relationships. You can talk about how it's not the victims responsibility, but if they're going to stick around and suffer for their sick partner's sake that they can at least try to be a part of the solution, that their behavior isn't inevitable.

I hope you see this. I hope you know how much this means to me, that knowing that kids might grow up seeing content like this and not relive the generational trauma I was stuck in. When our kids are old enough, I'm showing them this skit and talking with them about what I went through, how it's unhealthy and how different behaviors foster communication and love and not resentment and fear like these behaviors do. I only hope that when I do, I'll have more videoes of yours like this to show them as well.

Thank you for what you're doing. You're making the world a better place with content like this. Thank you, thank you, thank you ❤️

[AdamSturdi]

As a med student, gotta say it is obvious your heart is in the right place and I find your content in general and the cluster B skit to be informative and helpful. Even if the tiktok forum doesn't work out, if you can continue to demo the various thought patterns and processes but with an included or intermittent debrief maybe that would lessen the tension and make clear the purpose as educational and to raise awareness. Support and love to you, also appreciate seeing someone do an apology in a way that could be a role model for me when i'll inevitably need to respond to feedback in the future.

[mrfranponzio]

So sad the video was put down, cause I found the way you depicted cluster B behavior in relationship as the most concrete, effective. I would really enjoy if you posted similar content, hoping the guidelines won’t be as hard next time… Thanks!

[astbasi]

Don’t let them bully you and censor you. You introduced a totally novel way of learning about these symptoms that isn’t available and would be a tremendous resource for everyone. Especially for mental health professionals to correctly diagnose— I mean the sad reality is that this person would be diagnosed as “bipolar 2” or “ptsd” instead of NPD/BPD. You as a future psychiatrist would then be spending countless visits trying to explain why the former diagnoses are not relevant and trying to taper them off their multiple medications and encouraging them to continue/prioritize therapy. I really think you should keep doing these videos, or at very least turn it into a scholarly resident education project and publish it in academic psychiatry or something.

[asdfjklasdfjkl]

I thought this was SO helpful. I will never forget what a cluster B personality looks like.

[Low_pH]

I actually remember our psychiatrists preceptors acting out the clusters for us and we had ro try to identify them. It was funny but always helpful for the reasons you stated

[ashutoshsharmash]

Thank you so much for making that video Dr. Preston. I saw it before it was taken down. It was hard and it brought back flashbacks. It brought back memories of an ex who would behave exactly like this and brought me down so badly, that I started to question, whether I was the bad person. I was depressed and apologetic all the time. It got to a point where I was shouted at in public and I was literally scared. I decided I couldnt be in something like this and decided to leave. I'm a doctor myself (Internal Medicine, in residency), and yet, I couldn't identify what was wrong. So I really appreciate what you did. We need more such videos.

[T]

I also think most academic/clinical depictions of mental health are of people who require hospitalization, not people who are unwell/disordered but still able to function reasonably well in society so skits like the one you did have a lot of value.

[Puppybuns]

As someone neurodivergent who has found themselves in relationships with cluster b partners in the past: your depiction felt spot on, to the point where it reminded me why I screen for this kind of behaviour in my relationships nowadays.

I would say you did a great job eliciting those emotions.

[dmc]

I appreciate your candor Preston. I think with some slight modifications this could be a useful subseries for us to learn about accurate depictions of DSM disorders. Maybe include a disclosure in the video so the audience knows its meant to be a educational skit.

[agent]

I appreciate you honestly engaging with the criticism rather than just ignoring it

[omethingsBetterThanNothing]

I dont know, the accurate dpeiction might be uncomfortable for some but the overarching goal was different.. medicine can be uncomfortable, i mean no one wants to see a surgery of arm reconstruction… but its essential to see it through. I loved the new idea and welcome more of it

[ArloKnudsenFit]

I get guideline warnings all the time on TikTok. They can be unreasonable.

Your video was useful. It was almost immediately recognized as serious.

[ksir]

Your patients are very lucky to have you in their corner! Keep growing and making an impact!

[Ijnekono]

People need videos like that to recognize that they're in a toxic relationship. Very sad that a few mad cluster B's got it taken down.

[ditzyasmr]

you're completely in the right here. i personally find it quite irritating when i read comments about not "demonizing bpd or other cluster b disorders" when it's a video accurately showing a representation of that disorder. people who say that either have a cluster b disorder or they have never had to deal with someone who has it. i think that it takes away a layer of responsibility when it comes to the negative actions of people who have a cluster b disorder. Cluster b disorders are characterized by a lot of dramatic, emotional, and erratic behaviors, and unfortunately, a lot of the time that comes out as manipulative or harmful behaviors towards others. i think that in the end, videos like these help people who have encountered ppl like this, but they also help ppl with cluster b disorders in the sense that they can see their behavior from an outside perspective and see that it is wrong and use that as fuel to better themselves and take responsibility.

[gabeg]

Appreciate not only your introspection and reflection, but also the mention of psammoma bodies - reinforcing my current studies! ♥

[someonesomeone]

You are not just doing comedy with a skit, you are also a doctor.
I am a radiologist, this situation sounds something like if some people got offended or felt "stigmatised" with things like mockingbird sign, brocken heart sign idk star sign. It is easier for any normal human being to relate to familiar patterns than it is to actual pathology, so this is the way we learn to recognize.
In psychiatry, is there a better way than actually acting it to teach and recognize signs? I don't think negative comments are coming from professionals or anyone with education in the field. It is probably people who found themselves in your skit and got offended for some reason.
Imo it is more stigmatising to simply ignore the tools to recognize, just so, patients or certain people who for some reason feel relevant to discussion don't feel stigmatised.