January 5, 2007


Narcissism- what I believe to be the primary disease of our times-- is one side of a coin.  The other side-- the narcissist's enabler-- is the borderline.

If the analogy for narcissism is "being the main character in their own movie," then the analogy for borderline is being an actress.

Note the difference: the narcissist is a character: an invented but well scripted, complete with backstory, identity.  The narcissist is trying to be something-- which already has a model.  Perhaps he thinks himself an artist type, or a tough guy, or the type interested in spiritualism, or like the guy in the Matrix.  Types, characters.  The borderline is no one: the borderline waits for the script to define her.

Her?  Yes.  Narcissists are mostly hes, and borderlines hers.  (Not always, sure.)

The classic description includes: intense, unstable relationships; emotional lability; fear of abandonment.  The borderline has no true sense of self.

Ironically, the borderline is a borderline only in relationship to other people.  The borderline has a problem with identity only because other people in the world have stronger identities.  Your Dad wants you to be one way, so you do it.  Your boyfriend wants a different woman; so you do it.  Your husband wants something else; so you do it.  Who the hell are you, really?  You have no idea, because you are always molding yourself based on the dominant personality in your life.


This si done mostly out of fear of abandonment: if you don't "be" the person they want, then they'll leave you, and then what?  (Borderlines don't end relationships-- they end relationships for another relationship.)

The narcissist creates an identity, then tries to force everyone else to buy into it.  The borderline waits to meet someone, and then constructs a personality suitable to that person.

If a borderline is dating a guy who loves the Dallas Cowboys, then for sure, she will love the Dallas Cowboys.  If, however, she breaks up with him, and then dates a guy who loves the Giants, then she'll love the Giants.  But here's what makes her a borderline:  she will actually believe the Giants are better.  She's not lying, and she's not doing it for him; she actually thinks she thinks it's true.  Everyone else on the outside sees that it is obviously a function of whom she's dating, but she is sure she came up with it on her own. And she's not play acting: at that moment that she believes, with every fiber of her being, that the Giants are better.

Here's the ironic part: if a borderline was shipwrecked on a desert island with no one around, she'd develop a real identity, of her own, not a reaction to other people.  Sorry, that's not the ironic part, this is: she'd become a narcissist.

The bordeline has external markings of identity: tattoos, changing hair colors, clothes.  You may recall I said almost the same thing about the narcissist: the difference is, of course, the borderline changes her image as she changes her identity-- in other words, as she cahges the dominant personality in her life; but the narcissist crafts a look, an identity, which he then defends at all costs:  "I would sooner eat fire ants than shave my mustache."  Of course. Of course.

All those silly movies about a woman moving away, or to the big city, and she "finds herself:" that's a borderline becoming a narcissist.

If you look back on past long term relationships you've had, and are completely perplexed as to what on earth you ever saw in each of those people that kept you with them for a year; well, there you go.

This is why narcissists marry borderlines, and not other narcisstists.  Two narcissists simply can't get along: who is the main character?  Meanwhile, two borderlines can't be with each other-- who supplies the identity?  The narcissist thrives with the borderline because she provides for him the validation that he is, in fact, the lead; the borderline thrives with the narcissist because he defines her.  And, as she will tell you every single time, without fail: "you don't know him like I do." Everyone else judges his behavior; but the borderline is judging his version of himself that she has accepted.  

Go back to my white high heel shoes example.  The narcissist demands his woman wear white high heel pumps not because hem ay like them himself-- he might or might not-- but because he is the type of man that would be with the type of woman who wears white pumps.  He thinks he's the sophisticated, masculine man of the 1980s, so she damn well better be Kim Bassinger from 9 1/2 Weeks.  Blonde hair, white pumps.  She could weight 400lbs, that's not the point (though it will become one later.)  So she wears the shoes, and starts to believe she likes them, starts to believe that she is that woman.  He reinforces this with certain behaviors or language towards her (he'll open the door for her, push her chair in, etc.  You say, "well, what's wrong with that?  Nothing, except that he ALSO beats her when she doesn't wear the shoes.)

It's almost battered-wife syndrome: what keeps her with tat maniac is that when he's not beating her, it seems like he is actually being kind to her, so great is the difference between being beaten and simply not being beaten.  Meanwhile everything he does wrong has an external explanation: it was the alcohol, he's under stress, etc.  And she's doing this rationalizing for herself, not for him, because it is vital to her own psychological survival that he actually be who he says he is, that he actually have a stable identity that things happen to, because her identity depends on his being a foundation.

That's why the therapist has to maintain such neutrality, consistency in the sessions.  It's not just to avoid conflicts; by being the most dominant (read: consistent) personality, the borderline can begin to construct one for herself using the blueprints of yours as a guide.

If the borderline sounds like a 15 year old girl, that's because that's what she is.  The difference, of course, is the actual 15 year old girl is supposed to be flaky, testing identities and philosophies and looks until she finally lands on the one that's "her."  But if you're 30 and doing that, well...



(BTW, if you want to understand the mystery of women's addiction to shoes, here's my take: shoes are the article of clothing that represent possibility.  Each shoe is a different look, a different character, and she can select "who" she wants to be that day.  You might not notice the difference, but she feels it.  This is not borderline-- it's normal, but it's normal because the shoe changes and the rest of her doesn't.)


This is quite probably the ... (Below threshold)

January 5, 2007 7:45 PM | Posted by Cheryl Fuller, Ph.D.: | Reply

This is quite probably the best brief description of borderlines I have read anywhere. Bravo!

What do you make of research that suggests that men with borderline characteristics are more likely to be diagnosed with PTSD than as borderlines? I don't have citations at hand this moment but could find at least one if need be.

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Extremely informative. Why ... (Below threshold)

January 5, 2007 9:51 PM | Posted by Michael Didj: | Reply

Extremely informative. Why is self-mutilation associated with BLP?

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"Why the self mutilation?" ... (Below threshold)

January 6, 2007 4:13 PM | Posted by Admin: | Reply

"Why the self mutilation?" They'll tell you it isn't suicidal, that it relieves tension, stress, they see the blood and a feeling of discharge comes over them.

But I think it has to do with reality. Lacking an identity, how do you know who you are, how you act, what you feel is real? But at least the pain is real, for sure. It's a starting point. All things great were forged from fire, and fire hurts.

Michael: on your blog you had issues with the DSM. The DSM is entirely useless for describing character constructs. That's why it seems like narcissism and borderline are two completely separate things (in the DSM) yet I make them out to be parts of one whole.
And therein is the problem with psychiatry: reductionism using arbitrary categories.

I see you are a surfer (I can't even swim.) I would guess that your experience of surfing is either "zen-like"-- i.e. totally losing yourself, your identity, and become your actions (the surfing), or the opposite-- you become hyperaware of every part of your body, your movements, etc.

Using it only as an example, a borderline couldn't "let go" like that. Nor could a borderline make a good surfer-- because h/she would not be able to be hypreaware and in control of every part of her actions. But more passive sports (passive means you don't do much)-- skydiving, roller coasters, horror movies, bungee jumping, etc-- those would fit, because they make you "feel" without demanding you control.

I have to think this through a bit more, but I'd appreciate your thoughts.

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Dr. Fuller: you're probably... (Below threshold)

January 6, 2007 4:42 PM | Posted by Admin: | Reply

Dr. Fuller: you're probably better able to answer that since (I assume) you treat many more than I do. So one possible answer is that it's not the trauma, per se, that leads to borderline, but when the trauma occurs. I'd predict having a trauma during anal stage rocks your already tentative identity. So now who are you? Where as getting molested at age 8 might drive a man more to narcissism.

I think this also has a lot to do with the "inconsistent parenting" model of personality disorder. Borderline learned that she should be whoever she needs to be at the moment to please mom or dad. Narcissist learned that whoever has the power makes the rules. Note that neither develop a fixed, eternal idea of right and wrong.

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I enjoyed your take on bpd.... (Below threshold)

January 7, 2007 4:53 AM | Posted by Lily: | Reply

I enjoyed your take on bpd. I have been thusly diagnosed, but although my hackles were raised from the beginning of your post, I found a particularly helpful part. The part where you address the 'neutrality' of the therapist. I think this may get to the heart of why I want to fire my relatively new psychiatrist and move on-his neutrality-is supremely frustrating and places me in the awkward position of being, as you say, 'dominant'.

I wonder what you think of allegations that bpd is a 'trashcan diagnosis' or a 'sexist' diagnosis?

It isn't as if I set out to be this way. I was never accepted in my family. My likes, dislikes, dreams and goals were constantly disparaged. I tried to be who they wanted in order to stay out of trouble
thus leading me to believe that the possibility exists that the bpd label is stuck on those that don't conform in their families and perhaps in society as well. Indeed, the advice of my first therapist who I saw at age 20 advised me to 'just have a baby.' I have no children


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(question from a layman)</p... (Below threshold)

January 7, 2007 10:42 PM | Posted by AK: | Reply

(question from a layman)

The type of relationship you describe between someone with NPD and someone with borderline--mightnt that apply to persons who do not happen to have borderline?

I think James Masterson once suggested that there could be a varient on NPD--a condition he termed 'closet narcissism'.

This is someone whose inner landscape acquired a narcissistic configuration but does not actively seek mirroring of the grandiose self but instead does this vicariously by admiring an overtly narcissistic person's grandiosity.

Masterson suggested that this closet narcissism could develop if one has been reared by NPD parents who demand that the child provide mirroring, or could come about if the primary caregiver idealizes the child at an early stage of development, then attacks the child's grandiosity at a later stage of development.

(Masterson, The Search For the Ideal Self, p 103 1988)

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You may be right but I was ... (Below threshold)

January 8, 2007 2:41 PM | Posted by Cheryl Fuller, Ph.D.: | Reply

You may be right but I was actually thinking about the person making the diagnosis more than about the characteristics of the patient as in this from:

BPD is most frequently applied to women under 40 and to patients that therapists seem not to like. The patient suffering from PTSD (Post Traumatic Stress Disorder) is viewed sympathetically and as the “good” patient, while the patient with BPD, with her anger, aggression and resistance, is the “bad” patient (Becker). The criteria for the BPD diagnosis are so fluid that one researcher found 93 ways the criteria could be combined and reach a diagnosis of BPD. (Stone).

“In fact, borderline has become the most pejorative of all personality labels, and it is now little more than shorthand for a difficult, angry female client certain to give the therapist countertransferential headaches”(Becker)

Stone, M. H. (1990). Toward a comprehensive typology of personality. Journal of Personality Disorders, v. 4, 416-21.)

Becker, D. (2000). When She Was Bad: Borderline Personality in a Posttraumatic Age. American Journal of Orthopschiatry, v. 70(4), 422-32)

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This ode to fascinating wom... (Below threshold)

January 8, 2007 3:32 PM | Posted by flawedplan: | Reply

This ode to fascinating womanhood exemplifies one reason the appalling BPD construct needs to go.

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Any therapist that still se... (Below threshold)

January 9, 2007 12:42 AM | Posted by Donna Smart: | Reply

Any therapist that still sees Borderline as a synonym for "difficult, angry female client" is in serious need of training and education.
BPD is a devastating illness that wrecks people's lives for many years.

All we needed in the above comments was the word Manipulative to have the full uneducated view.

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My thoughts on BPD are that... (Below threshold)

January 9, 2007 12:58 AM | Posted by Michael Didj: | Reply

My thoughts on BPD are that the environment of the toddler plays a bigger role than is generally thought. Crying is a healthy attention getting behavior for infants (of course not in excess). At some point, the baby becomes consciously aware that ‘crying’ can exert control over Mommy and maybe Daddy. When Mommy is having a conversation with someone, baby will begin to squirm and cry, regaining the full attention of the parent. When the child becomes vertical (1-2), the need for their parent’s attention continues, the moment a parent’s attention strays, the child falls and bangs the knee or the head and begins to cry and regains the attention. As children grow older, these behaviors fall by the wayside because they do not ‘work’ anymore. Thus, I’d conclude that folks classified with BPD, have received an unresolved emotional trauma/injury just prior to walking. Self-mutilation is the give away. It provides the relief that mommy’s attention used to. This would also explain why eating disorders are associated with BPD. . The lack of a sense of self fits in as well because most children do not have a strong sense of self. I like how narcissism fits in as the other side of the coin. They have no sense of self, have to make one up and end up over compensating.

In conclusion, my suspicion is that prescribing medication merely reinforces the child-like belief that something outside one self is needed to stop the anxiety, 'emptiness' and lack of a sense of self. Years ago, when I put some of my ideas in to practice ‘on the field’, my client had great success with breathing therapy. I used other techniques as well but feel that ‘relaxing the body’ was the most significant factor. My client, a boy, was 9 years old when I began and 10 when I concluded. It was time consuming and took approximately 6 months. He had clearly displayed all the criteria of a BPD. Thanks for your careful consideration.

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One worrisome thing is that... (Below threshold)

January 9, 2007 10:47 AM | Posted by Ak: | Reply

One worrisome thing is that BPD is becoming such a stigmatizing term that its hard for sufferers to find the courage to present themselves for treatment.

Ditto for NPD.

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This blog holds a perverse ... (Below threshold)

January 9, 2007 1:59 PM | Posted by anonymous coward: | Reply

This blog holds a perverse fascination for me; I can't tear myself away. The industry I work in is largely characterized by narcissism; I didn't have a label for it before. Everybody thinks they're a rock star and expect to be treated as such. I'd been describing them as prima donnas but this definition is better. A large portion of the remainder could be considered borderlines. I've called them "flakes". So what's wrong with me that I surround myself with such people?

I think I'm a rescuer, surely just as pathological in some respects. I was married to a narcissist (I realize that now) but I wasn't a borderline. Rather, I rebelled against being what he wanted me to be, the downfall of our marriage. Not overtly initially; I was guilty of acquiesing to some extent, wanting to make things work. But fundamentally, I couldn't be melded into his image of what his wife should be. I think I became somewhat passive-aggressive, in retaliation for what I saw as the pending demise of my self. I repaired appliances secretly (an artist, his "wife" couldn't be handy if he wasn't); I wore clothes that didn't match, I shunned social activities.

Is it just me or are the arts predominated by narcissists? Why? Why am I drawn to repair these fractured people? It must be my neurosis. My mother was a flake; that probably explains it all.

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This description of borderl... (Below threshold)

January 9, 2007 3:28 PM | Posted by Just Me: | Reply

This description of borderline personality disorder is facile and -- in general -- sanctimonious. Get off your high horse.

Why do you care if anyone understands these disorders? Nowhere do you talk about the fact -- proven fact -- that borderline personality disorder is one of the most curable of all personality disorders.

Other fallacies in your "article":

-- Not all those with the disorder cut or even physically hurt themselves. Destructive behavior in general is seen as both a release and a punishment. Also as a "fuck it" type behavior -- why not engage in risky sex? Why not drive fast? What's worse than this existence?

-- I have never adapted my love for the St. Louis Cardinals for another team based on anyone I've known or loved. My dad loves another team, boyfriends and two husbands love other baseball teams. Where in the heck did this example come from?

-- Relaxing or breathing therapy won't cure this or any other personality disorder. It will require hard work, a combination of behavioral and talk therapy and -- sometimes -- anti-depressants and anti-anxiety drugs. Using anti-depressants as a first step toward treatment makes tons of sense: If a person can't bring themselves out of a funk long enough to want or get therapy, there is no second step. Writings like this that suggest it is simply a matter of willpower or "wanting" to "get over it" are cheap and easy and miss the point.

Be careful of what you write. Be mindful of who will read it. Be aware that people with borderline personality may feel invalidated by it. Be responsible for your words.

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Justme I'm one of those pe... (Below threshold)

January 9, 2007 4:44 PM | Posted by flawedplan: | Reply

Justme I'm one of those people who had a meltdown yesterday and am grateful for your insight.

There is a social trend of dehumanization toward people suffering with BPD and narcissism, numerous communities and books and recovery groups in existence that are comprised of self-proclaimed victims of narcs and bpd's. I won't link to them unless asked, but google can show you what goes on. One term in use is "fleas" it refers to bad psychological habits ostensibly picked up by people in chosen relationship with borderlines who are not identified themselves with a personality disorder.

So if you've a history of intimate engagement with a borderline person you can blame your emotional and behavioral problems on them, you are not responsible, it's these "fleas" you picked up from this animal (projective identification), and that's just one example of the hate and dehumanization that exists in our culture around troubled and troubling women. They're scapegoats.

I appreciate this discussion.

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Yes. Many persons have been... (Below threshold)

January 9, 2007 5:51 PM | Posted by Ak: | Reply

Yes. Many persons have been in wretched, wounding relationships. They get traumatized, stagger away, try to get some sort of mastery.

A good friend of mine was grievously harmed by someone who does appear to have been a criminal psychopath. He later fled the country when his past began catching up with him. My pal suffered because several therapists she consulted could not seem to comprehend how throughly this man had messed with her head.

When feeling frustrated and traumatized, persons who have left painful relationships can find it tempting to latch on to psychodiagnostic labels, apply them to the ex-partner in stigmatizing ways, and then reinformce this by visiting websites where there is little information given abou the need for kindess, care and caution in applying such labels as NPD and BPD.

This stigmatizing climate can be very disheartening for persons with NPD and BPD who are bravely attempting to achieve some self insight and who have found the coufage to enter and remain in therapy.

A tip for therapists working in the trenches:

Periodically visit discussion forums (psych, health and healing, parenting) on Craigslist.org
and some of the more shrill of the lay-run websites.

A periodic review of material on these sites can give you an excellent take on the social context your clients face and the kinds of stigmatization and misinformation that are making the rounds.

By being aware of this you can advise your patients and clients on what kinds of input will hurt them and is best avoided during times of personal vulnerabilty.

(note) If you register on the Craigslist forum, you can then access the search function. This can come in handy if you want to do a quick study on how people are talking about things like bipolar, borderline and even discussions on specific anti-depressants.

If you go to the parenting forum you will find a lot of discussion threads on ADD AHD.

A periodic review of craigslist can be enlightening. If you are member of a consultancy group or work as part of a team, this task can be rotated among members.

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Hi, "just me" said: "Relaxi... (Below threshold)

January 10, 2007 6:08 AM | Posted by Michael Didj: | Reply

Hi, "just me" said: "Relaxing or breathing therapy won't cure this or any other personality disorder. It will require hard work, a combination of behavioral and talk therapy and -- sometimes -- anti-depressants and anti-anxiety drugs. Using anti-depressants as a first step toward treatment makes tons of sense: If a person can't bring themselves out of a funk long enough to want or get therapy, there is no second step."

First of all, the breathing exercises were not the only technique utilized in my treatment plan. I suggest you reread that part of my comment. Yes, it was very hard work, extremely hard. Doctor Joeseph Chilton Pearce has a great deal of insight. All though it may not be obvious how it directly relates, it can be a primer for someone with an open mind.

Secondly, the over reliance on drugs can and often exacerbates the problem. An area that seems to be overlooked is the fact that the gastrointestinal tract contains 90% of the neuroreceptors for Serotonin. see: http://www.reference.com/search?r=2&q=Seratonin
Consequently, we are seeing all types of mental disorders because folks' 'poor' diets are inerfering with serotonin being synthesized properly. In fact just about all of these drugs are temporarily effective because they are impacting the gastrointestinal tract. The point here is that experience is infinitely more valuable then textbooks ghost written by the pharmceutical industry.

Finally, psychiatry is in its infancy. The breathing techniques utilized - that were just part of my client's successful recovery - are thousands of years old. I can understand your frustration but it may be helpful to remember that we all have the same goal. Which is to reduce suffering.

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Sorry -"just me" the commen... (Below threshold)

January 10, 2007 7:18 AM | Posted by Michael Didj: | Reply

Sorry -"just me" the comment I attributed to you were AK and for your edification:
thanx for your careful consideration.

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Narcissism- what I believe ... (Below threshold)

March 9, 2007 6:49 PM | Posted by Dave: | Reply

Narcissism- what I believe to be the primary disease of our times-- is one side of a coin. The other side-- the narcissist's enabler-- is the borderline.

I agree with this except to limit the male/female role. I am a borderline male 40 years old. My 2 ex wives and girlfriend all qualify as narcissist. The difference would be that it is further complicated in the roles of each. Neither tends to be satisfied for long as natural roles are challenged. Men are historically the providers and women the care giver. In other words, as a man with borderline - its that the man is more of a woman than the woman he is with. And the woman is more of a man than the borderline.

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This description of borderl... (Below threshold)

March 13, 2007 12:35 PM | Posted by Anon.: | Reply

This description of borderline is extremely simplistic. People who have borderline tendencies can behave very differently from this article. I just know borderline when I see (or feel) it. (I'm not a doctor or therapist) And I have certain strategies to help me interact with that person.

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I have a 24 years old daugh... (Below threshold)

March 21, 2007 9:58 AM | Posted by maria filomena: | Reply

I have a 24 years old daughter with bordeline disorder, the only thing she does not do is cut herself, she has suicidal thoughts....everyhing else described, is her....she does other self destructive behaviour such as shave her hair, etc
My question,she is now coming to live with me and her 2 year old baby.....pls help me strategies how to deal with her....she always screams at me,and like to party untill morning with different guys...pls help

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Here are some lyrics which ... (Below threshold)

April 12, 2007 2:07 AM | Posted by Gogu Skywalker: | Reply

Here are some lyrics which clearly show a borderline personality disorder:


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Hello Dr., I j... (Below threshold)

April 18, 2007 8:13 AM | Posted by tracy barnett: | Reply

Hello Dr.,

I just discovered your blog today and love it. I have been diagnosed with bpd and reading your description was amazing, especially the parts about tatoos, piercings and changing hair color (my personal favorite!)to try to find an external identity. I also can definately relate to the "15 year old" syndrome...I think of myself that way often and even "jokingly" refer to my self that way to to others..."I'm a 46 year old 15 year old".

I was doing fairly well while I had an amazing, wonderful psychiatrist for 3 years...he had strict rules, but was ever so kind and understanding, really helped me cope. Then we moved three years ago and losing him was devestating, I totally decompensated...was hospitalized about 9 or 10 times for od-ing on meds and etoh and bad cutting on my forearms, etc....for now, I am seeing a meds psychiatrist, but here in Va there are v e r y few MD's who do therapy....having had a horrible experience with a female psychologist years ago, I swore I would never go to a female or a non- md again. But I guess here I have no choice, it will have to be a male PhD....when I finally get myself to do it. I am sorry for the rambling, thank you for "listening",
and thank you so much for your blog,
sincerely, tracy in va

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i found this article very h... (Below threshold)

May 10, 2007 9:16 AM | Posted by Lee: | Reply

i found this article very helpful. i have been involved with a borderlne for two years now. one day she just up and left. very very blank and cold look in her eyes. no remorse at all. she is hiding from me and seems affraid. she took of with a guy she just met. was saying i might not take her back when this is all over. its a cycle she said. the fleas part is so true. i to am showing symptoms of he illness. what should i expect next? will she try to come back? its been almost 2 months.still had a hard time getting her to remove her stuff. all i wantis for her to get help. if i had only known her illness before. i do want her happy.she was under a huge amount of stress when she cracked. she just lost a loved one a few months ago.please help me understand what is going on. the shoe thing was also helpful. never met a girl with so many. and the changing of hair color. i know she was splitting and i got caught on the neg side. i did take care of her while we were together. i kept the household in order and all. she kept saying she needed me. help, just please give me some insight as to what comes next!!!!!!!?

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i am a doctor and was worki... (Below threshold)

May 25, 2007 2:16 AM | Posted by andy geddes: | Reply

i am a doctor and was working in a prison until a few years ago (working as a medical officer there, and going home in the evenings, not working making licence plates.) i had developed the concept while i was there that there was really no difference between the borderline personality and the antisocial personality.

(i am by the way very critical of DSM overall and its handling of personality disorders is poor. it is a inadequate way of describing the conditions, and makes no attempt at all to understand them. however, when in rome...)

both have the same lack of identity, lack of self respect, dependency on others for all their emotional support. the difference is the borderline directs any failings to cope internally and the antisocial directs it externally. if you remove the borderlines inhibitions (typically using alcohol) they behave much like an antisocial. and if you remove the antisocials capacity to act out they retreat internally and become borderline. underneath the behaviour (which is what is typically used to define the conditions) they are basically the same.

not sure how narcissism fits in to it all. i suspect these three (which make up the 'cluster B' personality disorders) are similar in that they all driven ultimately by the persistence of very immature defense mechanisms due to an early life that failed to help them actually grow up.

wonderful blog.

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Re: BPD being comparable to... (Below threshold)

June 27, 2007 10:28 PM | Posted by tcb: | Reply

Re: BPD being comparable to anti social pd. These are POLAR OPPOSITES !!! The root of anti-social pd is a complete lack of ability to empathize. People with BPD are extremely sensitive and have an almost super human ability to empathize with others.

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