I don’t like to quote Sam Vaknin much… for various reasons, but I stumbled on this quote from him about NPD vs. BPD. The reason this came up to begin with is that I was discussing whether certain people in on-line support groups might be dealing with something other than BPD.
There are certain support groups in which women make up a large proportion of the group. This confused me a bit, because BPD is much more likely to be diagnosed in women, rather than men. Removing the homosexual female component, there are still more women complaining about their abusive “BPD” men (most often BPxh – which means “Borderline Ex Husband” for all the uninitiated). When I read their accounts, it appears to me that their “BP men” are (mainly, but not exclusively) either suffering from NPD or suffering from the disorder of being an ass.
We talked about this on my board ATSTP some time ago. I also discussed it with an another knowledageble person about BPD. She disagreed with my assessment that BPD and NPD are (usually) mutally exclusive and my idea that perhaps these self-diagnosed “BPs” are really suffering from something else. (again all of this, as always, is my NON-MEDICAL opinion… and this quote below is from Sam Vaknin’s non-medical opinion – he’s a doctor, but not a medical doctor… and I’m not going into the rabbit hole of his degrees). Anyway, here’s the quote and my take on it (again emphasis mine):
http://samvak.tripod.com/faq82.html
NPD and BPD – Suicide and Psychosis
A sense of entitlement is common to all Cluster B disorders.
Narcissists almost never act on their suicidal ideation – Borderlines do so incessantly (by cutting, self injury, or mutilation). But both tend to become suicidal under severe and prolonged stress.
NPDs can suffer from brief reactive psychoses in the same way that Borderlines suffer from psychotic microepisodes.
There are some differences between NPD and BPD, though:
1. The narcissist is way less impulsive;
2. The narcissist is less self-destructive, rarely self-mutilates, and practically never attempts suicide;
3. The narcissist is more stable (displays reduced emotional lability, maintains stability in interpersonal relationships and so on).
Ok, well, given that quote the separation regarding acting on suicidal ideation makes sense to me. However, that being said, his comment about “borderlines do so incessantly (by cutting, self injury, or mutilation)” is basically inaccurate – self-injury is not about suicide, it’s about pain management (and in some ways even suicide attempts, purposeful or accidental, are about pain management)… but I digress…
I was looking over Dr. Heller’s site some more today and found that HIS “other common disorders associated with BPD,” don’t include NPD, but he’s a medical doctor and doesn’t seem to think any disorder should be called a “personality disorder.”
Although I don’t know much about NPD, I think that a borderline is likely to hate herself … a narcisstist love himself. It’s simple (of course again it’s IMO), but seems right to me. I just wonder if people with BPD have been given even more of a bad rap by being confused with those with NPD (or a similiar disorder like APD). Emotional tools will not work (in my experience and in the experience of members of my list with NPD husbands) for someone with NPD.
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Hey Bon,
I looked into NPD as a possible explanation for my wife’s behavior, whom I now believe has BPD, as you know.
Most people seem to argue that that there is a core of self-loathing that is masked by the narcissist, that the display of superiority is a means for denying their fundamental feelings of inferiority, and that the self-loathing itself is responsible for their need for others to idolize them and their desire to destroy the esteem of others, which is seen as a competitive threat.
What do you think? I still struggle to understand the differences between these 2 disorders (although I do think that the narcissistic behaviors seen in many BPs is fundamentally different from actual NPD).
Best wishes,
John
I think the narcissist does mask feelings of inadequacy and self-loathing… however, I think BPD is an emotional disorder and NPD is not. I don’t know too much about NPD, but my feeling about BPD is that it is a subclass of affective disorders and the tools that are effective with BPD are different than those with NPD. I don’t agree that BP’s have narcissistic feelings – they MAY have what seems like narcissistic behavior… but I think those are an outgrowth of a “flip-flop” (in a black and white thinking sense) of being judged. The basic mind-set is “oh yeah? well, what about YOU? Do YOU have a right to judge me?” It seems like narcissistic, but it’s really a defense against deep shame. And perhaps it is a shame closer to the surface than those with NPD.
Bon
Alternate theories (none of which are mutually exclusive):
More men with BPD are misdiagnosed with APD or simply written off as criminal (or maybe just “asses”), so that the actual numbers of men and women with BPD are more nearly equal (Makes sense if you buy into the school of thought that most spousal abusers have BPD, which is borne out by quite a bit of study now and goes a long way in explaining why anti-abuser treatment has been so hopeless. 95% of the men who chose to go to the same treatment place as my husband [the only place that will accept abusers without a court order in our area] re-abuse, no matter how hard they try to keep up with therapy, and even though they are in treatment by choice. The therapy pushes things like feeling bad for what you did, admitting it every week, in detail, and trying hard not to do it again. Obviously not very useful for the BPD-abuser)
More women are misdiagnosed with BPD when they actually suffer from another mental disorder or none at all. There’s a long history of psychiatrists diagnosing all female patients who don’t get better relatively quickly with Borderline, as well as teenaged females who claim sexual abuse without proof, lesbians and women who seem “masculine” and other women who fail to fit stereotypes. Again, so that the ratio of men to women with BPD is much more even.
More women are likely to seek support, esspecially public support and esspecially support to keep their marriages together, since in this society the woman is blamed when the marriage breaks up. Even if it’s because he hit her, it must be her fault in choosing the guy or provoking him in the first place. If the problems are less severe, it’s definitely her fault for not trying to keep the marriage hard enough. So they try harder and end up in more support groups.
I doubt that it’s just because many of those guys are asses for no reason. Generally when someone is chronically an ass and chronically mistreats the people they love, something is wrong with them.
Also, given what I’ve seen of BPD I’d highly question your ability to tell whose husband has BPD and whose has NPD, APD or something else via email. People with borderline can seem incredibly narcissistic. The differences (as you note) are that someone with NPD will generally not self injure (beyond a manipulative show), actually try to kill themselves, and will not be abnormally impulsive. They will also tend to be consistently narcissistic. Someone with BPD can be narcissistic, but will only be that way some of the time. Someone with APD will never truly have empathy for another and has consistent disregard or contempt for rules, including laws. Most people with BPD are basically law abiding, though they’ll make exceptions for highly emotional things or “unimportant” laws (like traffic laws). People with APD and NPD are generally more emotionally regulated than people with BPD, but for any discrete time slice, someone with BPD absolutely can look like someone with NPD or APD.
“Ass”-like and narcissistic behavior is absolutely part of borderline personality disorder, at least for some people, and a history of abusing one’s partner is a potential sign of BPD, not a sign that someone doesn’t have it.
(And just for the record, my husband was diagnosed by a rather well respected hospital. He isn’t self-dxed)
I am MARRIED to a psychologist who has NPD….he is being supervised while he treats a female patient who is a severe BPD….it is really disturbing to me because it seems as if he cannot be objective in order to help her in any way….she rages at him constantly when she is not IN LOVE with him….I am NOT a mental health professional and I am just not sure what to do in this situation. We live in a small community and this woman seems to stalk us and wants to know about our marriage and personal life. My husband and I are also in therapy for his NPD and then this client is really encrouching on our relationship because she calls during our weekends crying and needy. I am just not sure how to deal with all of this….and my therapist is not really responsive when I need to talk about my feelings…this is really hard for me. Can anyone help me understand or provide some sort of suggestions?