Where did BPD stigma come from?

stigma_truth

In recent years, BPD has earned a very disagreeable stigma, so disagreeable that people who have a BPD diagnosis are refused treatment, being told they cannot get better or feared by professionals who might treat them. NPD too, hasn’t always been as demonized as it is right now. NPD and BPD have become almost interchangeable in the narc-abuse community. I don’t recall it being that way in 1996 when I got my BPD diagnosis, and I don’t remember ever being told I was hopeless or unredeemable or evil or anything like that. I was treated pretty much like any other psychiatric patient, and was given therapy and put on antidepressants. I was obliged to take a DBT class, which at the time I blew off. (DBT is like CBT but exclusive to Borderlines–and it does work. The fact it worked for me makes me think maybe I *did* have BPD but no longer do!)

BPD was always classified as a Cluster B disorder, ever since its introduction into the DSM in 1980 (it was recognized, however, for much longer than that, and popularized as a disorder in the 1960s because of the research of Otto Kernberg, a German psychologist who studied “the narcissistic and borderline personalities,” and other “disorders of the self.”).* All “Cluster B” means really is the person has a weak, fragmented or nonexistent sense of self. Not being able to access a “true self” means they become either cut off from or cannot regulate their emotions. One of the results of this is a lack of empathy (but BPDs are the most empathetic of all the B’s, and some have normal levels of empathy). In NPD, a strong false self takes the place of the true one, which is a very dissociative symptom. In BPD, there’s not a strong false self like with NPD, but there is a weak and unstable one, and the person isn’t ALWAYS showing that false self. Some BPDs act quite a bit like over-emotional or unstable narcissists (or narcissists in the midst of a breakdown due to loss of supply). Others act like covert narcissists or just act neurotic and insecure but are otherwise nice people. Some feel their emotions too much, including empathy. A few are antisocial. I’m not sure why BPD (and maybe NPD) isn’t classified as a dissociative disorder, because essentially the person is cut off from their “self” in some form or another and that is what dissociation means. I’m not sure what the mechanics are in ASPD (antisocial personality disorder) but they are very different from either Borderlines or narcissists because they aren’t dependent on others to boost their weak egos. They are psychopathic and just do what they want.

bpd_stigma_quote

So the Cluster B’s, including BPD, were already around, but until the mid-1990s, no one thought of them as anything but mental illnesses or for ASPD, a kind of “adult conduct disorder.” They were psychiatric labels and nothing more. The narc abuse community started in 1995 or so, and Sam Vaknin was pretty much the first one online who wrote about it. Of course, he has NPD but even so, he first called attention to the “evil”-ness of NPD/narcissism (actually it was M. Scott Peck but at the time he wrote “People of the Lie” in 1983, the term “malignant narcissism” wasn’t in vogue yet and there was no connection of “evil people” to people with NPD. There was also no Internet to spread Peck’s concepts like wildfire the way they could have been in 1995 and later. But over time, M. Scott Peck’s book has become one of the most popular in the narc-abuse community) After Vaknin established his online narcissistic abuse community and wrote his popular book “Malignant Self-Love,” more narc-abuse sites got established (many or most of them started by victims, who were understandably angry at the narcissists who had abused them). Soon “narcs are evil” became a sort of meme, and by association, so did all the Cluster B disorders earn a “evil” reputation.

There are benefits to this, of course. Victims are being more heard than ever before. People are paying attention and avoiding narcissistic abusers. But some people who carry a Cluster B label are being hurt too, especially Borderlines (or people–usually women–who were erroneously diagnosed with it). Some experts want to get rid of BPD and just re-label BPD as Complex PTSD (probably not a bad idea). There are MANY similarities. The vast majority of BPDs are not anything like malignant narcissists and are not sociopathic at all. Most just act extremely insecure, needy, and maybe “high maintenance.” They can be manipulative or act out to avoid rejection. They may collude with people with NPD, however. But it’s possible to find these same types of behaviors in many people with Complex PTSD. Are they actually the same thing?

Another reason for the BPD stigma could be the tendency for narcissists and borderlines to form partnerships or be attracted to each other. In such a pairing, the Borderline is almost always the abused or codependent partner. In several “couple killings,” one of the criminal partners, usually the female, has had a BPD diagnosis. But they may have been so brainwashed by their abusers they were coerced into colluding with them against others (a form of Stockholm Syndrome).

Finally, a number of high profile criminals and serial killers have labels of NPD or BPD. But they almost always also have a comorbid ASPD diagnosis. Media icons like Joan Crawford who were known to scapegoat their children also had a BPD diagnosis. In Crawford’s case, she was also diagnosed with HPD (Histrionic Personality Disorder). It wouldn’t surprise me at all if she had NPD (malignant) or ASPD as well, as her behavior was very sociopathic behind closed doors.

Why am I “defending” people with BPD if I don’t have it?  Several reasons:

  1.  I was diagnosed with it and carried that diagnosis for two decades.   I have personally experienced being rejected by therapists once they saw my “red letter” on paper.
  2. Just because my current therapist thinks I don’t have it doesn’t mean I don’t.  Or maybe I did have it and no longer do.  If I no longer have it, that means BPDs are not “hopeless.”
  3. Maybe BPD isn’t a valid diagnosis.
  4. Many people I have cared about who were slapped with “BPD” have been hurt by it.

These are just my rambling thoughts about this matter; I’d be interested in hearing your opinions.

* Timeline of BPD

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Important updates about this blog.

alice3
New blog Down The Rabbit Hole

Things are beginning to gel together finally, after not quite knowing what direction this blog was going to take, after my shattering discovery about myself early this month.

I’ve been writing (and of course reading) a lot more about healing/treating NPD and BPD, but I felt strongly that those types of articles were out of place on a blog meant for survivors of narcissistic abuse. In the past, I posted them here, but they were becoming numerous as my own self awareness began to percolate to the surface of my conscious mind.

When I made my devastating self-discovery (which is actually one of the three best things that ever happened to me!), I didn’t feel at all comfortable posting those articles here anymore, and decided a separate blog was necessary, so I created Down The Rabbit Hole, intended to document my own experiences on this next stretch of my journey as well as try to offer support to people with BPD and self-aware NPD who want to be well again. A secondary goal is to help spread awareness of mental illness stigma, especially the Cluster B disorders.

It’s all a lot to process but I’ve decided, for now, to keep this blog the same as it’s always been. Almost everyone has been really supportive, and as a victim of abuse myself, I’m there with you. So I’m going to keep posting articles about how to survive narcissistic abuse, my own personal experiences, how to get away from abusers, recognize narcissistic behaviors, research, etc., as well as posting unrelated material as I see fit (and have always done). So you won’t be seeing too many changes. 🙂

Certain articles will (and have been) posted on both blogs, if they’re relevant to both. That’s why you might see double entries on my Twitter feed.

Emotional vs. “cold” narcissists.

histrionic_personality

Narcissists can be divided many different ways–covert vs. overt; somatic vs. cerebral; malignant vs. “benign,” etc. They can be divided another way too. Narcissists are either extremely emotional…or cold as machines. Underneath their mask, they’re all hypersensitive though, even if they hide behind a stone cold exterior. Malignant narcs are the HSPs who went bad. Somatic narcissists are probably more likely to be hyper-emotional, similar to people with HPD; and cerebrals more often the “cold, calculating” type, though not always.

cerebral_narc

I’d venture to guess emotional, dramatic narcs have HPD or BPD traits (borderlines can’t regulate their emotions) while the colder types have ASPD or Schizoid traits. Avoidant PD traits could go either way.

I wonder if any studies have been done to determine which MBTI types narcissists are most likely to be. I’d guess the emotional ones are probably INFJ and the second type INTJ. I don’t think most narcissists are that extroverted, even if their mask includes extroversion and sociability. Narcs really don’t like people and are too self-involved to be anything other than introverted, in spite of any outgoing front.

This means there isn’t a whole lot of difference between an emotional narcissist and an unemotional one, except for the thinking vs. feeling aspect. But even when they don’t show it, all narcissists are emotional and easily hurt when it comes to themselves. None of them feel much for others.

Bring it on!

itsmytime

This week has been very difficult for me emotionally. It started with an unnamed, free-floating but intense anxiety and panic, to the point I could barely function. A few days ago I plummeted into a black depression that seemed different somehow in quality from my prior zombie-like apathetic depressions. it felt more alive and more proactive in some way. I’m pretty sure I had an idea all along of what was about to happen but it hadn’t quite bubbled into conscious awareness yet. Its rising through the murky swamp of my unconscious caused me to panic and then a kind of grief took over but I still couldn’t name what it was.

Most of you who read this blog regularly know I began this blog almost a year ago as a form of self therapy (because I couldn’t afford a therapist). From the beginning, I committed myself to 100% honesty. Well, I’ve probably fallen short of that goal, as I’ve omitted some important discoveries and other things about myself that I simply didn’t feel comfortable sharing, even under my alias.

Last night–nearly 11 months from the day I started this online journal–I had a huge breakthrough. Prior to this, I tried to sleep but could not. When I did my dreams were upsetting and I had this overwhelming sense of aloneness and separateness. I woke up shaking and close to tears. I gave up trying to sleep and talked to 2 close Facebook friends for awhile. They’ve been a bit worried about me this week because my mood has been so erratic and I’ve done so much crying, which until recently has been unusual for me. I cried all the time as as a child but then dried up sometime during my teens.

Several things have led to my breakthrough: writing a LOT about my feelings and recovery from narcissistic abuse, reading as much about narcissism, BPD and PTSD as I could get my hands on, trying my best to always be honest no matter how painful or embarrassing (but not always succeeding), and finding God and the power of prayer. It’s been an incredible roller coaster ride.

For several weeks prior to last night, I’d been praying for the ability to regain the easy access to my emotions I had as a child, only tempered with the wisdom and restraint of an adult, of course. I kept reading, writing, and trying to elicit emotion through music, movie-watching, and self-reparenting. I knew this required making myself as vulnerable as possible. I took myself to see “Inside Out,” which loosened something inside me but not quite enough. It was like one of those almost-sneezes that never quite comes out and leaves you wanting to punch a wall in frustration. Nothing much happened after that. I was growing impatient.

dear_past

A week ago, I fell into my panicky, anxious state followed by a “wet” depression (that included tears instead of my usual catatonic apathy). I didn’t even know what I was crying about. I lost my motivation to write (in retrospect, I think this as a form of self protection when I needed it). I was snappish and irritable on the job but would come home and set aside alone time so I could just let everything out without fear of embarrassment or shame. I knew instinctively something important was about to make itself known and that scared me, but I felt a kind of excitement too.

It happened last night at about 3 AM after my Facebook friends and I ended our conversation. I read something that triggered a deep knowledge that hit me like jolt of electricity. For a few terrifying minutes I felt like I couldn’t catch my breath and I might even throw up. I felt hot and cold flashes and started to shake. What I learned was overwhelming and devastating–but I also knew I’d known this for a long time but had repressed it.

Everything suddenly made sense and I felt like I was seeing my situation and all my relationships—hell, over 50 years of my life–with eyes that had been closed since I was very young. I remembered, vaguely, that someone told me something when I was four years old. I couldn’t remember what was said or who said it but I did know whatever it was had been the catalyst when all my problems started that would not abate for over 50 years. One day when I’m ready I’ll remember what actually was said and who said it. I cried harder than I’ve cried since I was about 12. I can’t go into detail right yet about what this discovery was–I’m not ready. I may never be ready. But it’s something that although its discovery is incredibly upsetting to me, it’s also something I needed to have in my conscious awareness before I could really start to do the hard work necessary for real healing.

God answers prayers in his own time. He’s working on me. I have faith he works on all of us if we reach out with a sincere heart and ask for help. Now that I have this information that was revealed to me, the next step is to figure out what to do with it. Right now I just feel shell shocked. I have to be gentle with myself while I work through and try to understand everything that happened. I’m working on finding a therapist to help me sort it out because I think it’s too big for me to handle all by myself anymore. All I can do right now is keep on praying and writing every day and working on myself and being as mindful as I can until I find someone appropriate. I know the work ahead of me is going to be harder now than it has been and that’s okay. It may take a long time and that’s okay too. I feel like I graduated from something last night. I’m ready for the next step. Bring it on!

Somehow I feel lighter today although I’m exhausted and desperately need a good night’s sleep.
I know I can do this thing. But for the love of all that is holy, WHY DID IT TAKE SO LONG?

Cluster B disorders: an explanation

Informative video about the Cluster B disorders that discusses what they have in common and what causes someone to develop them. BPD has been unfairly stigmatized because of its similarity in some ways to the other disorders in this cluster, but few people recognize that borderlines don’t lack empathy or a conscience the way people with NPD and ASPD do, even though they can be difficult to deal with and even abusive when they are triggered.

Movies about narcissism and psychopathy (new header topic)

clapperboard

I have so many reviews and commentaries about movies that portray narcissism and other Cluster B disorders such as BPD that I realized it needed to be a topic in the header.
I am not including documentaries in this list, just theatrical films.

Narcissism and Psychopathy

“Risky Business” (1983)

“Ordinary People” (1980)

“Ferris Bueller’s Day Off” (1986)

“We Need to Talk About Kevin” (2011)

Article from another source about movies that portray NPD.
A Streetcar Named Desire
Black Swan
Lucy in the “Peanuts” comic strips (I know it’s not a movie, relax)
Gaslight
Mommie Dearest
Schindler’s List

Borderline Personality Disorder

“Welcome to Me” (2015)

“Mary Jane Harper Cried Last Night” (1977 TV movie)

Other

“Inside Out” (2015) — not really about narcissism, but about emotions and how they work.

Why narcissists and borderlines are drawn to each other.

narc_borderline

I’t’s uncanny how often people with NPD and BPD seem to find each other. Every one of my boyfriends (except for one, who was severely bipolar) and my ex-husband were narcissists. I know a lot of other borderlines who say they have the same problem–they simply are not attracted to a man or woman who is not a narcissist. There are reasons why this happens.

Both BPD and NPD are included in the category of Cluster B personality disorders in the DSM-V (along with Histrionic and Antisocial personality disorders). Cluster B disorders are all characterized at their root by problems establishing an identity early in childhood and integrity of the Self which causes people with these disorders to act out toward themselves or others in destructive ways and to have problems either accessing or developing prosocial emotions like empathy. All are prone to lie excessively and manipulate others.

All Cluster B’s are easily offended and quick to anger, which can be expressed either covertly or overtly. Here’s a quick description of these personality disorders.

Antisocial personality disorder (ASPD or psychopathy) is the most likely to break the law and violate the rights of others (many are in prison), act impulsively, and have no empathy at all. People with ASPD who aren’t lawbreakers will be ruthless in business or their chosen profession, and feel no compunctions about hurting others to succeed and may even take pleasure from it.

Narcissistic Personality Disorder (NPD) is less likely to break the law (but this is not a given–some narcissists will break the law if they think they can get away with it) due to wanting to present a good image to others, but have little, if any, empathy, and act out toward others and manipulate them to protect the False Self they use in place of their true one which cannot be accessed. They act arrogant, entitled, paranoid and touchy. Think of the most spoiled or brattiest child you know. If you saw that same behavior in an adult, that’s what NPD looks like to others.

Histrionic personality disorder (usually found in women) is a somatic form of narcissism where there is obsession with physical appearance and emotions are expressed dramatically but the emotions themselves are shallow. Histrionics of both sexes are often sexually promiscuous.

Borderline Personality disorder is the most baffling of the four, because it’s a disorder of contradictions. BPD is characterized by black and white thinking, overpowering emotions, impulsivity, self-destructive behavior, and idealization/devaluation of others. People with this disorder oscillate rapidly between opposites–feeling love and hate for others, pushing others away and smothering them, and accepting or rejecting them. They do this because of their fear of abandonment. Unfortunately, borderlines in their desperate attempts to not be abandoned, cause others to abandon them, or are self sabotaging–they may reject others in order to avoid being rejected first. Borderlines, unlike the other Cluster B disorders, are able to feel empathy, but because they can get so overwhelmed by their fear of rejection and their overpowering emotions and drama, they can “forget” others exist. They can feel remorse and guilt when they realize they’ve behaved badly but it sometimes must be pointed out to them.

Borderlines are chameleons who don’t have a False Self per se, but instead adopt whatever “identity” will suit the moment and whatever person they are interacting with–to make the other person accept them. In some borderlines, this rapid switching from one persona to another can appear to others similar to DID (Dissociative Identity Disorder). Not only their behavior, but also their emotions (which they have trouble regulating or controlling), opinions, or even their appearance can change from one moment to the next. This differs from bipolar disorder, where dramatic mood changes oscillate much more slowly.

narc_borderline2

Of all the Cluster B disorders, people with BPD have a Self that is the most fragmented and least likely to have integrated into something called an identity (even a narc has a False Self so that’s a kind of identity). As a result BPD’s are the most prone to experience dissociative or even psychotic episodes, where the person loses touch with reality. Ironically, although Borderlines are “sicker” than narcissists, they are more likely to seek therapy (because their disorder is ego-dystonic and most are not happy with the way they behave and feel) and they are also more likely to be cured.

Because borderlines are chameleons,* they make perfect supply for a narcissist. They lack an identity of their own, so they “become” whatever others expect them to be. It’s not really a mask in the same sense as a narcissist, but they can wear a sort of temporary mask that can change from one moment to the next or disappear completely, leaving the borderline in a depressed or near-psychotic emotional state. A borderline can be whatever the narcissist wants them to be, and as a result are easily manipulated and can become very codependent.

Borderlines can be very manipulative themselves, but because their personality is less integrated and and the narcissist appears to have an integrated self (even though it’s a false one), they are no match for a narcissist. Unless the narcissist is very low on the spectrum (or is a covert and vulnerable one), they cannot be overpowered by a borderline and will always get their way over the borderline’s needs.

Borderlines (like narcissists) never felt loved or valued, but the borderline hasn’t shut out their need to be loved and craves it more than anything else. A narcissist (in the beginning of a relationship) can appear to be highly passionate and attentive, promising the borderline all the love he or she needs–and be convincing enough they capture the heart of a borderline, who thinks they’ve met the perfect mate.

Relationships between narcissists and borderlines may be stormy and “unhealthy,” but when they work, they work well, with the narcissist giving the borderline a kind of identity as a codependent to the narcissist, and the borderline giving the narcissist the supply they need.

I think there’s often a familial aspect too. Cluster B disorders tend to occur in families, in varying configurations. If one or more parents is a narcissist (or a borderline), they are far more likely to raise narcissistic or borderline children, because both disorders are due to abuse and Cluster B parents tend to put their own needs ahead of their children’s, even if (in the borderline) their selfishness isn’t intentional. Therefore, borderlines and narcissists who were raised in abusive families tend to be attracted to people who unconsciously remind them of other members of their families, especially the parents. This type of connection is called a trauma bond because the connection is due to shared trauma and a conscious or unconscious willingness to to be abused or to abuse a partner. A relationship between a borderline and a narcissist is not what anyone would call functional, and yet in a way it can work for both of them, if they don’t wind up killing each other first. Some of these trauma bonds are examples of Stockholm Syndrome, where the abused identifies with their abuser.

Going No Contact with a narcissist is the best gift an abused borderline can give herself (or himself), but separating may be especially hard for them and they are likely to be drawn to another narcissist, so they need to stay on guard and be especially vigilant of red flags.

* I think their ability to be emotional chameleons is the reason why the entertainment, film and television industries seem to have a plethora of actors who have BPD.

“Splitting” and idealization/devaluation.

splitting1

Splitting–more commonly known as black and white or all or nothing thinking–is a primitive defense mechanism used by both narcissists and borderlines when they observe a threat–that someone doesn’t agree with them or is challenging them in some way, or when they fear abandonment (borderlines) or exposure/loss of supply (narcissists). In narcissism, splitting is usually referred to as idealization/devaluation, but other than the unconscious motive (fear of abandonment for borderlines, fear of losing a source of supply for narcissists), the phenomenon is really the same thing.

Splitting is normal in a very young child. When Mommy is present and hugging the child, Mommy is perceived as “good.” When she denies the child another cookie or she goes to work, the child throws a tantrum, and Mommy is now “bad.” Because the child still doesn’t see himself as a completely separate person from Mommy, when Mommy does something that makes the child unhappy or fearful, the child rejects her and thinks of HER as all-bad. The child is not yet capable of the concept that Mommy is an individual who can be both good and bad at different times and to different degrees depending on the situation.

The fairy tales we read to young children engage them at a level they can understand: fairy tale characters are all-good or all-bad, heroes or villains, with no in between. Only an older child can fully understand that people come in varying shades of grey, and pure black or pure white in one person is exceedingly rare. Realizing that most people are both evil and good at the same time is a sign of maturity and indicates the child has come to see himself as a completely separate person with his or her own identity who can afford to see others as individuals too, rather than one-dimensional cardboard cartoon characters.

Narcissists and borderlines never make that transition. Due to early attachment issues arising from neglect, abuse, or sometimes maternal smothering, they continue to see others as extensions of themselves, not separate people with their own identities, interest and opinions. If someone is an extension of yourself, of course the other person must be seen as “all good.” If the other person fails to provide adequate supply (for the narcissist) or disagrees with them or has differing opinions, they are perceived as a threat and must be rejected, devalued, and demonized as “other.” The only way a narcissist or borderline can see another person as a separate entity is when they have become “other” and are demonized and seen as “all bad.”

splitting

Splitting is common in today’s political landscape. Candidate A believes in health care reform, the legalization of marijuana, the cessation of the outsourcing of jobs, raising taxes on the wealthy–and that a woman has the right to choose whether or not to terminate a pregnancy. Candidate B believes in health care reform, the legalization of marijuana, the cessation of outsourcing of jobs, raising taxes on the wealthy–and that abortion should be outlawed. Candidates A and B, rather than focusing on what they have in common and using that to help improve people’s lives, instead go on smear campaigns against each other focusing on the only thing they don’t agree on: abortion. Candidate A accuses Candidate B of being a throwback to the “unenlightened” 1950s, while Candidate B accuses Candidate A of wanting to legalize murder. Neither acknowledges the many things they agree on–all either can see is that the other is a “murderer” or a “throwback troglodyte.” (Notice too how the accusing labels have become exaggerated and more abusive). That many politicians are narcissistic by nature makes splitting come second nature to most of them. Unfortunately, splitting has become standard in political campaigning and is intended to garner more votes (narcissistic supply) for the accuser while taking them away from the opposing party.

Robin and Tim are madly in love with each other. Robin idealizes Tim–she thinks he is the most perfect man she ever met, and she can’t imagine a life without him. He is the most handsome, smart, funny, sexy, and interesting man in the world, and she can’t believe her luck in having met him. Recently they have started talking about getting engaged. Tim thinks Robin’s wild mood swings are rather charming–but he hasn’t been the target of them yet.

On Tim’s birthday, Robin cooks him a lavish dinner and has a bottle of champagne ready to pop open and enjoy. He is supposed to be home by seven. Eight o’clock comes, and he isn’t home yet. At eight-fifteen, Tim calls and says he got held up. He is in the door by nine, apologizing profusely about his lateness–he was called into an emergency meeting by his boss and couldn’t get out of it. Rather than accepting his apology at face value and proceed to have a nice dinner together, Robin goes on a rampage. She accuses Tim of having a lover and never having loved her. The champagne bottle gets smashed against the wall and the dinner thrown in the trash. After fighting for hours, Robin tells Tim to leave and that she never wants to see him again and that he’d make a terrible husband to any woman who would have him anyway.

In the course of two hours, Robin has turned Tim, a normal man who really did love her but couldn’t get out of a meeting, from “the most perfect man in the world” into an unfeeling monster who is cheating on her and would “make any woman miserable.” Because he disappointed her and she couldn’t handle it or see him as a separate person with his own life and his own needs, she must demonize him and make wild accusations against him, accusing him of doing things he never did and saying things he never said. She has turned the good into the evil, and rejected Tim because he is “all bad” now. Both the “angelic” Tim and the “evil” Tim are creations of Robin’s all-or-nothing, black or white, thinking. Both are fiction.

Splitting is really a kind of blindness–the failure to be able to see any shades of grey in an individual, situation, religion, ideology, belief system, or really, anything at all. It destroys relationships, creates hate and discord, kills community spirit, leads to war and killing, and ruins lives.

Are BPD and complex PTSD the same disorder?

age_3_1961_2
Me at age 3 in the zone. Was the template for my BPD already laid down?

Ruji, a new commenter on this blog, made an interesting observation–that BPD should be divided into at least two subtypes: Empathy Challenged/Character Disordered (closer to NPD/ASPD) and Highly Sensitive Person with Emotional Dysregulation (closer to the type I have, although at different times in my life or when extremely stressed I have displayed the more character-disordered subtype). I agree with her. Ruji’s idea is remarkably similar to The World Health Organization’s two subtypes of BPD:

1. F60.30 Impulsive type
At least three of the following must be present, one of which must be (2):

–marked tendency to act unexpectedly and without consideration of the consequences;
–marked tendency to engage in quarrelsome behavior and to have conflicts with others, especially when impulsive acts are thwarted or criticized;
–liability to outbursts of anger or violence, with inability to control the resulting behavioral explosions;
–difficulty in maintaining any course of action that offers no immediate reward;
–unstable and capricious (impulsive, whimsical) mood.

2. F60.31 Borderline type
At least three of the symptoms mentioned in F60.30 Impulsive type must be present [see above], with at least two of the following in addition:

–disturbances in and uncertainty about self-image, aims, and internal preferences;
–liability to become involved in intense and unstable relationships, often leading to emotional crisis;
–excessive efforts to avoid abandonment;
–recurrent threats or acts of self-harm;
–chronic feelings of emptiness.
–demonstrates impulsive behavior, e.g., speeding, substance abuse

Psychologist Theodore Millon has gone even further, proposing that BPD should be divided into four subtypes:

1. Discouraged (including avoidant features): Pliant, submissive, loyal, humble; feels vulnerable and in constant jeopardy; feels hopeless, depressed, helpless, and powerless.

2. Petulant (including negativistic features) Negativistic, impatient, restless, as well as stubborn, defiant, sullen, pessimistic, and resentful; easily slighted and quickly disillusioned.

3. Impulsive (including histrionic or antisocial features) Capricious, superficial, flighty, distractible, frenetic, and seductive; fearing loss, becomes agitated, and gloomy and irritable; potentially suicidal.

4. Self-destructive (including depressive or masochistic features) Inward-turning, intropunitively angry; conforming, deferential, and ingratiating behaviors have deteriorated; increasingly high-strung and moody; possible suicide.

Millon’s Types 1 and 4 would correspond to the Highly Sensitive Person/Emotional Dysregulation type mentioned above (and therefore closer to the Avoidant/Dependent PDs); Type 2 sounds very much like NPD; and Type 3 seems closer to ASPD or Histrionic PD.

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

There are so many diverse–almost opposite–symptoms that can appear with this disorder that one person with BPD can be very different from the next. In fact, you can take 10 borderlines and they will all seem very different from each other, with barely any similarities in their behavior at all. One will be shy, fearful and retiring, never making waves, acting almost like an Aspie or an Avoidant; while another may break the law, lie constantly, and act obnoxious and rage whenever things don’t go their way. A borderline could be your raging boss who drinks too much and ends every annual Christmas party with one of his infamous rages, or it could be the sweet and pretty schoolteacher who goes home every night and cuts herself. She could be the come-hither seductress or the nerdy computer programmer. He may have few or no friends or a great many.

This diversity is not the case with the other personality disorders, which have more cohesiveness in the symptoms their sufferers display. So I wonder–is BPD really a personality disorder at all? Does it even exist, or is it really just a group of trauma-caused symptoms the experts in their ivory towers stuck in a single box called “BPD” because they didn’t know how else to classify them?

In fact, all these diverse subtypes have one thing in common–they are all very similar or identical to the symptoms of someone with complex PTSD (C-PTSD). People with C-PTSD are often misdiagnosed as Borderlines because their behaviors can be just as baffling and manipulative, and both disorders also include dissociative, almost psychotic episodes. Extrapolating from that, I wonder if ALL borderlines actually have C-PTSD.

Earlier today I posted an article outlining 20 signs of unresolved trauma, and I was struck by how similar these were to the symptoms of BPD. And there is also this article that Ruji just brought to my attention that also describes how remarkably similar the two disorders are, but that the idea of fear of abandonment (which is recognized as the root cause of BPD) is not recognized as a factor in causing PTSD and that may be part of why they have been kept separate.

The BPD label, like any Cluster B label, is very damaging to its victims because of the “evil and character-disordered” stigma it carries. One psychologist has even included us, along with narcissists, among the “People of the Lie”!

Yes, it’s true some borderlines do act a lot like people with NPD or even Malignant Narcissism or ASPD, but most probably do not, and are really much more similar to people with Avoidant or even Dependent personality disorders, which hurt the sufferer more than anyone else. But if you have a BPD label, people start backing away from you slowly due to the stigma. Therapists are reluctant to treat you because they assume you will be either difficult and hateful in therapy sessions, or will never get better. Insurance companies won’t pay claims where there is a BPD diagnosis, because it’s assumed there is no hope for you. I’ve had this problem when I’ve tried to get therapy. I remember one therapist who I had seen for the intake session, who told me he needed to obtain my psychiatric records before we could proceed. The session had gone smoothly and I felt comfortable with him. A few days later I received a phone call and was told he did not treat “borderline patients” and wished me luck. So that’s the kind of thing we’re up against if we’ve had the BPD label slapped on us.

Also, as an ACON blogger who works with a lot of victims of narcissistic abuse, my BPD label sometimes makes people wary of me and they begin to doubt that my motives here are honest. At first I was reluctant to talk about my “Cluster B disorder” here, because I knew it might be a problem for some ACONs, who think borderlines are no better than narcissists. But I eventually decided that to hide it away like an embarrassing family secret would be misleading so I “came out” about having BPD (I never actually lied about it, but played it down in the beginning and rarely mentioned it). I’m glad I fessed up, but there have been a few people who left this blog after I came out about it or began to doubt my motives. So there’s that stigma and it’s very damaging.

Both C-PTSD and Borderline PD are caused by trauma. Both are complex defensive reactions against future abuse and both involve things like splitting, dissociation, psychotic episodes, self-destructiveness, wild mood swings, and behavior that appears to be narcissistic and manipulative.

The way I see it, the only real difference between C-PTSD and BPD is that the traumatic event or abuse happened at an earlier age for someone with BPD, perhaps during toddlerhood or infancy, while all forms of PTSD can happen at a later age, even adulthood. But the symptoms and defense mechanisms used to avoid further trauma are the same for both.

Psychopathy and malignant narcissism: what is the difference?

hannibal_lecter

I have been reading a blog written by a self-confessed Psychopath (who scored 36.8 on Hare’s Psychopathy Checklist) who writes engaging and well-informed articles about his disorder. I’ve always wondered myself about what it is exactly that distinguishes Malignant Narcissism from Psychopathy, because a MN can be every bit as cruel and callous as a psychopath. The primary difference is the Psychopath is not an attention-seeker, but the malignant narcissist is still trapped by his or her need for approval, attention and adulation from others. That is also one of the things (along with impulsivity–which ASPD has in common with BPD–as well as the likelihood of law-breaking) that distinguishes Antisocial Personality Disorder (ASPD) from NPD/malignant narcissism.

There are those who believe that ASPD is on the same spectrum as NPD (but is at the top of the scale, while NPD is in the middle), but I’m not sure if it should be because there are qualitative, not just quantitative, differences. My opinion is that malignant narcissism is high spectrum NPD with ASPD traits. But they still need narcissistic supply. Psychopaths do not.

This writer has an interesting observation–that perhaps the only type of person able to control and/or take down a narcissist is a psychopath. He has little respect for narcissists due to their need for others (even as supply) and emotional sensitivity to rejection and criticism.

psychopathy_diagram
The anatomy of a psychopath. Malignant narcissists share with psychopaths the Factor 1 traits, but not Factor 2.

I think this article will explain these differences better than I can.

Narcissism or Psychopathy–Differences?
http://www.psychopathicwritings.com/search/label/Narcissism%20and%20Psychopathy

A Reader asks:

I would be interested in reading anything you wrote on psychopaths need for attention/acceptance. Have you? Like, how would they react to rejection?

Basically the need for attention and acceptance, if it’s a prominent and dominating aspect of what drives a person, is a distinctive trait in Narcissism. As such it is not exclusively something psychopaths are known for.

It is often said that psychopaths have strong narcissistic tendencies, and the statement isn’t completely wrong. But I also often see statements saying Malignant Narcissism and Psychopathy are the same, and this is not the case. There are some very important fundamental differences between psychopaths and malignant narcissists.

Narcissists may be callous and abusive – malignant narcissists definitely are callous and abusive! – and they lack empathy. These are things they have in common with psychopaths. But narcissists have a very strong emotional need for attention or Attention Seeking, Acceptance and Admiration. Their self esteem depends on whether or not they receive these things, and this makes them very vulnerable to rejection and other forms of negative attention such as humiliation, being out shined by someone else, or of being deliberately or naturally ignored.

Psychopaths do not need attention and we certainly do not need acceptance, at least not just for the sake getting it. Their emotional well being does not depend on whether or not they get these things, but they do play a part for most psychopaths’ sense of satisfaction. In this we’re probably not that different from normal people: We like to get attention, to be admired and respected just like everybody else, but we do not feel bad if we don’t get these things.

For psychopaths getting attention and respect from others is most of all a technique to get what they want without having to resort to coercion – threats, blackmail, and physical violence, i.e. – with the same frequency as we otherwise would. Having attention and respect – and acceptance – from others is really only paramount for as far as it is necessary to avoid the risks associated with the more negative techniques. In short: Attention and acceptance to psychopaths are not goals or ends, they’re means to ends.

When we (psychopaths) do care about whether or not we get attention it is not because we have an emotional dependency on being recognized or confirmed by our surroundings. It doesn’t matter to us that people speak badly about us, or that they try to avoid us. Being feared makes an opening for controlling those who fear you, and control leads to possible power.

Making sure you get a lot of attention is also a kind of control, it is a potential opener for gaining power, and it is the central, and often the only, reason why we seek to get it.

This is a well known fact, and the entertainment industry – just to mention one – knows and uses it: Make yourself known, make sure people notice you and that they can’t overlook you, and you have the basis for influencing how people respond to you.

If people like you, there’s a greater chance that they’ll support you or help you in other ways, especially if it’s mutual. <– This is what I've chosen to do, but I certainly did not always use a friendly approach. I've been very abusive in the past, and it has worked very well for me too. – But I've changed in many ways, and I find the mutual idea much more interesting now – and that is good, because it keeps me out of prison, and it has created a good possibility for me to actually do something valuable that others can benefit from… But that was a side note.

Narcissists seek attention and acceptance for it's own sake, and are miserable if they don't get it.
Psychopaths seek attention and acceptance because it is part of a technique to get something else. Attention and/or acceptance for it's own sake doesn't matter to how a psychopath feels.

A Narcissist, opposite a psychopath, is very vulnerable to Social Rejection and rejection in general. If you deny them admiration and respect, and – more important still – if you humiliate them publicly, you can crush a narcissist completely (provided you do it right and with timing).

Narcissists get very hurt when they get rejected.
Psychopaths do not feel any emotional pain or discomfort when they get rejected.

No narcissistic person can go through public humiliation and not feel emotionally very disturbed by it. With this knowledge one can destroy a narcissist quite easily… This is the typical area of most psychopaths' expertise, and it is why we so easily can control most narcissistic people. For the same reason most psychopaths have a lot of contempt for narcissistic people. We see individuals who love to abuse and humiliate, but who are even more vulnerable to these things themselves, and it's hard to find it in your heart to respect such people…
– I suspect we may have this in common with most neurotypicals.