“Back from the Edge”–video about borderline personality disorder

Posted on May 31, 2015 by luckyotter

Here is an excellent and informative video featuring three people who suffered and were successfully treated for their BPD. Marsha Linehan, a psychologist who also had BPD and developed DBT therapy for borderline patients, is also featured, as well as Otto Kernberg, an psychologist who specializes in NPD and BPD.

BPD is best defined as a severe lack of a sense of self which has its roots in abuse and often sexual abuse during childhood and adolescence but it also has a genetic component. Brain scans of people with BPD show their brains are actually wired differently. Self destructive behaviors such as cutting serve to help the sufferer regulate their emotions for the short term. Borderlines find their inability to regulate their emotions so painful and debilitating that many resort to suicide. One shocking statistic is that 8 – 10% of borderlines will ultimately either kill themselves or die of their self destructive behaviors.

Unlike people with NPD, medications that “turn off” the parts of the brain that overreact to emotional stimuli have been successful for treating and controlling BPD symptoms. Also, while people with BPD are more impaired in being able to function than people with NPD, therapy is much more likely to be successful.

Is BPD a real disorder or should it be eliminated as a diagnosis?

Posted on May 28, 2015 by luckyotter

The myriad ways experts “see” borderline personality disorder. (click to enlarge)

There’s a great deal of confusion and disagreement in the professional literature about the nature of Borderline Personality Disorder. The blogger BPDTransformation (whose blog is excellent if sometimes a little on the scholarly side), who was cured of BPD, thinks the label should simply be done away with and that BPD doesn’t really exist at all–the label being merely a placeholder for a group of symptoms that are widely variable, and that experts can’t even agree on. He believes BPD is categorized as a Cluster B (dramatic/emotional) disorder only because mental health experts can’t decide where else to put it.

The stigma of BPD as a Cluster B disorder.

The problem with labeling BPD in the Cluster B category of personality disorders is the stigma that classification carries–that people with BPD (like those with NPD or ASPD) are evil, untrustworthy, selfishly manipulative, grandiose, dishonest, lack empathy, and really no better than people with malignant narcissism or even ASPD. (It sure doesn’t help any that an obviously sociopathic criminal like Jodi Arias has a diagnosis of BPD, when she more likely fits the criteria for high spectrum [malignant] narcissism, at the very least.) Insurance companies assume anyone with a Cluster B disorder is incurable, and therefore will not pay claims where a person is diagnosed with a Cluster B disorder. This is very damaging to those of us with BPD who have either successfully learned to modify and control our symptoms–or have even been cured, as BPDTransformation has been. People continue to believe we are lying about the success of the treatments or therapy we have received. Borderlines who have never been treated may find it difficult to find a therapist willing to work with them.

BPD is far more amenable to deep insight therapy than NPD (which is extremely difficult to cure but not impossible for non-malignants) and light years away from a disorder like ASPD (antisocial personality disorder), which can probably not be cured. Because the symptoms of BPD are so disagreeable to the sufferer (and not just to others), it is common for borderlines to present themselves for therapy, unlike people with NPD or ASPD. The vast majority or borderlines are unhappy with themselves and the way their lives have turned out. But many therapists won’t work with borderlines (other than with behavior modification treatments like DBT) because they know insurance companies will not pay such a claim.

What are borderlines on the border of, anyway?

The name “borderline” itself is confusing. What are borderlines on the border of anyway? Neurosis and psychosis? A normal sense of self and Narcissism? Mexico and the United States?

The experts are all over the map on this, with some recent theories stating that BPD is actually a less adaptive, more ego-dystonic form of narcissism. But the original term “borderline” actually referred to the belief that the disorder was on the “border” between psychosis and neurosis:

[…]It is called borderline because it was originally thought that people were on the ‘border’ of psychosis and neurosis. BPD is also sometimes called Emotionally Unstable Personality Disorder (Borderline type). Approximately 75% of people given this diagnosis are women and 50% have experienced physical and/or sexual abuse.

Because BPD is more commonly diagnosed in women than in men, it’s also been referred to as the female form of narcissistic personality disorder (which is more commonly diagnosed in men than in women).

Psychotic, neurotic, both, or none of the above?

Credit: Judgybitch/Dzhokhar Tsarnaev

The reason why BPD is sometimes regarded as the midpoint between neuroses (mild and easily treated anxiety or depressive disorders) and psychoses (disorders where the victim is out of touch with reality, such as schizophrenia and the manic-depressive form of bipolar disorder) is because people with BPD can, when emotionally upset, display psychotic or delusional symptoms such as splitting (black and white thinking), dissociation (feelings of unreality either about the self or the environment), magical thinking, severe paranoia, delusions of grandeur or persecution, and sometimes even hallucinations and disorganized speech or thought. However, for a borderline, these psychotic symptoms don’t last and as soon as the emotional crisis has passed, the borderline’s “sanity” normally returns. Antipsychotic medication can be helpful, but isn’t always necessary, as it usually is for a truly psychotic individual.

Others have speculated that BPD is really a severe form of PTSD or C-PTSD caused by trauma, and should be treated the same way as PTSD. Personally, I think it’s more long-standing than a reactive disorder like PTSD and is a true personality disorder, but it does make sense that BPD may have originally begun as a form of PTSD at an early age, often due to sexual abuse.

There is so much confusion and contradiction in the literature about BPD that I’m slowly coming around to BPDTransformation’s way of thinking that it should possibly be removed from the Diagnostic and Statistical Manual of Mental Disorders (DSM) until mental health professionals can get a better handle on what BPD actually is, and whether it’s even a valid diagnosis (or simply a group of symptoms that could indicate several other disorders). There should at least be more agreement among the professionals at any rate.

Borderlines are human chameleons.

Posted on May 27, 2015 by luckyotter

My latest obsession seems to be the similarities and differences between people with NPD and BPD. I’ve been trying to come to terms with the idea an increasing number of mental health professionals hold that BPD may actually be on the same spectrum as NPD (for more information about this, see Alexander Lowen’s “Spectrum of Narcissistic Disorders”) but is a less adaptive (to the sufferer) form of the same disorder. What I’ve been reading is disturbing to me because I had no idea how similar BPD and NPD really may be.

The most important thing both disorders seem to have in common is that both borderlines and narcissists feel empty inside. Both feel as if they have a black hole inside them, and many try to “fill” that hole with things like substances, sex or compulsive shopping. People with both disorders are prone to abuse drugs or alcohol, or engage in other unhealthy or self-destructive behaviors (with the borderline more likely to be deliberately self-destructive and the narcissist callous or destructive toward others). Filling the inner black hole becomes so important that people with these disorders may disregard the needs of others in their need to get their “fix.”

I found an article in Psychology Today that discusses the devastating conundrum that both narcissists and borderlines have to face: the lack of an identity. It’s this absence of a true identity that make people with these disorders feel so empty and hollow, and drives them to do the kinds of things they do. The primary difference between these disorders is that narcissists adopt a false self to replace the lost true self, while borderlines–although not having a false self per se — instead become human chameleons, adapting their behaviors to a given situation (to avoid rejection)– but none of these identities are really “them.” The truth is, they don’t know who they really are. That’s why borderlines seem to change with the wind and confuse those they are close to.

The article I’ve linked to discusses these ideas in more depth. It’s extremely interesting stuff, but somewhat upsetting to people like me with a BPD diagnosis.

This article is Part 7 of a series about the differences and similarities between BPD and NPD.
The other 6 can be linked to from this one. (Of course I’ll be reading all of them.)

Who Am I? The Conundrum of Both Borderlines and Narcissists

I cannot repost the article here here without written permission from the author, so you will have to click the link to read the article.

Here is an article by the same author about the False Self the Narcissist uses to mask their lack of an identity: https://www.psychologytoday.com/blog/stop-walking-eggshells/201111/behind-the-facade-the-false-self-the-narcissist

The curse of the Aspergers/Avoidant/Borderline triad.

Posted on May 24, 2015 by luckyotter

Today I attended a beautiful Pentecost mass that was held outdoors. The day couldn’t have been more perfect for an outdoor celebration of the descent of the Holy Spirit on Jesus’ disciples. Unlike the disciples, I didn’t experience a sudden spiritual epiphany or dramatic change in my heart, or start speaking in tongues. But as always when I attend mass, I felt God’s presence around me (if not actually IN me) and felt surrounded by peace and light.

I looked at the tall trees gently swaying in the distance, their bright spring greens illuminated in the bright sunshine against the azure blue sky, and asked God to change me, to let the Holy Spirit flow inside me and fill me with its divine gifts of empathy, unconditional love, and joy. I asked Him to make me a better person who can connect with other people on a meaningful level–and having those gifts would make it so much easier for me to do that.

The truth is, I feel that I’m lacking in all three of these gifts. I do not have NPD and therefore have no desire to act in evil or toxic ways to others, but due to my other disorders–only one of them probably not due to abuse (Aspergers)–I often feel like there’s an emotional blockage keeping me from really being able to connect with other people, to really being able to empathize and feel WITH them the way people who have not been abused and do not have these disorders can do.

This particular triad of disorders is a tragic one. Even having one of these disorders cripples you and isolates you in various ways from others and can lead to a lonely life lacking in meaningful relationships, but having all three at once is devastating. It’s so hard for me to connect with the rest of humanity except on the most abstract level and as a result I’m often so very sad and lonely.

First, being an Aspie (the only disorder I was probably born with) makes it almost impossible for me to read social cues normally and although I can socialize well enough online (because it doesn’t require me to “think on my feet”–I have time to think through what I want to say or how to respond), in the day to day physical world my Aspieness makes me appear awkward and sometimes slow when I am forced to socialize, especially with neurotypicals who don’t understand people with Aspergers, so I avoid people. Due to my awkwardness I was a frequent target of school bullies, and it didn’t take long to learn that it was best to just keep my mouth shut and say nothing. I became painfully shy, fearing ridicule and humiliation. The old adage, “Tis better to say nothing and have others believe you are daft than open your mouth and remove all doubt” has been my motto most of my life.

The other two disorders I have–avoidant AND borderline personality disorders–I am certain were due to years of abuse by my narcissistic mother and to a lesser extent, my codependent father who colluded with her most of the time (although I never really doubted his love for me). The AVPD (a Cluster C “anxious” personality disorder) only exacerbates my Aspergers. They feed off each other.

Avoidants shy away from social contact because of their low self esteem and overwhelming fear of rejection. As a result they are usually painfully shy but can even seem aloof or cold. Avoidants are not schizoid though (people with Schizoid personality disorder dislike other people and prefer a hermit-like lifestyle; they don’t care how others regard them): on the contrary, we WANT friends, we WANT meaningful relationships, we WANT romance, we WANT others to like us–but our fear of engaging with others due to possible rejection keeps us isolated and alone. We build a protective shell of aloofness around ourselves so we can’t be hurt. People with AVPD are risk-averse, and are likely to be underachievers due to their unwillingness to take risks that may expose them to social embarrassment.

An Aspie with AVPD is nearly–or is–a social hermit, but not out of choice, like a person with schizoid personality disorder. Making friends–a skill that comes so naturally to most people–is something most of us never mastered well, if at all. Even having a relaxed conversation or opening ourselves to another human is like rocket science to those of us with both disorders. It’s a wonder that I was even ever able to engage in romantic relationships and have a family. Of course, all the men I dated and of course the one I married were narcissistic, mirroring the toxic dynamics I had with my family of origin.

Like the girl in this cartoon, I can relate to all of this, even the refusal to play charades! I was always terrified of that game because it requires a level of being able to read social cues and an ability to think on your feet, two qualities I don’t possess. And of course, the fear of risk-taking and humiliation.

And that brings us to my borderline personality disorder. BPD is not usually marked by overwhelming shyness or social awkwardness; in fact most borderlines are quite socially adept. But their disorder, like an Avoidant, is fueled by a deep-seated fear of rejection and almost always has its roots in childhood emotional abuse or neglect, as do all the personality disorders.

Borderlines long for close relationships and actively seek them out, but then push others away if they sense the other person might pull away or reject them first. They overreact to slights and are highly sensitive to criticism or rejection. Like a narcissist, they can be difficult to deal with because of this type of selfish oversensitivity can lead them to engage in some of the same antisocial behaviors and game playing people with NPD or even ASPD are guilty of, though not usually to the same degree because people with BPD have a conscience (even if it’s stunted in some) and don’t normally actively seek to hurt others. There are exceptions though–I was shocked and dismayed to read that both the murderer Jodi Arias and serial killer Aileen Wournos were both diagnosed with BPD, though in Wournos’ case, she was also comorbid with ASPD. Still, most borderlines, when they are made aware of how they have hurt their loved ones, feel remorse–but their guilt and shame can make them feel worthless and lead to self-destructive behaviors. It is not a fun disorder.

Though Borderlines are more likely to be self-destructive instead of deliberately destructive to others, this self destructiveness causes huge problems in their ability to form meaningful relationships, and due to their “go away–come closer” way of relating to others, their relationships are usually stormy and short-lived.

Sometimes I feel like either Lucy or Charlie Brown (who I’m pretty sure would have AVPD), and sometimes both of them at once.

I am cursed with the overwhelming shyness and social anxiety of Aspergers and AVPD, but during the rare times I have been able to form relationships or friendships, sooner or later I push those people away in some form or another–not because I want to, but because I either become so afraid of rejection I reject the other person first–or more frequently, unconsciously do something to make the other person leave me. BPD is very maladaptive to the sufferer–it tends to bring on the very thing the Borderline fears the most–rejection.

I was diagnosed with BPD in 1996 during a three month long hospitalization for major depression. At the time, I also had PTSD from being a victim of abuse by a malignant narcissist husband, who gaslighted me constantly and even tried (but eventually failed) to turn my own children against me. During that hospital stay, I was given a copy of Marsha Linehan’s excellent manual for BPD, “Skills Training Manual for Treating Borderline Personality Disorder.” Dr. Linehan is a borderline herself (she had originally been diagnosed with schizophrenia but felt her “schizophrenia” was really a manifestation of her BPD). The techniques in the book are a form of DBT (dialectical behavioral training) which teaches the Borderline patient to act mindfully–to think before they act and consider consequences, because Borderlines (unlike people with NPD) act on impulse when they feel threatened.

Linehan’s excellent manual can be ordered here.

Linehan’s book helped immensely and since my long-ago hospital stay, I have learned to control many of my borderline symptoms. In fact I have become so good at it I rarely fly off the handle the way I used to or overreact to the degree I used to do. I still have my copy and have recently begun doing some of the excercises again because I still know there’s a LOT of room for improvement.

Like NPD, BPD doesn’t just go away. All personality disorders are incredibly hard to cure because they have become so much a part of the individual’s personality. There are still many times I unwittingly either push other people away OR get too close (or do both at the same time); I still have problems with understanding where other people’s boundaries begin and end. I also feel like there is a wall there keeping me from really being able to empathize with other people in a normal way. I can empathize in an abstract sort of way (it’s hard to explain what I mean by that but the empathy I do feel is sincere). It’s just so hard for me to connect on a meaningful level because I fear rejection so much. I want to be a friend to others; I want to make others happy; I want to be able to fully share in their emotions, good or bad–but I find it all so hard–not just because of my BPD, but my fear of engaging with others in the first place due to Aspergers and AVPD. This triad has been a huge curse all my life. But at least I know what my problem is. I’m what you would call “complicated.” I have my work cut out for me.

Having all three disorders has made my life incredibly difficult and my relationships–when they exist at all–have been stormy or don’t last. But I don’t feel that I’m beyond hope. In fact, I’ve been feeling much better about myself since I started blogging and accepted God into my life. I do feel that He is changing me in a very meaningful and deep way. Maybe it’s not happening as quickly or dramatically as I had hoped, but it’s happening. I am feeling more ability to empathize with others and feel moments that come very close to pure joy. I have always had a great capacity to feel guilt and shame, so that has never been a problem. For a person with a Cluster B disorder, my conscience is probably TOO well-developed. I apologize for things I haven’t even done. Sometimes I feel like I’ve spent my entire life apologizing for my existence. I hate the idea of being a bad or evil person. I like it when I know I’ve made someone else happy. Those times when I can make others happy are becoming more frequent, and I think that’s a step toward healing. I’m also happy to report that my lifelong problem with envy appears to be disappearing. Envy is so toxic–mostly to the person harboring it. It’s a great relief to have that particular monkey off my back most of the time now.

So today’s celebration of Pentecost had special meaning, because even though I wasn’t knocked to my knees by the Holy Spirit, I felt a deep sense of peace, centeredness and just “being in the moment” that has always eluded me. I felt a genuine desire to become a person who can make a positive difference in the lives of others and can feel unconditional love even for those I do not know well. Now I just need to overcome my fear of engagement with others, but I have faith that in time that will happen too, and when that happens, a whole new world will open up to me as the walls I built at an early age begin to crumble and reveal the me I want to be–which is really the me God meant for me to be.

Never give up hope. Ever.

Clearing up some misunderstandings about BPD.

Posted on May 19, 2015 by luckyotter

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?

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.

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.

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.

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.

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.

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.

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).

#23 – The Borderline-Narcissistic Continuum: A Different Way of Understanding “Diagnosis”

Posted on May 10, 2015 by luckyotter

This is more the sort of thing I want to blog more about. Here’s a somewhat scholarly but interesting and thought provoking article about BPD (borderline personality disorder) being on a continuum that ranges from psychosis (being totally out of touch from reality) to normal (neurotic) behavior (the idea being that everyone is neurotic to some degree, which is what makes us human).

Borderline Personality Disorder was originally given that name because mental health experts studying this disorder in the early years believed that borderlines straddled the line between psychotic and neurotic in their thinking and behaving patterns. For a borderline undergoing healing, NPD (actually functional narcissism, which includes developing self esteem) is the first step toward mental health.

According to the experts mentioned in this article and many mental health professionals, BPD is a less functional and more ego-dystonic form of NPD.

BPD Transformation

For the purpose of understanding psychiatric problems in a more nuanced and optimistic way, here is a diagram from Donald Rinsley’s book Treatment of the Severely Disturbed Adolescent:

Please click on the picture to see it larger. Each row corresponds vertically to the rows above and below in describing degrees of emotional development, and each row describes emotional growth over time from left to right. The majority of the text in brown is Rinsley’s own diagram; the bottom additions in white are mine.

Donald Rinsley was among the most respected authorities on borderline and narcissistic conditions in the second half of the 20th century. He was a psychodynamic therapist who ran a psychiatric hospital for severely troubled adolescents in Topeka, Kansas in the 1960s, 70s, and 80s. He later worked extensively with personality-disordered and psychotic adults in an outpatient psychotherapy practice.

I believe that much can be learned from studying Rinsley’s…

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NPD vs. BPD: they are not the same thing!

Posted on April 25, 2015 by luckyotter

Articles like this one make me want to rage. The author, Doug Bartholomew, a licensed social worker, believes that people with Borderline Personality Disorder (BPD) are pretty much the same as people with Narcissistic Personality Disorder (NPD). He even goes so far as to say BPD’s, along with NPDs, fit the criteria for M. Scott Peck’s “People of the Lie.”

Wait just one second. Peck’s People of the Lie don’t even include all narcissists–his definition describes those with Antisocial Personality Disorder and malignant narcissism (there’s a huge difference even between MN’s and garden variety narcissists–a malignant narcissist has ill will toward others and decided antisocial traits while a “benign” narcissist isn’t necessarily ill-intentioned but is just self centered and doesn’t care about your feelings). Peck never said all manipulative people (people with one of the four Cluster B personality disorders) were by nature evil, but evil people is what his book is about.

At the same time I understand where Bartholomew is coming from. On the surface, people with BPD can be manipulative and even resort to some of the same unpleasant tactics and mind-games (gaslighting, etc.) that narcissists like to play. They can appear to lack empathy, because they get so caught up in their own drama that they can literally forget that others exist. They can be demanding, high maintenance and prone to irrational rages (just like narcs) but are far more likely than narcs to turn their rage inward and become self-destructive or even suicidal.

Not much to do with this article, but I couldn’t resist.

Borderlines also usually regret their acting-out and selfish or manipulative behaviors when the crisis has passed or their bad behavior is called out to them. They may be self-centered and impulsive but are not lacking remorse or the ability to feel shame and guilt. The problem with Borderlines is they tend to act as they feel at the moment without thinking things through. They can get so caught up in their own fear of abandonment that they almost literally forget that you have feelings too. However, after the fact Borderlines usually will feel remorseful and ashamed of their behavior, and on top of that, realize that their offputting behavior may cause others to do what they fear the most–abandon them.

Bartholomew also states that all Cluster B disorders are characterized by a lack of empathy:

The overwhelmingly most commonly mentioned behavior or trait associated with all the Cluster B Personality Disorders is a lack of empathy or compassion. They seem unmoved by the effect their behavior has on their loved ones other than what is necessary to keep their loved ones engaged and around. It is as if they were tone deaf or color blind to the feelings and experiences of others.

While it’s true that people with NPD and ASPD are characterized by a lack of empathy, I disagree that this is true of people with BPD. I think this is a gross overgeneralization.

Borderlines can feel empathy, but due to their impulsiveness and fear of abandonment, they can act in selfish, defensive, and manipulative ways that may hurt others (but they hurt themselves even more so). However, unlike malignant narcissists and people with ASPD, Borderlines do not set out to hurt others and they do care how others feel. Unfortunately their good judgment is clouded by their disorder which makes it difficult or impossible for them to regulate their emotions. That’s why they act so impulsively and often fail to think things through before they act out. It’s also why their relationships tend to be stormy and short-lived.

A person with BPD does not wear a mask or have a “false self” like someone with NPD–but their fear of abandonment can cause them to knowingly or unknowingly push others away. Their ambivalence in relationships can be very confusing to others–they can seem to adore you one moment, and then hate you the next. They can seem needy and rejecting by turns. When others grow tired of this crazymaking and confusing “I hate you, don’t leave me” behavior and finally leave them, the Borderline genuinely doesn’t understand what they have done to drive the other person away, and so they become even more fearful of being abandoned. Their behavior is maladaptive because it tends to cause the very thing they are trying so desperately to avoid.

We are just burning toasters.

A much better description of the similarities and differences between Borderlines and Narcissists can be found in “Borderline vs. Narcissistic Personality Disorder: How Are They Different?” from the Clearview Women’s Center’s website.

While the two disorders, both being part of the Cluster B group of personality disorders, do have overlapping symptoms and are often confused with each other and/or misdiagnosed as the other disorder (with males being far more likely to be diagnosed with NPD and females with BPD), this author, unlike Bartholomew, understands that both the motives and mechanics of the disorders are quite distinct from each other:

[…]both BPD and NPD deal with conflict in a way that is unhealthy to themselves and those around them. It’s the expression of the anger that results from the conflict that is different.

In her article “Blame-Storms and Rage Attacks,” Randi Kreger, co-author of Walking on Eggshells, points out the difference in how those with BPD and NPD express anger. While those with Borderline Personality Disorder may fly into a rage and push people away, they will often calm down, feel shame for their reaction, and promise never to do it again.

“Unless they’re in treatment, the underlying issues don’t go away. Some conventional [borderlines] do not get angry at all, but hold it in or express it inwardly through self-harm,” says Kreger.

“The anger of narcissists, on the other hand, can be more demeaning,” she continues. “Their criticism evolves from their conviction that others don’t meet their lofty standards — or worse, aren’t letting them get their own way.”

I write so my head won’t explode.

Posted on April 23, 2015 by luckyotter

Alaina, a frequent commenter on this blog, said she almost named her blog “I Write So My Head Won’t Explode” but decided it was too stupid to be a blog name.

I think it’s great. So great I decided to write an article with that name. It’s great because it’s the truth. If I didn’t have this blog and wasn’t able to write every day about the good, the bad, and the ugly, I think I would have gone insane by now.

Writers are by nature people with issues. We have mental problems. That’s why we write. If we didn’t write, we’d be drinking, drugging, sleeping all day or stuffing our faces with junk food, or engaging in any number of other unhealthy and self-destructive activities. I know I did until I started writing.

If you can write, you are blessed. If you enjoy and are good at any creative endeavor (writing, art, acting, singing, dancing, etc.) that can add something useful, entertaining, educational or beautiful to the world and at the same time provide an outlet for your deepest, most painful or confusing emotions, for the love of God, use your God-given gift.

Writing is my safety valve. It’s something I love doing that isn’t going to destroy my mind or my body. But it’s a discipline too. Sometimes I have to force myself to write, even when I don’t want to. I’m always glad I did.

As ACONs and survivors of narcissistic abuse, we also have a calling and a responsibility to educate others about what we have experienced. Nothing happens for no reason. We were given the lives we were given as an education so we could help others. Part of our responsibility as narcissism bloggers is exposing the N’s of the world who have nothing but ill will for other human beings–and we do that through writing.

Since my daughter moved out Tuesday night, I’ve been more depressed than usual. In fact, I haven’t been this depressed in over a year. It’s not so much because she’s not here(though I do miss her), but that she lied to me when she was leaving. I confronted her about the lie yesterday–she told me her grandfather had sent her birthday money in a card, when he actually did not because I called him and asked–and she explained it was a bluff because she thought maybe I had stolen it and was possibly trying to get money out of me (playing on my “guilt” for having “stolen” it).

I felt betrayed and hurt by her lack of trust in me as well as her lying to me in such a mean spirited way. It’s been bothering me since it happened. It made me worry that she may really be a narcissist and not a borderline at all. I started thinking maybe she was diagnosed with BPD so her insurance would pay for her treatment (I don’t think NPD is covered by most insurance companies). I really don’t want my daughter to have NPD. It’s a painful and horrible thing to face–that your own kid who you love more than anything in the universe, may be a narc. I’d rather believe she has BPD. Maybe that’s all it is. I hope.

Yesterday I didn’t even go to work, I was so depressed about all this. I lay in bed sleeping most of the day instead, which is what I do when I’m depressed. Of course that just made me feel even worse. I didn’t want to write, I just wanted to sleep and feel sorry for myself.

But I also felt like pressure was building up in my head and that if I didn’t write, my brain might explode. So I forced myself to write, and I did feel a lot better–I no longer feel stressed to the point that I think I have to wear a head truss to to keep it in one piece.

Depressed.

Posted on April 22, 2015 by luckyotter

My daughter moved out last night with her current boyfriend. This was of course the plan, but I’m really in the dumps today because we fought last night. It ended with me telling her to pack up and get out last night, which she did. For a couple of months she has been sleeping on the couch (my roommate–yes, she’s still here but has been a bit better–has the other bedroom) and just got a job last month. She had paid nothing toward the rent because she was saving to move out. I had told her this was okay.

We are usually best friends but because we also both have diagnosed BPD, things can get heated between us sometimes. There can be drama. I hate drama. There was plenty of it last night though. Two things happened that made us fight.

1. When I was in the shower, she stole $10 from my purse. I wasn’t so much upset because this was all the money I had until Friday (which is bad enough–go ahead and try to make $10 last three days), but because I’d started to believe I could trust her again. (She used to steal from me a lot). I confronted her about it and she admitted she took it but called it “borrowing.” This led to a fight, because what she did was STEAL, not BORROW. I told her she didn’t seem that remorseful and that worried me. Later on she did admit she was wrong and admitted it was stealing, but that didn’t happen until several hours later, after she was gone, and it didn’t help my mood at all.

2. My father called her and asked if she had received a gift card and birthday check (her birthday was last week) because he hadn’t heard anything. She never did receive anything in the mail. Now she believes I took it when I got the mail (apparently the check was made out to me) and cashed it and used the gift card without letting her know. I don’t collect the mail (my roommate does, which makes me wonder if SHE took it). I have never stolen from my daughter and never even entertained the thought, but due to the circumstances I could actually understand why she would think along these lines. I’m also afraid my father will believe her over me, if she tells him she thinks I stole from her. I don’t know why I’m worried about this but I just am.

Even so, I was hurt that she would think I would steal from her. I told her I didn’t want to live with someone who not only stole from me, but would accuse me of stealing from them when I didn’t. I can’t convince her it might have been lost in the mail. She isn’t mad anymore but still believes I stole her money. There is nothing I can do to make her think otherwise.

It’s for the best she’s out. She is 22 and too old to be living with mom. I can’t help feeling a little sad though. I’ll miss her, even though I’ll be seeing her almost every day probably. I’m used to having her around.

I have more space now and can actually use the living room again, but because the fight happened late last night, I was so upset and wound up I didn’t sleep at all. I had to call in sick to work today (which always makes me feel guilty). It’s a pretty day and I may go outside for awhile and work in the garden or just sit on the porch and read. But right now I just want to lie on my bed and sleep the day away. I know that will only make things worse. I just want to cry right now.

ETA: I called my father and he said he never sent her anything (he doesn’t trust her and is sort of No Contact with her, so I thought it was odd he would even be sending her money). So she is lying to me though I can’t fathom why she would do that. I am going to confront her with this information and see what she has to say for herself. She doesn’t have NPD but is good at playing some of the Narc games that she learned from her father. BPD’s can be almost as manipulative sometimes.

Cluster B personality disorders and the emotional thermostat.

Posted on April 14, 2015 by luckyotter

If you think of the Cluster B (“dramatic”) disorders (characterized by either too much emotion or the masking of true emotions) as malfunctions or problems of the sufferer’s “emotional thermostat,” their differences make more sense. The emotional thermostat determines how a person handles their own emotions or reacts to those of others.

Borderline Personality Disorder (BPD): inability to regulate emotions (a thermostat that works but is having problems–cutting on the heat or air when it isn’t needed or shutting it off when it is, but half the time works perfectly). This explains their ambivalence in relationships (“I hate you…don’t leave me,” “go away, come closer.”)

Histrionic Personality Disorder (HPD): inability to control emotions (a thermostat that is always on High and blasting heat even when it’s already too hot). That’s why they overreact to everything.

Narcissistic Personality Disorder (NPD): inability to access true emotions (a thermostat that sets to “cold” and turns on the air conditioner when heat is needed, and “hot” and turns on the heat when the air conditioning needs to be on). This explains their lack of empathy and show of fake emotions that may not fit a given situation.

Antisocial Personality Disorder (AsPD–psychopathy, sociopathy): total inability to empathize or respect the rights of others (a broken thermostat that doesn’t work at all.) People with ASPD are unable to feel any emotions except rage.