Clearing up some misunderstandings about BPD.

borderline

There seems to be a lot of misunderstanding about borderline personality disorder. I’ve noticed many people seem to confuse it with narcissistic personality disorder (NPD). While there ARE some overlapping symptoms (and it’s even been speculated by a number of mental health professionals that BPD is actually a less severe form of NPD), they are quite different from each other. I’d like to clear up a few of these misunderstandings and discuss both the similarities and the differences.

New DSM Criteria for BPD.

According the the DSM-V (2013), these are the diagnostic criteria for BPD (the new list of criteria is quite long and ponderous so I will not attempt to talk about each of these points here):

A. Significant impairments in personality functioning manifest by:

1. Impairments in self functioning (a or b):

a. Identity: Markedly impoverished, poorly developed, or unstable self-image, often associated with excessive self-criticism; chronic feelings of emptiness; dissociative states under stress.

b. Self-direction: Instability in goals, aspirations, values, or career plans.

AND

2. Impairments in interpersonal functioning (a or b):

a. Empathy: Compromised ability to recognize the feelings and needs of others associated with interpersonal hypersensitivity (i.e., prone to feel slighted or insulted); perceptions of others selectively biased toward negative attributes or vulnerabilities.

b. Intimacy: Intense, unstable, and conflicted close relationships, marked by mistrust, neediness, and anxious preoccupation with real or imagined abandonment; close relationships often viewed in extremes of idealization and devaluation and alternating between over involvement and withdrawal.

B. Pathological personality traits in the following domains:

1. Negative Affectivity, characterized by:

a. Emotional lability: Unstable emotional experiences and frequent mood changes; emotions that are easily aroused, intense, and/or out of proportion to events and circumstances.

b. Anxiousness: Intense feelings of nervousness, tenseness, or panic, often in reaction to interpersonal stresses; worry about the negative effects of past unpleasant experiences and future negative possibilities; feeling fearful, apprehensive, or threatened by uncertainty; fears of falling apart or losing control.

c. Separation insecurity: Fears of rejection by – and/or separation from – significant others, associated with fears of excessive dependency and complete loss of autonomy.

d. Depressivity: Frequent feelings of being down, miserable, and/or hopeless; difficulty recovering from such moods; pessimism about the future; pervasive shame; feeling of inferior self-worth; thoughts of suicide and suicidal behavior.

2. Disinhibition, characterized by:

a. Impulsivity: Acting on the spur of the moment in response to immediate stimuli; acting on a momentary basis without a plan or consideration of outcomes; difficulty establishing or following plans; a sense of urgency and self-harming behavior under emotional distress.

b. Risk taking: Engagement in dangerous, risky, and potentially self-damaging activities, unnecessarily and without regard to consequences; lack of concern for one’s limitations and denial of the reality of personal danger.

3. Antagonism, characterized by:

a. Hostility: Persistent or frequent angry feelings; anger or irritability in response to minor slights and insults.

C. The impairments in personality functioning and the individual’s personality trait expression are relatively stable across time and consistent across situations.

D. The impairments in personality functioning and the individual’s personality trait expression are not better understood as normative for the individual’s developmental stage or socio-cultural environment.

E. The impairments in personality functioning and the individual’s personality trait expression are not solely due to the direct physiological effects of a substance (e.g., a drug of abuse, medication) or a general medical condition (e.g., severe head trauma).

Is it really true that Borderlines can’t feel empathy?

welcome_to_me_photo
BPD patient “Alice” (Kristen Wiig) in “Welcome to Me.”

The very first thing that stood out to me (and was not included in the older DSM criteria) is “lack of empathy.” Yes, it is a fact that many borderlines have difficulty feeling empathy under normal circumstances, but the reasons for this are vastly different than the lack of empathy seen in people with NPD.

Most people with BPD have the capacity to feel empathy, and can feel very guilty when they become aware (or it’s pointed out to them) that they have treated others badly, but because Borderlines have great difficulty regulating their emotional reactions and have an unfortunate tendency to lose themselves in their own drama when they perceive they are being attacked, at those times they can “forget” that others exist, and this can lead to them acting selfishly and disregarding the feelings of others. This can appear very narcissistic. It’s not that they CAN’T feel empathy though, because they certainly can. They can also feel remorseful. But it may take a disaster (such as losing a good friend or a broken relationship) for them to realize the damage their impulsive and selfish behavior has caused. If their bad behavior is pointed out to them by someone else–such as when the character Alice in the movie “Welcome to Me” loses her best friend Gina, who tells her how much she was hurt by Alice’s insults against her–they will feel remorse and try to make amends in whatever way they can.

Borderlines just want to be accepted.

wizard-of-oz2

Unlike narcissists, borderlines hate to be hated. Narcissists like any form of attention–negative or positive (and some even prefer to be hated!) while borderlines only want to be loved and thought of in a positive manner. Most of them WANT to be good people and WANT to be liked, but don’t always act in ways that make them seem very nice, due to their impulsivity and tendency to act out whatever emotions they are feeling at the moment.

Impulsivity is a primary issue with a borderline–a trait not shared by narcissists (but IS shared with people with ASPD)–because they fail to think ahead and consider consequences of their bad behavior.

Borderlines can act narcissistic because of their deep seated need to feel accepted. Most hate themselves (as do narcissists) and some can act grandiose and full of themselves in their attempts to be liked and admired. Deep inside, they feel worthless. It’s not hard to take down their braggadocio, however. Cut a borderline down to size and they may react with rage or tears (as will a narcissist) but are also more likely than a narcissist to admit you are right and they are really just worthless losers. They might even apologize profusely for acting so out of line.

I can’t help but think of the Wizard in The Wizard of Oz. An insecure little man who stood behind a curtain projecting the face of a raging tyrant onto a huge screen. When Toto pulled back the curtain to reveal who the “Wizard” really was, and Dorothy upbraided him for being a “very bad man,” the Wizard immediately became humble and apologized profusely to the group, telling them that yes, he was just a humbug. Some people have said the Wizard was a narcissist, but I think his behavior was more typical of a borderline. A narcissist would have continued to insist on his superiority, even with his true nature having been revealed–and his true nature would not have been so benign. The Wizard’s intentions for Dorothy and her friends were also good.

While a narcissist may rage and perhaps even use tears (to manipulate others into feeling sorry for them), they will almost never admit their wrongdoing or admit they are anything other than God’s gift to the world. Doing so is far too dangerous to them.

Why Borderlines act selfishly.

BPD_cartoon

A borderline who is not under stress or in the midst of an emotional drama, or has learned to control their impulses through behavioral training like DBT–dialectical behavior training which was developed by Marsha Linehan (it does work–I can attest to its efficacy), can certainly feel empathy for others, and can be genuinely good and kind people. Genuine kindness and concern for others is rare in a narcissist and almost unheard of in a malignant narcissist. Borderlines generally have this capacity, but unfortunately, if they haven’t learned to control or regulate their emotions, their ability to feel for others or show a conscience is eclipsed by their own drama, which at the moment becomes all-important. They really just don’t know what they are doing, but if you call them out or make them suffer consequences, in most cases they will try to make it up to you.

Borderlines don’t live a lie.

cluster_b

Borderlines do not wear masks, as narcissists do. They cannot pretend to be someone they are not (or if try to, they usually fail miserably, like the wizard in The Wizard of Oz). They are not trying to fool you, even though to avoid rejection, they can be manipulative and use some of the same games (gaslighting, blame-shifting, rages, etc) that narcissists do. Borderlines, if anything, show TOO MUCH of themselves–and that includes the bad along with the good. With a borderline, it’s all WYSIWYG. They can’t wear a mask, because they lack the ability to plan things out ahead of time the way someone with NPD does. Wearing masks requires cunning and the ability to lie. While borderlines can and do lie (usually to exaggerate the pain they are facing or to idealize/devalue someone else), they can’t lie about who they are or what they’re feeling. In that sense, they’re even more honest than the average non-disordered person.

Idealization/devaluation in borderlines and narcissists.
hashtag_borderline

Both narcissists and borderlines do tend to idealize and devalue other people, and both are guilty of black-or-white thinking. But the motives for this behavior are different. A narcissist idealizes someone they see as a good source of narcissistic supply. They do not see the source of supply as a person, but will put them on a pedestal as long as they’re providing enough supply. Should the victim stop providing supply (or the narcissist just becomes bored and needs a new source of supply), the narcissist devalues and discards the victim, without mercy or regret.

Most borderlines idealize and devalue others based on their need for acceptance and love, not the need for supply. If they perceive another person as good and kind, and accepting of them, they will tend to idealize the person and sometimes become clingy and needy (a narcissist can be clingy and needy too, but for different reasons). If the borderline feels the other person losing interest or pulling away from them, they may suddenly, without warning, devalue the other person and reject them. They do this not to be mean, but to avoid being rejected themselves. This explains the “I hate you…don’t leave me” or “come closer…go away” behaviors many borderlines show. It’s confusing and contradictory to others, but it helps them to avoid the inevitable rejection they believe is coming to them. Borderlines live in constant fear of being rejected; narcissists live in constant fear being ignored–losing their “drug” of narcissistic supply. While their behaviors may seem similar on the surface, the motives behind them are quite different.

A borderline is not usually deliberately malicious or sadistic. It’s not their intention to hurt others or cause them misery, even though they unintentionally do it all the time because they have so much trouble controlling their impulses. They usually are not even aware how much their unpredictable and contradictory behavior is confusing or hurting others. If a borderline is made aware of what they are doing, they are far more likely to seek therapy than a narcissist, because someone with BPD wants more than anything to be loved and accepted. A narcissist just doesn’t care what you think of them, as long as you are paying attention to them. Of course, there are some low-mid spectrum narcissists who have enough self awareness and hate the fact they can’t feel the more sublime emotions (love, empathy, joy) of a normal person, and those few may actually seek help too.

BPD is maladaptive to the victim.

linehan_biosocial
Marsha Linehan’s diagram that shows why BPD doesn’t work well for the sufferer. (click to enlarge)

Borderline personality disorder is ego-dystonic: that is, it isn’t adaptive to the sufferer and their behaviors cause them as much or more misery than it causes others. People with any ego-dystonic disorder or mental illness–depression, anxiety, phobias, certain personality disorders such as Avoidant, Borderline or Dependent–are more likely to seek treatment because they aren’t happy with the way they behave and feel. They don’t necessarily blame others for their own misery, the way a narcissist will do.

Borderlines are also far more likely than narcissists to engage in suicidal ideation or even attempt suicide when they become depressed. They are self-destructive and more dangerous to themslves than others. A narcissist is not as likely to consider or attempt suicide, but if they do, they are more likely to attempt to “take you with them.”

Narcissistic personality disorder is ego-syntonic: that is, it usually is adaptive to the sufferer and in most cases their bad behaviors don’t bother them at all (they don’t care how you feel), they only bother others. This is why narcissists are so unlikely to seek treatment, unless they have lost their sources of supply and are undergoing severe depression (narcissistic crisis). Narcissists are miserable people, but they are far more likely than borderlines to blame others for their own misery.

Both disorders are included under the Cluster B category of personality disorders because both involve a malfunction of emotional regulation. In a narcissist, emotion is strong but is hidden and masked; in a borderline, emotion is strong but cannot be hidden or regulated at all. Both disorders cause others misery, but a narcissist lives a lie; a borderline generally does not.

BPD as a defense mechanism that arises in early childhood.

scared_child

Both NPD and BPD (and all Cluster B disorders) arise out of childhood from early attachment disorders with caregivers. Both are desperate attempts not to be hurt anymore and have their origins in abuse or neglect as young children. Most narcissists and borderlines were abuse victims as children. Both narcissists and borderlines are incredibly sensitive–so much so, they have constructed almost intractible defense mechanisms to avoid further pain and hurt. Unfortunately for the borderline, their defense mechanism of overreaction to everything is maladaptive and hurts them more than they can hurt anyone else. But due to this, they are far more likely to seek treatment.

Upcoming Post:
Later on, I plan to post an article about Marsha Linehan’s DBT and other therapies for people suffering from Borderline Personality Disorder. (They are similar to the methods used for people with NPD).

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29 thoughts on “Clearing up some misunderstandings about BPD.

  1. The BPDs in my life are very sensitive, indeed. They know it, too. They sometimes say overly dramatic things and then say, “Never mind, it’s just me.”
    The Narcs in my life are so shut down, virtually everything they say is a lie, or at the least, a grandiose sense of truth.
    Still, I can see the similarities, especially in the origins.
    Great clarification here.

    Liked by 2 people

    • Thank you. I’m glad you understand the differences. Both are sensitive,but a BPD doesn’t mask their sensitivity. And yes, we can say (and mean it) when we say “it’s just me.” We don’t always blame others for our misery. A narc can’t do that.

      Liked by 2 people

  2. Be careful what you wish for 🙂 Here are my critiques:

    I am tempted to start this comment with, “Perhaps there is so much misunderstanding about Borderline Personality Disorder because it doesn’t exist.” Oops… I just said it. Ok, there is my first point: that while all the BPD “symptoms” are real in different varieties and degrees, there is no clear evidence that a disorder comprised of these symptoms exists in any reliable (consistent from person to person), valid way. So while I read this, I am always viewing BPD as an artificial placeholder for various kinds of serious distress.

    I see that some of the comments you made about “borderline” or “narcissistic” people could be relevant; but they don’t apply to any individual, and they are sometimes all or nothing. I don’t believe it’s true that “borderlines” cannot lie, or cannot intend to sadistically harm someone else. When I was “borderline” I could do and did do both these things (now you should be worried to have me commenting here right?). And about narcissists “never admitting their wrongdoing” – I think this is too extreme. You should have met Tony Brown and the other people on his HealNPD site; they could be quite honest in admitting bad things they did, both to victims and to people on the site… not all the time, but some of the time.

    So… my point is that generalizing behaviors into BPD or NPD doesn’t adequately reflect how complex and individual people are. It is like making general statements about different generations (E.g. Generation X or Baby boomers)… it can sound sexy and convincing, but it usually fails to actually apply to many people in the so-called “group”. You were on better ground when you said things like “more likely…”, i.e. less certain, all-encompassing statements. Studies show that people who speak in more cautious, broad-spectrum terms are more accurate in various ways than people who make generalized, all-or-nothing statements. There is a good book about this called Future Babble, about people who try to predict the future.

    As for Linehan’s biosocial theory; I think most of her diagram describes something real. However, the part about “emotion vulnerability” – which I remember from reading Linehan refers to the notion that borderlines may have a biological vulnerability toward people overwhelmed emotionally – has never been proven. There just is no evidence that people who become “borderline” are biologically or genetically more vulnerable than so-called normal people. If you have it, please share.

    Also, this part: “While there ARE some overlapping symptoms, they are very different disorders and are not even on the same spectrum.” – I would argue the last part is incorrect. IMO BPD is a less advanced form of narcissistic condition and NPD is a more advanced form of borderline conditions; i.e. they are actually along the same spectrum of emotional development; merge into each other, and are not clearly separable. There is a free book that explains this:

    http://freepsychotherapybooks.org/component/content/article/13-contents/87-borderline-psychopathology-and-its-treatment

    Starting page 137, Gerald Adler describes the “Borderline-Narcissistic Personality Continuum”, illustrating how people move from one to the other during a good psychotherapy treatment. But I think his definition of NPD would be quite different from yours…

    I think there is confusion because some people who you describe as narcissistic would be better characterized as sociopathic. Some of the contrasts you made seem to be between “borderline” and “sociopathic” (malignant narcissistic) people. Again, I think these are spectrums that merge into each other… so I am having to suspend my disbelief in writing about them as if they were real discrete entities which people “have.”

    What else; I think we can help people by changing certain words; e.g. replacing symptoms with “distress”, replacing patient with “people” and replacing disorder by just talking about the real problems people are having without labeling them. Who wants to have their whole personality called a disorder?

    Sorry if this is a bit harsh – I appreciate that you are trying to explain things and your comments about borderlines are sympathetic in an encouraging way. But I am being honest and I hope this will give you some food for thought.

    Liked by 3 people

    • I had to laugh when I saw “borderline personality disorder doesn’t exist.” I knew you would say that! As for the rest, I have to read this more carefully and give you a better reply later. You always make me think.

      Liked by 2 people

      • As you know, what I mean is that the artificial organization of distressing experiences that is labeled BPD lacks validity and reliability, and does not truly exist as an organization discrete from other organizations. Just like I argue that BPD does not truly exist outside of psychologists’ minds, I could make the same argument that the constellation Sagittarius does not exist outside of astrologers’ minds, and that would be quite anologous.

        Liked by 2 people

    • BPDT– because yours and CZ’s replies make such similar points, I am going to answer both of you in one comment, posted under her comment. Thanks!

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  3. Very interesting article, Otter. I appreciate reading your personal “take” on a complicated disorder. One that has been political to some degree since women were frequently diagnosed as having BPD instead of examining past (current) traumas. I try to keep up with current literature about BPD suggesting it is treatable, even curable with proper intervention (and hard work on the part of the person wanting to change his/her behavior). I would question any diagnosis of BPD prior to the past ten years. Diagnosis is much better today and some have argued for BPD to be renamed as “emotional regulation disorder”. Is this Linehan’s proposal?

    I am not a psychologist but have had personal experience with people diagnosed with BPD. They have been intentionally malicious, although I “get your point” about emotional dysregulation and the inability to think about others while in an aroused state. It would be fairer I think, to say that people with Aspergers are without guile, than people with BPD.

    As BPDTransformation said, people are so complex. Diagnosis is a bit of an art form. The other thing to consider is that psychologists agree on the same diagnosis about half the time. (Paula Kaplan, “They Say You’re Crazy”)

    I was wondering about your comment, “While there ARE some overlapping symptoms, they are very different disorders and are not even on the same spectrum”. My understanding is that they are on the same spectrum and there is tremendous overlap, making it difficult to know which disorder is primary. I’m here to learn so please don’t be concerned about offending me or disagreeing. This is a graph I pulled together for my blog which shows the pathological narcissism underlying Cluster B disorders: http://n-continuum.blogspot.com/2013/11/narcissism-key-from-healthy-to.html

    And, narcissists will indeed seek therapy. What I’m learning is that therapists see many people with narcissistic disorders (it’s reputed to be the most common problem in therapy today). Depending on the degree of narcissism, treatment is effective (the more psychopathic, the less treatable however).

    I have an ex-in-law with an official diagnosis of BPD and he is a ruthless, self-gratifying, lying and dangerous man. He would rather hurt people than change. Perhaps he would have been diagnosed with AsPD had he seen another clinician? That is always the question in my mind.

    Hugs,
    CZ

    Liked by 3 people

    • CZ, because yours and BPD’s replies make similar points, I am going to answer both as one reply, if that’s alright.

      I agree with both of you about the fact I was making generalizations–BPDT’s analogy of my suggesting ALL narcissists are one way and ALL BPD’s are another way to stereotyping members of Generation X, Boomers, etc, is a good one. For that matter, astrology is probably about as accurate.

      I was not talking about individuals here, but about the disorders in a general sense. Of course there are narcs who want treatment and aren’t that bad (and I have said this myself many times), as well as borderlines who can be sadistic and highly abusive.

      When we are talking about generations, for example, people will say things like ALL members of Gen-X are slackers or politically conservative and ALL baby boomers are entitled and smoke pot, and ALL Millennials are spoiled and narcissistic. Of course when you look at individual members of those generations, there will be many exceptions. Some may even fit another generational type better than their own. But when you’re talking about a large class of people, generalizations will be made for convenience. Of course the downside to this convenience is that it breeds stereotypes and those can be very damaging.

      I like the idea of symptom-based treatment without labels being used, if that is possible. Of course the mental health field has a long way to go before they will ever ditch the labels. And of course the insurance companies require them to pay claims anyway, but that has nothing to do with mental health.

      As far as NPD and BPD not being on the same spectrum, I was wrong that they are not so I’m going to take out or rephrase that statement to reflect the fact they are probably on the same spectrum.
      Of course, as you said, psychiatric diagnosis is very much an art form. It’s not scientific at all.

      Thanks for the BPD links. I was actually looking at the list of these links on your website, and had intended to read them. If I’m going to be writing a lot more about BPD then I have lots more reading to do. I appreciate it.

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      • Lucky Otter, I see that your answer to both of us is under her answer, not mine… she must be more special… just kidding 🙂

        While I largely agree with CZ’s comments, which I think are insightful, I want to question one thing: “Diagnosis is much better today” (compared to 10 years ago). I am not sure where this came from… DSM 5 field trials showed worse reliability than DSM IV or III.; DSM 5 has very poor overall reliability (meaning how consistently different psychiatrists agree on whether the same person has a given condition). Here is a table, half way down this page, listing the reliability ratings for different conditions:

        http://www.huffingtonpost.com/allen-frances/dsm-5-reliability-tests_b_1490857.html

        0.2 means it’s pure chance whether someone will get diagnosed with the same label by different psychiatrists, like flipping a coin, and 1.0 means perfect agreement. Major Depression, OCD and Antisocial personality disorder are almost at 0.2, which is awful. Perhaps CZ meant reliability for diagnosing BPD in particular… if so, I would be curious what source she had in mind. Reliability in DSM V for BPD may be higher than some truly awful reliability ratings for other disorders; but I doubt it is much higher.

        My viewpoint is that BPD in its DSM form (as well as the rest of the DSM) should be abolished: It is unreliable, invalid, confusing, generates stigma, does not aid treatment decisions, and does not promote understanding of why someone has the problems they do. I would argue it should be replaced either by an understanding of the borderline spectrum of functioning which is less concrete, emphasizing dimensionality and individual differences, or by abolishing the term entirely and listening to the stories people tell without labeling them.

        Liked by 2 people

        • I agree with you about the DSM description, especially in the “new and imrpoved DSM V” sucking balls. Diagnosticians try to treat this stuff like an exact science, and it isn’t and never will be. Wherever people are concerned, everyone is different. I’m coming around to your way of thinking that the labels are pretty much useless and only symptoms should be treated. Won’t happen any time soon though.

          I had to pick one of you to put my answer under, since hers was last, that made more sense. Nothing personal at all! (I know you were joking though).

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        • Hi BPDT!

          You’ve done amazing work compiling information even though some of it’s over my head. That’s okay. I’m used to standing on ladders to read psych literature. ;-P It’s always been worth my time to learn as much as possible so thank you for the time it takes creating such a great blog.

          Where did I get information suggesting BPD is more accurately diagnosed today than ten years ago? A wild guess. ha…not really. It’s been insinuated through the lectures on a website called NEABPD, that psychologists are better informed about BPD today. This is the link for any readers who aren’t familiar with this organization: http://www.borderlinepersonalitydisorder.com/ Their approach is “family friendly” and their annual conferences are generally posted on YouTube so that makes the information accessible to everyone. I have learned a lot about coping with family members who struggle with emotional dysregulation and cognitive distortions. And I have learned a lot about myself, my reactions, my contributions to conflicts.

          Another reason why I said “ten years ago” is because of Dr. Paula Caplan’s frustration with the psychiatric community pigeonholing women (esp.) into a BPD diagnosis without considering past trauma. She wrote (1995), “to focus on saying that male or female victims of severe abuse have “Borderline Personality Disorders”…swings the focus away from the perpetrator and treats the victims’ psychological survival mechanisms as abnormal.” (pg. 237, “They Say You’re Crazy”). Now that we know about complex ptsd and the impact of childhood trauma, I assumed doctors would be better at distinguishing a personality disorder from a trauma disorder. Maybe not. You will know more about that than myself and I look forward to your opinion!

          Liked by 1 person

          • I’ll have to think about this and reply when my brain is more alert and I’ve had some coffee! I certainly don’t think I’m any kind of expert, ESPECIALLY not on complex PTSD, which even though I was also diagnosed with THAT, I have done very little research or reading on. I know what it is, but not the fine points at all, or even what the difference is between C-PTSD and regular PTSD. Let me mull all this over and give you a better reply tomorrow when I’m more awake.
            Once again I thank you so much for your blog. It’s opened my eyes about so much. More than you’ll ever know.

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            • Oops. You were calling BPDT an expert not me. *blushing* I was wondering how you could think I was an expert, I just didn’t read that post correctly. Sorry about that.

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          • I agree BPDT’s handle on the topic of Cluster B’s and his expertise on these disorders is incredibly impressive. He has a thing or two to teach these so called mental health professionals.

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          • I know this group. I am sure they do some good work. On the other hand, many of their members are university professors who are heavily funded by the drug industry. Therefore, they use the medical model approach, and in my opinion; that means they will be prone to certain distortions about what BPD is or isn’t. You can see that in the way they write of BPD as a “mental illness”, a “disorder”, a “diagnosis that is easily missed”, etc (it occurs to me that maybe it is easily missed because it is vague, unreliable and invalid…)
            I was asked by Perry Hoffman, the leader of BPD NEA, to contribute my story to a group of articles about recovery from BPD they were putting together. She really liked my story, until she read the part about my realizing that BPD was completely unreliable and invalid and how this helped my recovery. Then she suggested they might include it without that part. I said no.

            Liked by 2 people

            • I don’t even know what would happen to our household if we weren’t drug-friendly. The whole place might blow up. ;-P

              Yes, I understand the complication between doctors and pharmaceutical companies. Prescribing medications and skipping treatment is not effective in the long run. Patients are also part of the problem because they’d prefer taking a pill if it will solve their problems. Wouldn’t we all?

              I figured you know about the NEABPD organization! I don’t suppose you’ll ever be number one on their Hit Parade if you don’t agree BPD even exists. I’m very curious about your perspective so perhaps I’ll pop over to your blog this evening!

              Liked by 1 person

            • Well, I think borderline functioning exists in the loose sense of a borderline spectrum or what some psychodynamic psychotherapists call borderline personality organization. This refers to use of splitting in which the all bad sets of self/other images are mostly dominant over the all-good pairs. It refers to a developmental arrest somewhere in the symbiotic phase of emotional development, when a child need a enough love and security to regulate their feelings but unfortunately doesn’t get it.
              As for NEA BPD… I’m not their friend. I strongly disagree with their medical model terminology of illness and disorder. In my view BPD is not a medical illness, nor is “it” caused by or based on with misfiring brain chemicals or genetic vulnerability. IMO believing that BPD, or more broadly human emotional functioning and subjective experience, can be reduced to a medical diagnosis is foolish and simplistic. I invite you to check out my viewpoints on these topics. I am going to check out your blog.

              Liked by 2 people

  4. Hello. This is so true. I wonder if people think about the very real fact that some folk with BPD also have NPD????? I am so tired of reading posts about folk who have it all wrong! I have read abusive posts by folk who seem to think that people with BPD are monsters. When you read through the experience they have had with said monster you can see clearly that the person is not Borderline or just Borderline…….. This sort of judgement really does fuel stigma! Thank you for your post. So important that we and they get it right. K.

    Liked by 1 person

    • Yes, it all leads to negative stereotyping and stigma. I can’t help it that I have BPD, I don’t think it’s fair to be crucified and told I’m a narc or evil because of that. For that matter, that applies to people with NPD too–just not the malignant narcissists (they really are evil, in my opinion). They think anyone with a Cluster B is a monster. I’m a monster? That’s news to me. I always felt like a codependent victim pursued by monsters.

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      • I agree folk that folk with NPD are unwell and need treatment as much as anyone one of us. I recently attended a workshop at a University here in Sydney and walked away with a better understanding of NPD. I don’t believe that these souls were born this way – their path/upbrining formed them into who they are – like a lump of clay so to speak. I felt a great deal of emapthy for these lost souls. No more monsters than you or I just a different kind of messed up. Malignant Narcissists – run a mile! I have always felt like a victim as well – I seem to attract people intent on bringing hurt into my life although I have managed to evict these types of people from my world………

        Liked by 1 person

        • Wow….I was just thinking about this subject again which seems so volatile and upsetting to some, and then i read your reply. I have less empathy than you for them, but I do reserve some for certain cases and I believe in almost every case the disorder can be traced back to abuse. Thank you for commenting.

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  5. To BPDT and CZBZ–
    I edited the article to make it sound less like I was generalizing and stereotyping, as well as changing my incorrect statement about BPD/NPD not being on the same spectrum. I hope that helps.

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    • You can say whatever you want to say about how you experience BPD. But it’s especially kind of you to consider what your readers had to say about “the spectrum.” Your willingness to accept other points of view says a great deal about you, Lucky. It’s why we must stop categorizing all people with BPD as one-and-the-same. There’s an infinite variety of behaviors and on top of that, an amazing capacity for self-change when that person is motivated to change. People can either support healthy change in someone with a “supposed” personality disorder or they can become part of the problem by stigmatizing that person as a “monster.” I really hate that—especially in the Narcissism Community where such a thing as “Healthy Narcissism” exists.

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      • This is one reason why I’m starting to drift away from this being a strictly ACON blog…that keeps me bound to keeping a particular mindset that I find very limiting and unworkable for me anymore….

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  6. After reading a number of articles which totally misunderstood BPD. It was a delight to read your article.

    One problem with BPD is the narrow examples and extreme behavior focus. A person with BPD does not look for or desire to be noticed. They are there for a specific reason or purpose other than others admiration. A movie which to me clearly shows a high functioning BPD is Patton (1970).
    The General’s behavior in the movie shows classic BPD behavior, e.g. controlling, impulse control, anger and rage. There’s a scene in the movie where Patton almost begs Omar Bradley to give him a command. The General is besides himself with disbelief he might miss the “world at war”. As a prominent Veterans administration expert has characterized individuals with BPD as “border lion”.

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    • Dante, thank you for your comments. I almost forgot I wrote this. You’re right–a person with BPD is not looking for supply. Instead, they act the way they do because of their fear of abandonment. In some ways it resembles narcissism, but BPDs have more empathy. They just get caught up in their emotional turmoil and that overrides any empathy they might have, which comes out when they aren’t in a crisis (except BPDs are usually in crisis mode).

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