Cluster B disorders are not cool.

uncool

Although Cluster B disorders (the dramatic, emotional, erratic group of personality disorders), are largely demonized on the Internet by narcissistic abuse survivors, there’s another growing attitude online that’s pretty much the opposite–that having a Cluster B disorder somehow makes you an uber-cool badass.

This is a dangerous delusion. ¬†Take it from me, having a Cluster B disorder like BPD (in my case) is NOT fun. Nor is it cool. In fact, it really really sucks. ūüė¶ Both for yourself and everyone else.

This growing attitude of “Cluster B coolness” I’ve been seeing more of goes something like this:

NPD:

bad_sport
This is what your narcissist is really all about.

The Myth: ¬†If you have Narcissistic Personality Disorder (NPD), you’re a self-confident, go-out-and-knock-em-all-dead, ambitious, and highly intelligent badass who Gets. Things. Done. Psychopaths are similarly glorified, but they’re basically the reason why everything’s wrong with the world and empathy is seen as a “weakness.” The narcissistic woman is regarded as a diabolical yet seductive Jezebel who turns strong men into whimpering slaves at the snap of her pretty fingers and who every other woman strives to be. The narcissistic man is regarded as a buff, handsome, masculine, virile, successful go-getter who all women melt for (and that’s how they regard themselves, of course).

The Reality:¬† In actuality, if you have NPD, you’re a negative, selfish, deluded, demanding, envious, entitled, whining crybaby with no real sense of self who everyone hates (and who hates everyone) but are afraid to say so because it might set off one of your infamous rages or you giving them the even more crazymaking “silent treatment.” People are always walking on eggshells around you because you’re really so unstable, hypersensitive to criticism, ¬†and deluded by and drunk ¬†with your own “greatness.” ¬†You’re a sore loser too and can’t stand to see anyone else do well or get any attention. ¬† No one really likes you and you’re probably right that people are talking about you behind your back, but frankly you deserve it. Also, many narcissists are just plain stupid and have no emotional intelligence. ¬†As for their reputed skillfulness in bed, ¬†many narcs (especially the cerebral types) hate sex and can’t or won’t perform. ¬†Or, as with everything else, they only care about their own needs and to hell with yours.

BPD:

mommie_dearest2
Joan Crawford had a BPD diagnosis. Is this sexy, alluring, and “quirky” to you?

The Myth: If you have Borderline Personality Disorder, some people think this means you’re a sexy beast or babe who’s alluring, unpredictable, passionate, always charming and “quirky”, and never boring. Your chameleon-like abilities to match the attitudes of those around you is seen as evidence of potential Oscar-winning ability. It’s always pointed out how many actors and musicians suffer from BPD.

The Reality: ¬†Let’s be honest. ¬† If you have BPD you’re emotionally unstable, volatile, almost crazy (the original term “borderline” referred to the disorder being on the border between neurosis and psychosis), out of touch with reality, unable to take a firm stance on anything (or conversely, switching back and forth between two extremes, which just makes you look insane) due to your terror of being rejected or abandoned, prone to be an addict, (drugs, booze, gambling, shopping, cutting, eating and/or dieting, other people), clingy, ¬†codependent, insecure, high-maintenance, ¬†and fickle. The borderline doesn’t really have a false self per se like the narcissist, but they can’t access their true self either, so they wind up “taking on” the attitudes and emotions of those who happen to be around them like some kind of emotional bodysnatcher (in contrast with true empathy, their feelings overwhelm them and are out of control), and they just plain overreact to every damn thing so you feel like you’re always walking on eggshells.

HPD:

clown_makeup
You think you look seductive. Everyone else thinks you look like a clown.

The Myth: Although Histrionic Personality Disorder (HPD) isn’t widely talked about, its reputation is similar to that of BPD (but is really the stereotypically feminine form of Overt NPD): usually female, a sexy, seductive siren, dramatic, highly social, loves parties and being the center of attention, and is never, ever boring. You’ll fall madly in love with this bewitching seductress due to their many charms and their great looks.

The Reality: The real truth about people with HPD is that they’re insincere, emotionally labile to the point of being embarrassing (but their over-the-top “emotional displays” are largely an act), shallow, materialistic, and emotionally retarded. They often overdress (or underdress!) or are overly made up for an occasion, are sexually promiscuous, and are inappropriate in social situations, but they don’t care if you’re cringing in embarrassment for them because even negative attention is still attention and that’s what they crave more than the air itself.

ASPD:

aspd
Nuff said.

The Myth:¬† So here we are at the juggernaut of the Cluster Bs, the baddest badass of them all, Antisocial Personality Disorder (ASPD). Often confused with Psychopathy (and often overlapping with it), the antisocial or psychopathic badass is a sexy and fearless rogue, unconcerned with how others feel about them, possessed of an arresting and penetrating gaze (actually a predatory, creepy stare) that makes you feel like they are really listening to you, determined to get what they want (whether it’s their latest kill or their latest corporate takeover) and never giving up or allowing themselves to be intimidated, by anything. They’re the Rebels Without a Cause, the self-confident Ferris Buellers, the Coolest of the Cool, the celebrated anti-heroes of novels and films socially sanctioned to serve as a receptacle for the Shadow Self that resides within us all. The ASPD badass gives us permission to mentally “act out” our darker impulses, without actually hurting anyone, and that’s why we all love serial killers so much, and why the Ted Bundys and Charlie Mansons of the world get more marriage proposals than any football or film star.

The Reality:¬† The antisocial badass is really just a heartless and criminally minded horse’s ass, who has no capacity for empathy, isn’t even socially constrained by their need to impress others to garner narcissistic supply (because they don’t require any), and is frequently in prison or has a rap sheet the size of War and Peace. This is a guy (or gal) who will make your life a living hell, beat you to a pulp any chance they get and leave you in a heartbeat and not even remember your name.

If they’re high functioning, they’re the people who are responsible for everything that’s wrong in the world today and the reason why you work 3 jobs and can’t afford a vacation or health insurance.

If they’re low-functioning, if they’re not straight up criminals, they’re flabby, pasty Basement Dwellers who dishonestly leech off the system or their family members so they never have to work and spend all their time trolling Internet forums to get a rise out of random strangers. ¬† Just like my ex.

 

basement_dweller

Ah, what a studly, irresistably dangerous heartbreaker you are.

If you’re a psychopath or sociopath, you operate more like a machine than a human. Is that something we should be aspiring to?

So there you have it. Cluster B disorders are not cool. They are serious mental (and some believe, spiritual) illnesses, and they are pathetic. ¬† And let’s not forget that people suffering from Cluster B disorders are not happy people. ¬†In fact, most of them are pretty miserable. ¬†They are to be pitied (and avoided) rather than emulated.

A rebuttal in defense of Cluster B. 

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Histrionic personality disorder: the other Cluster B disorder

Histrionic personality disorder (HPD) is the forgotten step-child of the Cluster B group of personality disorders, which also includes the Borderline, Narcissistic and Antisocial personality disorders.

HPD: the “other” Cluster B disorder.

histronic_pd

NPD is of course the King of the Cluster B disorders (which is exactly the way a narcissist would have it). It’s one of the hottest topics on the Internet right now, with ACONs everywhere (adult children of narcissists) rising from the silence of abuse like vampire slayers on a mission of justice. In addition, there are probably hundreds of blogs and forums about NPD and the damage people with that disorder inflict on everyone else. If you Google the word “narcissist” or “narcissism” you will see thousands of articles, personal stories, quotes, videos and support groups for victims of narcissistic abuse (but only a sprinkling of the same for people WHO HAVE the disorder–because NPD normally hurts its victims more than its sufferers).

Borderline personality disorder (BPD) is also widely discussed on the web, and it appears to be a common catch-all diagnosis, especially for women who were victims of abuse or sexual abuse and show emotional instability resulting from that. People diagnosed with BPD may actually be suffering from an array of other disorders (such as PTSD) and labeled BPD because the experts have so little understanding of BPD and it might not even be a real disorder anyway. Or maybe it is a real disorder but is a lot rarer than you’d think because so many people (mostly women) are erroneously diagnosed with it. In any case, there are blogs, support groups and forums all over the web for people with BPD and those who love them (or must cope with them).

And finally, if you’re like me and enjoy reading about psychopathic and sociopathic murderers, serial killers, mass murderers, cult leaders, and other violent (and non-violent) criminals, you are going to find out a lot about Antisocial personality disorder (ASPD), which is actually at the top of the narcissistic spectrum if you’re of the school of thinking that believes narcissism runs on a continuum from merely manipulative to heinous beyond words. Sociopath World is an interesting website that features blog posts written by ASPD writers. If you like this sort of stuff, or are just curious to find out what the inside of a sociopath’s head is like, I recommend checking out the site.

A fourth (and rather interesting) Cluster B disorder, HPD or Histrionic personality disorder, somehow got lost in the Cluster B shuffle. You don’t hear much about it and there’s very little written about it either, except for cursory mentions in the psychological and psychiatric literature, and it’s rarely featured by itself–it’s only mentioned in articles about the Cluster B disorders in general. But while it’s not widely talked about, Histrionics (mostly women) are frequent characters in movies, novels and TV shows because they make good theater.

histrionic_symtoms

People with HPD crave attention, so much that Sam Vaknin speculates that HPD may actually be the somatic, “female” form of NPD–or at least resembles it a lot. Most (but not all) Histrionics are women. A woman with HPD will act very much like a somatic narcissist, but may show somewhat more empathy or genuine (but shallow) emotion than a true narcissist. In fact, showing emotion is what Histrionics do best–hence their name. Their exaggerated emotional displays are over-the-top and dramatic. They are the original drama queens. I’m going to go out on a limb here and speculate that a lot of male HPD’s are probably flamboyantly gay men of the type who have exaggerated feminine affectations and interests (this is certainly not a slur on gay men, just an observation). Histrionics are also easily bored and besides attention, crave constant activity or social interaction. They tend to smother those they become attached to.

For convenience’s sake (and because most histrionics are women), I’ll describe a hypothetical woman with this disorder.

Histrionic Haley.

histrionic_personality

Haley was the youngest child of her family of origin, and also the prettiest. At the age of 12, her parents divorced and her mother remarried. Haley’s stepfather appeared to love her–but that was just how things appeared. In actuality, he came into her room at night and forced himself on her, telling her how pretty she was and what a beautiful woman she was turning into. He made her strip naked and lie down on the bed while he fondled her developing breasts. When Haley questioned him about why he did this, her stepfather told her he was just “checking to see how she was developing.”

Haley was spoiled by both her mother (a narcissist who actually hated Haley for “seducing my husband” but still needed her because Haley made HER look good) and her stepfather, who constantly bought her clothes, mostly revealing outfits that showed off her adolescent curves.

Haley was never encouraged to think for herself or develop her mind or any skills other than her physical appearance and flirting ability. Her mother, a somatic narcissist, taught Haley that acting helpless and exaggeratedly feminine was the most effective way to attract a boy. Haley was spoiled rotten but abused at the same time. She was attractive, obsessed with clothes, makeup and shopping, and used her “feminine wiles” to attract boys, who she proceeded to manipulate (usually using sexy smiles, skimpy outfits, exaggeratedly demure behavior, or tears) to get whatever she wanted.

Haley was highly romantic–besides being obsessed with cheap romance novels, she was constantly “in love” with someone. Unfortunately she never learned how to love anyone on a deeper level because she didn’t know how to give, only take. She learned that sex was the best way to obtain what she wanted, and that’s all most of her lovers wanted her for anyway, so she was more than happy to oblige. Due to her immaturity and emotional instability, she was prone to drawn out, over the top tantrums when she didn’t get her way. Of course, her frequent temper tantrums, crying jags, unreasonable demands, and general high-maintenance behavior caused all her relationships to be short lived. With each breakup, Haley got worse, and upped the ante for the next relationship, believing she hadn’t asked for enough the last time. It never occurred to Haley that she might be too demanding and high maintenance. She never learned from her own mistakes, because being needy and demanding was all she had ever been taught.

Haley had good social skills, and became the life of any party she attended. While she had no close friends (due to her inability to maintain any deep and meaningful relationship), she had plenty of acquaintances and casual friends, who though of her as a dynamic, fun and exciting woman. She had lots of charm, was very pretty, and adored being the center of attention–just as she had been in her family growing up. Each year she would throw herself a huge birthday party, and expansively invite more people than she could realistically afford to entertain. But that didn’t matter because she had so many admirers, no one cared that the food and drink always ran out. Haley kept everyone entertained. Even though she’d almost always wind up sobbing loudly and theatrically at some point due to some slight during these parties, even that in itself kept her admirers around, who became protective of her. Haley basked in all the solicitous attentions she received.

Haley also used her sexuality in inappropriate ways. On several job interviews, she wore revealing see-through tops or short shorts, or allowed her bra strap to “accidentally” fall down her shoulder from under a tight spaghetti strap tank top. She openly flirted with her male interviewers. While a couple of employers fell for the bait and hired her–Haley was never taken seriously as an employee and then she’d tearfully complain to anyone who would listen about how she was treated like a sex object and got no respect.

How HPD differs from BPD

comedy_tragedy

Histrionic personality disorder resembles BPD in some ways–but the Borderline is ambivalent about relationships and tends to alternately smother and abandon people–their tendency toward “splitting” (black and white thinking) causes them to idealize others followed by devaluation or pre-emptive rejection when they perceive a slight. A histrionic will just keep on smothering and making more demands. They lack the ambivalence of a borderline.

While a borderline may be sexually promiscuous or seductive, not all are–and they don’t use their sexuality or body to exclusively the way someone with HPD does. Borderlines also tend to be more self-destructive (cutting, eating disorders, drug abuse, compulsive gambling, etc.) than a Histrionic, and more prone to suicide or suicidal ideation, as well as having dissociative and sometimes psychotic symptoms that Histrionics lack.

Cluster B personality disorders and the emotional thermostat.

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.

emotional_thermostat

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.

Is antisocial personality disorder really NPD on crack?

I have to admit I’ve been confused by the distinctions between the Cluster B personality disorders, especially those of NPD and ASPD. There seems to be little distinction in most literature between NPD and ASPD (antisocial personality disorder) with most experts saying the difference is just a matter of degree, with ASPD (psychopathy or sociopathy) being higher on the spectrum than NPD.

Let’s turn to the Bible of mental disorders for some clarification. These are from the DSM IV-TR, but have apparently been updated, because these descriptions are all labeled obsolete. But for our purposes, I’ll stick with these criteria.

Diagnostic criteria for 301.81 Narcissistic Personality Disorder

Handsome narcissistic young man looking in a mirror

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

(1) has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)

(2) is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love

(3) believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)

(4) requires excessive admiration

(5) has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations

(6) is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends

(7) lacks empathy: is unwilling to recognize or identify with the feelings and needs of others

(8) is often envious of others or believes that others are envious of him or her

(9) shows arrogant, haughty behaviors or attitudes

Diagnostic criteria for 301.7 Antisocial Personality Disorder

antisocial_personality

A. There is a pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years, as indicated by three (or more) of the following:

(1) failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest
(2) deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure
(3) impulsivity or failure to plan ahead
(4) irritability and aggressiveness, as indicated by repeated physical fights or assaults
(5) reckless disregard for safety of self or others
(6) consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations
(7) lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another

B. The individual is at least age 18 years.

C. There is evidence of Conduct Disorder with onset before age 15 years.

D. The occurrence of antisocial behavior is not exclusively during the course ofSchizophrenia or a Manic Episode.

Just for comparison’s sake, let’s include the (obsolete) criteria for the other two Cluster B disorders: BPD (Borderline Personality Disorder) and HPD (Histrionic Personality Disorder):

Diagnostic criteria for 301.83 Borderline Personality Disorder

borderline

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

(1) frantic efforts to avoid real or imagined abandonment.
Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

(2) a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation

(3) identity disturbance: markedly and persistently unstable self-image or sense of self

(4) impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, Substance Abuse, reckless driving, binge eating).
Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

(5) recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

(6) affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

(7) chronic feelings of emptiness

(8) inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

(9) transient, stress-related paranoid ideation or severe dissociative symptoms

Diagnostic criteria for 301.50 Histrionic Personality Disorder

histrionic_personality

A pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

(1) is uncomfortable in situations in which he or she is not the center of attention

(2) interaction with others is often characterized by inappropriate sexually seductive or provocative behavior

(3) displays rapidly shifting and shallow expression of emotions

(4) consistently uses physical appearance to draw attention to self

(5) has a style of speech that is excessively impressionistic and lacking in detail

(6) shows self-dramatization, theatricality, and exaggerated expression of emotion

(7) is suggestible, i.e., easily influenced by others or circumstances

(8) considers relationships to be more intimate than they actually are

It does seem that ASPD is more linked to criminality than NPD, most likely due to poor impulse control, which isn’t a problem in people with NPD. People with ASPD are more willing to break the law and are more likely to be in prison. They are less likely to be concerned with image or consequences of their actions (most people with NPD want to maintain their sqeaky clean image which means staying out of prison). Antisocials also seem more prone to violent behavior.

The DSM criteria for ASPD seem to describe psychopathy/sociopathy. Most narcissists are probably not psychopaths, but are on the same spectrum. Does this mean that ASPD and NPD should really be considered the same disorder, with ASPD higher on the psychopathy spectrum?

BPD is more clearly distinguishable from ASPD and NPD because a person suffering from this disorder does have a conscience and can feel empathy and remorse, but like someone with ASPD they have problems with impulse control. Also, their motives for doing what they do are different: they fear abandonment, while people with ASPD and NPD fear their true self being exposed.

HPD seems very similar to the somatic form of narcissism and includes many narcissistic traits. However, it seems that someone with HPD would be more prone to drama, neediness and tantrum throwing (although these traits aren’t unknown in narcissists). Like BPD, the motives for the sufferer’s behavior seem based on insecurity and fear of abandonment rather than the need to maintain a false front.

NPD and ASPD are more common in males than females, and HPD and BPD are more common in females than males. Does gender determine what disorder a child is more likely to develop later in life? Are BPD and HPD really the “female” forms of the other two disorders?

ASPD almost seems like an exaggeration of typically male traits–aggressiveness, lack of emotion (except rage), and risk taking; whilst HPD seems like an exaggeration of typically female traits — excessive emotionality, preoccupation with beauty/sexiness, and excessive neediness. BPD and NPD are somewhere in between these two and can include elements of both: ASPD –> NPD –> BPD –> HPD

The fact that the American Psychiatric Association keeps changing their criteria just makes things even more confusing.