This goes over most therapist's and society's head. The symptoms that the label of BPD encompass are already severe on their own. But substance abuse make it considerably worse, specially when it's both your coping mechanism and your self-harm of choice.

I'm not saying I'm a special snowflake, but I'm constantly reminded that there's no treatment for me. I'm either too coherent to be "crazy" or too coherent in being "crazy" that I'm seeing as a lost cause and most doctors just give up on me. If I don't want to be hospitalized I can fuck off and do whatever I want to do and fail miserably. You can call me smart and bright all you want, you can explain diagnosis and treatment to me, I could write a thesis on it. But actually facing the symptoms that come with BPD+comorbidity with other stuff is totally different than contemplating symptoms and treatment.

And this is where I disagree with most clinicians. If you wouldn't make a schizophrenic person responsible for his/her actions, why would you apply punishing treatment for patients with BPD? Both experience psychosis on their own way. If I'm clearly delusional about death and rejection, why make me responsible for it? I can't control it, I can't control hallucinations, mood swings or impulses. It's unfair, telling me I'm responsible for this.  Yes I might speak coherently, but perceived intelligence has nothing to do with mental illness.