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Author Topic: DIFFERENCES|COMORBIDITY: Borderline and Narcissistic Personality Disorder  (Read 23906 times)
argyle
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« Reply #40 on: October 13, 2011, 04:18:11 PM »

Are there any statistics on the probability of significant improvement for a BPD entering therapy?

--Argyle
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ViciousCycle
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« Reply #41 on: October 13, 2011, 04:21:09 PM »

Aren't codependents inverted narcissists?


You know, that is kind of how I look at it.

Ever since learning about Co-Dependency following my ex leaving me, I've labeled myself a Co-Dependent. But what I've also noticed is that I DO have some narcissistic traits, but I'm far from a full blown Narcissist.

My question is, is it possible to be a Co-Dependent with Narcissistic traits? Sometimes I scare myself into thinking I have things like NPD or BPD just because I exhibit a small portion of the traits, but then I come into a realistic view and realize how far off I am from those things. I am also an undiagnosed ADD, which I've also discovered since my break up and have realized that it's because of that that I'm attracted to very turbulent relationships.  
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argyle
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« Reply #42 on: October 13, 2011, 04:31:17 PM »

Here is an editorial on STEPPS, a 20 week program that can be used in additional to DBT or other behavioral therapies. DBT programs are often a year (once a week).   Usually there is some general talk therapy too... no question that this is expensive and intensive process.

This editorial reports 40% of patients with borderline personality disorder remit (remission) after 2 years, with 88% no longer meeting Diagnostic Interview for Borderlines—Revised or DSM-III-R criteria after 10 years

Oh.  Google is good to:

http://www.borderlinepersonalitysupport.com/fact-sheet-on-borderline-personality-disorder.html
Remission in most studies is defined as a decline in the number of DSM-IV diagnostic criteria for Borderline Personality Disorder a patient meets, from five or more of the nine possible criteria (which constitutes a diagnosis) to four or fewer.

About 50% of patients with Borderline Personality Disorder go into remission within two years. Reasons for remission vary but involvement in therapy/treatment is key.

In one study, the rate of remission was 30% after one year, 50% after two years, and 75% after six years, with only six patients relapsing.

Once in remission, few people relapse.18

So, I guess that there may be some hope with treatment.

My understanding is that co-dependents and narcissists do tend to share a belief in fixing people/ability to control people outside themselves.  So, they have that in common.  My BPDw does seem to exhibit traits of both.

--Argyle
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« Reply #43 on: October 13, 2011, 05:23:26 PM »

Are there any statistics on the probability of significant improvement for a BPD entering therapy?

--Argyle

Not really.
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Author, The Essential Family Guide to Borderline Personality Disorder, Stop Walking on Eggshells, and the SWOE Workbook. Coauthor, Splitting: Protecting Yourself While Divorcing Someone with Borderline or Narcissistic Personality Disorder.  www.BPDCentral.com
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« Reply #44 on: October 14, 2011, 05:07:42 AM »

There is a wealth of material that discusses the variety of shapes and forms these two personalities can take- especially concerning their differences and their bonds to one another.  Joan Lakhar Ph.D has been writing on this subject for many years, even before the advent of the Internet.
 
bpdfamily.com/book_review/joan_lachkar.htm

Contrary to popular belief, Narcissists and Borderlines are not evil or untreatable, they just need to make sense of their behavior if they wish to accept reality. Making sense of the behavior is what object relations theory (Klein) and the psychology of the “Self” (Kohut) is all about.  

Lakhar makes a point to diffuse stigmatization with “although I use the terms borderline and narcissism as distinct entities, neither disorder is the same across individuals or even in an individual over time. Discussion would be impossible, however, without making certain abstract distinctions between them in order to frame the conflict.”

Rather than lumping them into one big wastebasket of broken humanity as a statistic, Lakhar realized that the anxiety of this arrested behavior each person experiences is as different as snowflakes, but these differences must be respected as qualitative differences in order to be assessed.

In her theory, Lakhar felt that Narcissists were more concerned with mirroring that was “Self”-directed while Borderlines were more concerned with becoming a part of something = “Object”-directed.

The Narcissist has been taught that they must be closed off and carefully protected from engulfment by others- and he/she inflates in much the same way a puffer fish does for protection. The Borderline is more like a remora, a clinging, parasitic, part-self, other-directed persona that seeks to attach and go along for the ride.

The real construct here is the extent to which people control or allow themselves to be controlled by others.

There are so many people who are brilliant theorists that it would be a shame not to at least delve into one or two of the ideas about arrested development to see where the origin of the problem begins.

James F. Masterson spent 40 years of his life detailing the differential diagnosis of Narcissism and Borderline and even went so far as to contribute a differential diagnosis on their high and low functions. In his 1981 book, the “Narcissistic and Borderline Disorders” he details many case studies and differentiates the developmental theory of both personality types as well as treatment outlines.  

Borderline failure to separate/individuate during the pre-oedipal period causes a lifelong view of “other-directed” actions. The same is true for Narcissists; however, Narcissists “subsume” others into their intrapsychic World as extensions while Borderlines (part-time selves) fuse to others in the mistaken belief that they will become whole persons.

Both partners wear masks of “false selves” to hide their vulnerable true selves. Narcissists are gullible, and instead of seeing their perfect “false self” reflection in the Borderline as fraudulent, they believe that they have found a fellow narcissist who shares their World view and compunction for perfection.

Both partners present themselves as misunderstood in life and now share each other’s World view- but the Borderline does this as a Trojan horse offering in order to slip inside the Narcissists protective outer. The Narcissist unwittingly subsumes the Borderline as a part of themselves and gives rarely allowed access- thinking that the Borderline has the same protective outer that demands rigid rules for membership. Alas, not only does the Borderline *not* know these rules- they cannot even try to implement them- and the Narcissist becomes aware of dis*ease* between them (a.k.a. red flags of odd behavior) Something clicks in the Narcissist, that this person really wasn’t who they said they were and control issues arise when the Narcissist tries to get the Borderline back in line with the idealized self that was initially presented. When this fails (as it always does) the anxiety turns persecutory for the borderline and the Narcissist withdraws.

Eventually, the Narcissist comes to a painful process of understanding that the borderline actually mirrored the Narcissist and the Narcissist actually mirrored their own self.  Judging the amount of shame that arises during Smear campaigns, distortion, and the blame game are all narcissistic injuries in the aftermath of the broken mirror.  (Note: One does not need to have Narcissistic Personality Disorder to have narcissistic traits. Narcissistic traits can be healthy unless they subsume others.)

Fortunately there are many books that stay away from the stigmatization of the “all or none” characteristics to personalities- these books concentrate on the quality of behavior instead.  Schema therapy by Jeffrey Young Ph.D, was created n 1994.  It is a beautifully modern interpretation of the diagnostic manual which applies to everyone who struggles with abandonment, mistrust and abuse, dependence, vulnerability, emotional deprivation, social exclusion, defectiveness, failure, subjugation, unrelenting standards and entitlement. These eleven "lifetraps" are lifelong patterns or themes that replicate the DSM diagnostics. They are self-destructive personality traits and yet they struggle for survival. The end result is that we manage to recreate the conditions of our childhood that was most harmful to us because we are familiar with the feelings.

Young’s theory is tightly woven into a structured, systematic model of therapy themes, called Schema.  Both Narcissists and Borderline personalities are behaviorally dissected in a way that shows distinct differences to how they view themselves and how to approach them in treatment. Add that to the 30 year old Masterson approach and the treatment options keep encouraging people to get at what ails them in talk therapy.  The understanding of the wants and needs of people vs. fantasy/reality is confronted.  The end result is reality testing and truth.

There are, unfortunately, a plethora of books and blogs that do stigmatize, born out of frustrating personal events and without much introspective clarity for the whys and hows of getting involved with the Borderline or Narcissistic personality and the reasons for continuing to stay with them. (Yes, there are reasons.) According to Joan Lachkar, “it’s not that people are crazy, it’s just that each partner stirs up some un-developmental issue in the other that desperately needs to be worked through.”

In 1988, James F. Masterson M.D. released his brilliant analysis, “The Search for the Real Self, Unmasking the Personality disorders of our age.” In the preface he writes: “This negative attitude about the difficulties of successfully treating borderline and narcissistic patients survives to the day in many areas where therapists have not become aware of the newer discoveries. It often continues to be the prevailing attitude in lay circles and in the media, which is one of the important reasons I wrote this book. Not all, but many patients, given the proper therapeutic support, can and will overcome their developmental problems and their real selves will emerge.” ~ Masterson

Masterson knew that we all had bits and pieces of maladaptive coping mechanisms- and a little bit of family history went a long way toward understanding, but it wasn't all or none.  There was a possibility of acceptance and change.

Lachkar’s “The narcissistic/borderline couple: new approaches to marital therapy.” is now in its second printing.  â€śListen for the theme,” Lackhar says. “At the core of the dynamic flow between narcissistic/borderline partners is a duel between omnipotence and vulnerability.”   One partner withdraws and the other chases, one partner closes in (engulfment) and the other flees… Both people are desperate for love but unable to trust it.  It is a dance. Again, The real construct here is the extent to which people control or allow themselves to be controlled by others.

Investigating and treating the behavior of both parties offers less stigmatization of the separate personalities and more treatment avenues - and this is what the Masterson institute, Jeffrey Young and Joan Lachkar specialize in.

Whether it’s object relations therapy, or Self psychology or Schema therapy, there is no such thing as a NON.  We are all human beings and we all need to work on our separate issues in the aftermath of the relationship. Understanding your partner’s negative life patterns will allow you to see your own- Young calls these self defeating maladaptive coping mechanisms “lifetraps” and he even has information on his website. It’s not enough to turn your back on a Borderline- you have to confront your reasons for being attracted to this cipher in the first place.  Young’s book, “Reinventing your life” is also a good start.  Doing the right thing

amazon.com/James-F.-Masterson

amazon.com/Schema-Therapy-Practitioners-Jeffrey-Young

amazon.com/Reinventing-Your-Life-Breakthough-Behavior




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« Reply #45 on: October 14, 2011, 08:30:34 AM »


It’s not enough to turn your back on a Borderline- you have to confront your reasons for being attracted to this cipher in the first place.

I couldn't agree more. My BPDex has been a blessing in disguise for me. People come into our lives for a reason, a season or a lifetime. Without this experience I would have never realized how much I needed to heal my own dysfunction. I had to come face to face with the fact that little Ms. Perfect was indeed emotionally broken and not so perfect. I had my own damaged script that I applied to relationships hoping the other person could rescue me making me realize what a truly emotional mirrors my ex and I are. Both starved for love, both wanting to control and both not trusting love or feeling worthy of it.

This stuff is deep and heavy.

HG

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« Reply #46 on: October 14, 2011, 09:20:15 AM »

Again, to all the brilliant analysis on this thread...thank you and please post this in tools or get it over to the "Staying" boards..

This thread really helped me tremendously in the last couple of days to process what "my world" with my uBPD spouse is/was all about.

And it encouraged me to delve further into self-analysis which has enabled me to obtain a slight measure of inner peace.

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« Reply #47 on: October 14, 2011, 10:34:33 AM »

Randi, do you think most of us partners of BPDs are Narcissitic?  I used to think I was, especially because I have a uNPD father and a uBPD mom (agreed upon by al siblings & cousins).  

My uBPD has accused me of all the traits of NPD since I moved in with him; a former boyfriend of mine who has tremendous power & wealth (socio-economic) had once accused me of not being vulnerable -he ended our relationship to be with a stripper.  

Recently I took various PD tests which I answered in 2 different ways.  One as I would if it were my husband asking me the questions and the other as if it were just me asking me..being brutally honest with myself.  

I was surprised.  I expected to be "normal" in my first response (as if with my uBPD husband) but instead I was "moderately histrionic and highly narcissitic".  

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Randi Kreger
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« Reply #48 on: October 14, 2011, 02:37:58 PM »

I would go over the questionnnaire with a therapist or a good friend to give you some objectivity.

If you do have narcissistic features, you can work on them. If you're willing to work on yourself you can accomplish anything.
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« Reply #49 on: November 17, 2011, 07:41:54 AM »

hi all,  its taken me a looooooong time to try to work out the dynamics of pd's in my life, both current and past.  this was because i could never work out the difference between an npd and bpd.  but now that i get it things feel alot clearer for me and i wanted to share my understandings.

ok...an npd has a false image of themselves that they maintain with their own beliefs, material goods and the attention/praise of others.  any attempt to question this 'image' or its values results in a narc attack steming from defensive behaviour.  this can involve; withdrawal,sulking and the silent treatment, accusations, anger and/or avoiding the question by changing the subject.  they demand that others be their distraction/entertainment so they don't have to face their authentic self.  the npd's only interest is strengthening this image to continuously convince him/herself that they are this person and not the loss of self that dwells beneath this pd. 

the npd prefers not to show emotions whereas the bpd is often over-expressive emotionally.  in the greek myth narcissisus gazes into the lake at his own reflection while echo dies from his neglect.  what they don't mention commonly is that narcissisus insists that echo only interact with his reflection and any attempt to interact with his true self is met with hostility.  the lack of authentic emotion and neglect kills echo (and her inability to walk away).

a bpd can be mistaken for a npd because both have a lack of true empathy and compassion.  BUT, the bpd has an intense perceived fear of abandonment that causes alot of anxiety and consumes all their attention and will do almost anything to avoid being reminded of that connection to their authentic self as it contains so much perceived pain.  so while a npd has created a false identity in order to interact with the world, the bpd is running from their true self, and/or clinging to/suffocating others in hope of finding themselves there.

so perhaps the difference is that the npd has created a false image in order to interact in a perceived safe way with the world, whereas the bpd is constantly looking to others to live their self through in a safe way.  why are they mistaken for each other?  because of the feeling others have in relationship with them.  they both use people and are unable to see the other for who they really are, only what the pd 'needs' from them.

does this make sense to anyone?
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poodlemom
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« Reply #50 on: November 17, 2011, 09:22:52 AM »

Wow! You all are all so insightful, concise and articulate! Thanks for laying this all out there in understandable terms. :-)
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« Reply #51 on: November 17, 2011, 10:41:13 AM »

so perhaps the difference is that the npd has created a false image in order to interact in a perceived safe way with the world, whereas the bpd is constantly looking to others to live their self through in a safe way.  why are they mistaken for each other?  because of the feeling others have in relationship with them.  they both use people and are unable to see the other for who they really are, only what the pd 'needs' from them.

does this make sense to anyone?

I agree with that description. Having a bipolar (uBPD) mom and uNPD exH, here are other differences that stood out to me:

* While both were invested in their "image" (what other people thought of them), the "images" they created were very different. uBPD mom prefers the victim/poor me image, while NPD exH built up the image of a debonair, intelligent, high class guy. He told me that he was British when I met him and even used a fake British accent. uBPD mom seemed to really BELIEVE her image while uNPD exH put his image out there for others to believe.

* uBPD mom was very low functioning. uNPD exH was very high functioning (in fact much of his image depended on doing well in his job). I've never heard of a low-functioning narcissist. (But it seems BPD can happen either way.)

* Yes to "the npd prefers not to show emotions whereas the bpd is often over-expressive emotionally." My uNPD exH very carefully controlled his displays of emotion. It seemed impossible for him to do or feel anything spontaneously, and spontaneous displays of emotion actually seemed to disgust him. uBPD mom, on the other hand, constantly reacted to whatever emotion she was feeling in the moment. Near zero control of emotions, and if she did manage to control some horribly negative emotion for which she considered you responsible, you better believe you were gonna get an earful about it later.

* uNPD exH seemed to know what other people thought of him might be different than what he thought of himself, and he just didn't care. ("Yeah, they think I'm an idiot at work, but they just don't appreciate what a genius I really am.") Also, uNPD exH could attribute acts/thoughts to the appropriate actor/thinker. uBPD mom has neither ability. She cannot imagine anyone thinking any differently of her than she thinks of herself. Also, she can't "match up" actors/thinkers and the actions/thoughts. She once demanded that I tell her what my Uncle J was thinking when he asked a question about personal finances six months previously. I told her that if she wanted to know that, she'd have to ask Uncle J (the appropriate thinker/actor). How the hell was I supposed to know what someone else - someone who I rarely talk to - had been thinking half a year ago? She wouldn't even tell me the question/s he asked; I guess because if she knew them, I should know them too.
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« Reply #52 on: November 17, 2011, 11:21:06 AM »

Quote
Yes to "the npd prefers not to show emotions whereas the bpd is often over-expressive emotionally." My uNPD exH very carefully controlled his displays of emotion. It seemed impossible for him to do or feel anything spontaneously, and spontaneous displays of emotion actually seemed to disgust him.

that caused me to see the differencies there also.  ubpdm is very able to laugh at the expense of others (when it makes other appear stupied), whereas if i ever made the the npd i know spontaniously laugh, he would catch himself, stop laughing immediately and snip at me.  neither are nice to be around.  npd's are so cold and bpd's are so out of control.  so different, yet with similar results felt by others.
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« Reply #53 on: November 18, 2011, 06:44:14 PM »

I think there are a lot of overlapping traits.  They are both in the cluster B personality disorders, and share characteristics.  If you google the dsm criteria for personality disorders you can read the list of symptoms for each.

I think co-morbidity is probably common, but also someone can have BPD with narcissistic tendencies.
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« Reply #54 on: December 16, 2011, 09:56:50 PM »


Just some food for thought.

BPD is about abandonment, right?

They abandoned you - and now you are in a meltdown trying to deal with it. You have gone to every length to keep them, but they are utterly selfish. And doesn't it feel good when they validate you. It is/was the best feeling in the world. You felt whole again.

How come you cannot love someone that does not play games with you?

Normal people would just walk away knowing they were abused.


Just something to think about.
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« Reply #55 on: December 16, 2011, 10:05:36 PM »

Well...you might be half right, but some of us DID walk away, and I know i can love someone who doesn't treat me like that because I have before and I will again. There's a lot of reasons why we feel extra hurt because of these relationships in particular but I don't think you should compartmentalize everyone into that category because every situation and relationship is different just like the people who engage into them. What exactly brought you to this general conclusion if I may ask?
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« Reply #56 on: December 16, 2011, 10:43:14 PM »

I think you are making some assumptions that do not apply to a lot people on these boards.  Many of us stayed too long for unselfish reasons.  Many of us can and do love people who do not play games with us.  Certainly not everyone here is in a meltdown.
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« Reply #57 on: December 16, 2011, 11:27:04 PM »


Just an experiment.

You may THINK you are not displaying all of the BPD points (such as low self esteem, and frantic fear of abandonment, substance abuse, etc)

However, rather than go by your gut feelings (I am not!), write down in a clinical manner what exactly you did when you were abandoned. What steps you took - calling, driving by, checking up, texts etc.

Now look at what you wrote - see anything?

You have to take your emotions out of the picture. Facts only. You can then apply this to all of the 'symptoms' of BPD.

Remember most crazy people do not know they themselves are the crazy. 
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« Reply #58 on: December 16, 2011, 11:33:32 PM »

I wondered this myself. And I went to therapy for it and brought it up many times.  My therapist, who is actually trained in these things pointed out that I am nowhere near any personality disorder.  Slight codependent tendencies that I've shown in this and other relationships but nothing even remotely close to BPD.  you're generalizing far too much.  

I will say I see some truth in what you are saying though.  It's as if our BPD exes set up a situation where we will feel what they felt at the original core wound.  Then they get to watch how we react. This is all subconscious.  I know because I did this with an ex of mine (to a much lesser degree and much less harmful results). Again, it was nowhere near BPD, but it certainly wasn't healthy. Using other people to figure out our parents' problems... maybe.

I will readily admit that I have had my own abandonment issues as well.  But I also have spent long amounts of time single and even enjoy it. Not all abandonment issues stem from a serious personality disorder.  Our dysfunctions "fit" though.

In addition, the difference between someone such as myself and someone with BPD is not only the clinical diagnosis and criteria but the repetition of the same behaviors. 
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« Reply #59 on: December 17, 2011, 01:25:34 AM »

Bob, are you wondering if you might have BPD or are you really concerned that everyone here has BPD?

Anyone can look like they have something like bpd when under extreme stress.

I work in behavioral health. All humans can experience abandonment/engulfment fears situationally. Having a strong reaction to abandonment does not qualify a person for having a personality disorder. In fact, all nine symptoms of BPD is commonly seen in the normal population. To be a personality disorder Those symptoms have to be 5/9, and they must be showing up as a pervasive and enduring pattern from adolescence through adulthood in a way that profoundly affects and impacts a persons life and those around them.

There are no doubt people on this site who may qualify for having BPD and their partner is NPD. There are also people who have codep traits, depression, anxiety, etc. Most on this board have spent an inordinate amount of time scrutinizing and questioning themselves about such things, and look into it by speaking with professionals, taking diagnostic tests, and asking for feedback here. I know I have. I do not qualify for a dx of borderline personality disorder, or any personality disorder. I do have some codep issues that are mine to work on, not thrilled about it but it is what it is.
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