Borderline Personality Disorder,  Other Disorders

Borderlines vs. Psychopaths

Just a note or two on BPD vs psychopathy…

Firstly, when shown the Ekman faces (just google it if you don’t know what those are), borderlines are likely to view neutral faces as angry and angry faces as extremely threatening. Borderlines think “that person is angry *at me*”. With fear faces, borderlines actually express empathy, even if Baron-Cohen says they don’t. I disagree with him in this regard. I believe the lack of empathy in borderlines occurs during a “failure to mentalize” and is not a general BPD trait.

Psychopath’s brains only activate on fear faces. Disturbingly, they get “excited” about fear in others (i.e. the pleasure centers of the brain light up).

Secondly, psychopaths are the only class of disordered individuals that use goal-directed aggression. Borderlines do not. Their aggression is reactive. Now, you may read that and think “oh my god! My ‘BP’ is a psychopath!” yet what is really happening is that you probably don’t see the trigger of reactive aggression. The trigger for a borderline (or another emotionally sensitive person) can very well be internally-generated – by ruminating or misreading the intentions of others. Psychopaths, however, LIKE to see fear in you. Borderlines just don’t like to feel fear in themselves.

The thing is… I am differentiating the groups because the skills taught in WHINE will not work with psychopaths. In fact, it will probably make them more manipulative because they can gain an understanding of your emotions (whereas they have very little ability to mentalize about others’ feelings, intentions, etc. – they just don’t care) and use that knowledge to get what they want.

For more on psychopathy, listen to Dr. James Blair’s presentation to the 2009 ISSPD.

And some books – Dr. Blair’s book included:

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3 Comments

  • Bon Dobbs

    Reality,

    I’m pretty sure you will not get this comment in your email, as you provided a fake email address. But for others, I’ll post it here. This is a snip from a blog about BPD vs psychopathy:

    http://www.scilogs.com/the_quantum_lobe_chronicles/aggression-spectrum-disorders-the-distinction-between-borderline-personality-disorder-and-psychopath-2/
    ===
    Borderline personality disorder
    1. Prolonged disturbance of personality function in a person characterized by depth and variability of moods.The disorder typically involves unusual levels of instability in mood; black and white thinking, or splitting; chaotic and unstable interpersonal relationships, self-image, identity, and behavior; as well as a disturbance in the individual’s sense of self.
    2. over-active amygdala (i.e. overly responsive to emotion-related stimuli) (Donegan et al., 2003)
    3. insecure attachment (i.e. history of verbally/physically abusive parent) (Aaronson et al., 2006)
    4. ability to empathize (Fertuck et al., 2009) = intact mirror neuron system?

    Psychopathy
    1. An abnormal lack of empathy combined with strongly amoral conduct, masked by an ability to appear outwardly normal. They can use charisma, manipulation, and intimidation to control others and to satisfy their own need.
    2. under-active amygdala (i.e. unresponsive to emotion-related stimuli) (Blair, 2008)
    3. insecure attachment (i.e. history of verbally/physically abusive parent) (Saltaris, 2002)
    4. inability to empathize = dysfunctional mirror neuron system? (Fekteau et al., 2008)

    My speculative model in sum:

    Borderline personality disorder = insecure attachment + overactive amygdala response + functional mirror neuron system => high reactive/impulsive aggression

    Psychopathy = insecure attachment + underactive amygdala + dysfunctional mirror neuron system => high proactive/unemotional + reactive/impulsive aggression

    Psychopaths = happy victimizers into adulthood?
    ===

    Although you may be angry with a person with BPD and feel you’ve been victimized, they are not psychopaths.

  • Caroline

    This post is really excellent and certainly accurate to my experiences. I particularly agree with your point about the trigger for the aggression sometimes being hidden. In contrast to the definition of a psychopath, I find that those with BPD actually are extremely empathetic. While those with BPD can (and often do) hurt others, this often is dysfunctional coping with a perceived insult rather than something inherently pleasurable. It’s unfortunate that these two groups can look so similar from the outside, when their needs and thought patterns are so different.

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