Borderlines: incurable demons or trauma victims?

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The symptoms of Complex PTSD are almost identical to those of BPD.

Something has come to my attention during the time I’ve been blogging, which I think is important enough to merit another post about it.

Borderline Personality Disorder (BPD, DSM code 301.83) is classified by the Diagnostic and Statistical Manual of Mental Disorders as a Cluster B (emotional/dramatic/erratic) personality disorder having many similarities to character disorders like Narcissistic Personality Disorder (NPD) and Antisocial Personality Disorder (ASPD). Both NPD and ASPD are characterized by a lack of empathy, entitled behavior, and disregard for the rights or feelings of others. It’s also true that some Borderlines act out in ways harmful to themselves and others. Hence, “Cluster B” has become a pejorative category and some ACONs (adult children of narcissists) and others have demonized people with BPD as being amoral, immoral, and almost inhuman, nearly or as bad as as people with NPD or ASPD. Some even go so far as to lump all borderlines in with the “narcs” and barely make a distinction between them. In their minds, if you’re a Borderline, you’re no better than a “narc” and that’s all there is to it. You’re a bad person and to be avoided.

To make matters even worse, many mental health professionals refuse to treat people with BPD, believing them to be troublemakers, incurable, or both. I remember one therapist I saw years ago for an intake session and seemed to connect well with, called me a few days later after he received my psychiatric records, and told me he couldn’t take me on as a patient. “I don’t work with borderlines,” he said.

It’s true that there are some similarities between the Cluster B disorders, and both BPD and NPD/ASPD have roots in childhood abuse or neglect. But the similarities don’t run very deep. What I mean by that is while both a borderline and a narcissist cn be manipulative or abusive to others, the reasons are very different. There’s also the matter of intention. Borderlines, if they act out against others, aren’t usually aware they’re being abusive and/or manipulative. If their bad behavior is brought to their attention, they normally become very upset and feel terrible about it (unless they have a comorbid NPD or ASPD diagnosis). They act out because of overpowering emotions that they haven’t learned how to control. In contrast, a narcissist or person with ASPD acts out because they can. If their behavior is brought to their attention, they’re likely to become angry and rage against the accusation, make excuses, blame-shift it onto someone else, or deny it.  Unlike most borderlines, they don’t feel remorse, guilt or shame for hurting others.

In addition, many borderlines are much more harmful to themselves than to other people. If they do act out against others, most are as frightened by their own outbursts as others are and sometimes more so. In a nutshell, people with BPD know they have a problem and wish they could be different. Untreated BPD makes a Borderline’s life miserable, while people with NPD or ASPD are usually not bothered by their disorder. That’s why, even though Borderlines can act “crazier” than narcissists, they can get better and are much more responsive to therapy or behavioral treatments such as DBT or CBT.

But we’re still caught in a gray zone, neither here or there.   The stigma against borderlines (in my observation) has grown worse, and most narcissistic abuse sites pretty much regard people with BPD  as the “female or over-emotional version of NPD.”  (actually, Covert/Fragile NPD or Histrionic Personality Disorder would come closer).   If we’re narcissistic abuse victims suffering from complex PTSD, it takes a great deal of courage to admit you also have a BPD diagnosis.  It took me a few months to come out about it on this blog. Fortunately,  I haven’t received too much (or really, any) flack about it.

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Click to enlarge graph.

The good news is, a number of BPD bloggers are helping to reduce the negative stigma that we’re “bad seeds” with an untreatable disorder just because we’re OMG “Cluster B.” Think about this: have you ever noticed that there aren’t too many people with NPD (or ASPD) blogging about their challenges and insecurities, or fighting to reduce the stigma against their disorder? If they blog about their narcissism or psychopathy, it’s usually to brag about how NPD/psychopathy makes them superior or allows them to have control over others and be successful in the world. That’s because they don’t think they have a problem (They just cause others to have problems). Most Borderlines know they have a problem and struggle with it constantly, since it makes them feel so crazy and lowers their quality of life. I can only think of ONE blogger with NPD who was unhappy with his disorder and successfully treated for it (or so he says). That man probably had low-spectrum and probably covert NPD; a person with malignant or high spectrum grandiose-type NPD will never have enough insight or willingness to admit that THEY are the ones with a problem. In contrast, I can think of about 20 bloggers with BPD who are in treatment or therapy or have even been healed! I’m sure there’s many more that I don’t even know about.

BPD also seems to co-occur a lot with complex PTSD or PTSD. Most BPD bloggers I can think of also have complex PTSD or are in treatment for it. The symptoms of BPD and Complex PTSD are almost the same. The DSM does not recognize Complex PTSD as a diagnosis; it only recognizes PTSD, which is not caused by chronic trauma over a long period of time (such as having been abused as a child), but by one traumatic incident (such as fighting in a war or being raped). Therapeutic treatments for complex PTSD and BPD are also almost the same (for that matter, NPD and other personality disorders are treated almost the same way). Both BPD and Complex PTSD have a higher cure rate than NPD. Since Complex PTSD isn’t recognized as a valid diagnosis, I think a lot of people (especially women) who might have been diagnosed with complex PTSD if it was recognized get slapped with the “Borderline” label instead. Although I accept my BPD diagnosis (and have even become a little attached to it), I wonder if I might never have been diagnosed with it at all had Complex PTSD been recognized by the psychiatric profession. I think in some cases, BPD may not really be accurate, or could even be the same thing as C-PTSD due to their many similarities. At least one blogger (BPD Transformation, who used to comment here but stopped for some reason), doesn’t even think BPD is a valid diagnosis and shouldn’t exist at all.

Further reading:

Are BPD and Complex PTSD the Same Disorder?

Is BPD a Real Disorder or Should it Be Eliminated as a Diagnosis?

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The Cluster B stigma and the nature of evil.

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I don’t care if what I’m about to say is controversial or unpopular.

There are some folks in the ACON community who think ALL narcissists are evil, and some think all BPDs are evil too. (In fact there are some BPDs who are worse than some narcs).
It’s understandable why people feel that way (and I did for a time myself), but the people who abused them were usually high spectrum malignant narcissists or sociopaths so they think all narcissists (and even all Cluster Bs) are as bad as the abusive or rejecting parents who raised them.

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The stigma against Cluster B disorders is very pervasive and it’s getting worse. NPD used to just be a psychiatric diagnosis. Now it’s a condemnation to hell. Even if a low-mid spectrum narc or a borderline is self aware and wants to get better, they’re still put in the “evil” box along with the malignants, psychopaths and sociopaths. It’s always assumed they “have an agenda” or are “full of shit” and everything they say is a lie. I wondered why hearing people say this used to bother me; now I know why. It hurt my feelings because inside, I already knew I was one. I’m self-identified now and really, really want to change and every word I say on my blogs is my reality and truth. It’s my true self speaking, always. I think.

Cluster B’s are cut no slack by some ACONs. We are told we deserve no sympathy even though we were abused too and were victims too. This is extremely damaging to those of us who want to be rid of our Cluster B disorders.

The Cluster B stigma also makes it hard for those of us who want treatment to find it. Many therapists won’t get near someone with NPD or BPD with a 100 foot pole. I remember one therapist I had an intake session with, who I felt comfortable with, but said he’d need to order my psychiatric records before we could go any further.
A few days later he called me and said, “I’m sorry but I don’t treat Borderlines.”
Even if a therapists is willing to see someone with a Cluster B disorder, most insurance companies or government-funded health insurance like Medicaid or Medicare won’t pay a claim for a “Cluster B diagnosis” because it’s assumed they’re incurable. So we are given some other diagnosis instead and treated for THAT disorder (such as depression or anxiety) which doesn’t get to the root of our real problem but only treats symptoms.

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People who judge and demonize all narcissists are doing exactly what NPDs and BPDs are so well known for-–engaging in black and white thinking. They don’t believe or realize that narcissism is a spectrum disorder and those in the bottom half of the spectrum probably aren’t evil, even if they’re usually PITAs.

I know there will be some of you who will disagree. That’s fine and we can agree to disagree. I’ll hold to my belief that narcissism is a spectrum disorder with many shades of gray ranging all the way to black (evil).

So what is evil? Evil to me means a person who wants to bring harm to others and has no remorse over what they do and doesn’t care about the suffering they cause–and even enjoys it. It’s a person who goes out of their way to hurt others. It’s a person who tries to destroy the reality or the soul of another human being. It’s a person who never feels guilt or shame over their actions and has no empathy for the pain they cause. All evil people (as far as I know) are of the Cluster B persuasion and most are narcissists (or ASPDs), but not every narcissist or borderline is evil.

To really get a handle on what evil is, Dr. M. Scott Peck’s book “People of the Lie” is the best analysis out there. Most of the stories in his book describe people who would today be called malignant narcissists (high spectrum narcissists with antisocial traits).