borderline or narcissistPerhaps you have been involved with someone who appears to be seriously interested in the relationship but who sometimes goes emotionally off the rails, lashes out at you, and becomes over-defensive. And what if they also have an exaggerated need for attention, over-react when criticized, and seem to shut you out for no reason?

Leaving aside the question of whether you should stick around, and assuming instead that you see some value in this person, you may be wondering whether they are exhibiting signs of a personality disorder. And if you think they are, you may begin to speculate as to whether the person is a narcissist or a borderline.

The common sense idea of these disorders is that the narcissist is self-absorbed, and controlling and the borderline is insecure, and unstable. In fact all of these things can be true of either type of personality disorder.

I would like to share my thoughts on the basic similarities and differences between these two disorders of the self and how they might affect relationships.

Disorders of the self

Disorders of the self, or personality disorders, have long been understood as enduring patterns of thinking, emotion and interpersonal functioning which result in poor coping mechanisms and impaired relating of one sort or another. These patterns were at one time called characterological and were seen as essentially unchangeable.
Thanks to the work of the late James Masterson MD and others, it now appears that these personality types are laid down early in life as ways to cope with the absence of necessary supports and supplies at a crucial time in the development of the personality.
It has only been in my lifetime that this understanding of problems related to childhood disruptions in attachment and individuation have come to be seen as in fact quite treatable. And the treatment technique for borderline personality disorder called Dialectical Behavior Therapy is well established and heavily evidence based.

The DSM 5 classifications list ten types of personality disorder, two of which are “Borderline personality disorder” and “Narcissistic personality disorder”. The common descriptions make them appear to be quite distinct:

Borderline personality disorder: Unpredictable, manipulative, unstable. Frantically fears abandonment and isolation. Experiences rapidly fluctuating moods. Shifts rapidly between loving and hating. Sees self and others alternatively as all-good and all-bad. Unstable and frequently changing moods. People with borderline personality disorder has a persuasive pattern of instability in interpersonal relationships.[27]

Narcissistic personality disorder: Egotistical, arrogant, grandiose, insouciant. Preoccupied with fantasies of success, beauty, or achievement. Sees self as admirable and superior, and therefore entitled to special treatment. is a mental disorder in which people have an inflated sense of their own importance and a deep need for admiration. Those with narcissistic personality disorder believe that they’re superior to others and have little regard for other people’s feelings.[29]

Similarities

Both of these disorders are the result of an incompletely formed sense of self. This results from poor or incomplete individuation. Healthy and secure separation from parents or caregivers means coming to see oneself as an independent being. The crucial time for this phase of development is thought to be around 18 months to 3 years (which coincides, quite logically, with the terrible twos).

Both narcissists and borderlines grow up needing to define themselves in terms of other people in order to feel viable. The narcissist constructs a facade or false self built on feeling and being seen as better than others. The narcissist depends on others to affirm his or her specialness and seeks out people and situations that support this illusion. The borderline attaches to another person who may be seen as a potential of savior. The other person is necessary in order for the borderline to feel safe from abandonment and to fill a void.

Both narcissists and borderlines lack the self-awareness of an “observing ego”. That is they have difficulty reflecting on what they feel or need or want and are likely to be dishonest, avoidant or manipulative rather than clear and assertive. They act from an incomplete sense of agency or efficacy and may be impulsive and unpredictable.

Underlying both personality disorders is the potential for a complete meltdown in the face of any major challenge to their fragile adjustment. Under serious stress, both types decompensate and can become essentially non-functional.

With the deflated Narcissist this can take the form of extreme rage, suicidal despair or sociopathic acting out or some combination of these. This is the disgraced tycoon or the politician with a secret fetish. The severely decompensated borderline becomes emotional and self destructive to the point that he or she may appear to be psychotic. This is the person who finds out they have devoted their life to a sham or that their hero has feet of clay. The flimsy sense of self has disintegrated leaving a feeling of anihilation and an inability to cope.

In a milder form these are normal responses to adversity or victimization. And certainly they can be responses to acute trauma situations in people with no pre-existing issues.

Differences

Does it really make a difference whether you are attempting to have a relationship with a narcissist or a borderline? Both are likely to have some serious challenges when it comes to sustaining healthy relationships. And both exist on a continuum of severity such that a more disordered person will be more difficult to relate to and less quick to find and accept help.

Since disorders of the self result from early attachment issues it may be less important to pin down whether the person is a narcissist or a borderline and more important to gain insight into their typical attachment style. Are they distancing and guarded? Insecure and clinging? Competitive and ego-driven? These outdated “survival skills” are based on the particular nature of the person’s early trauma combined with the developmental trajectory that followed.

To a great extent we all have patterns of relating that were laid down early but that may make no sense today. Part of having a meaningful relationship will be learning and growing stronger, together and separately.

If you are an intuitive person you will be able to see the signs of what went wrong in another person’s early bonding experiences. If you know their history, their parents and family, you may even have insights into how those relationships were distorted or problematic. Above all, do trust your own insights and let the person know what you observe. My best insights about my relationships with my family often came from a partner. We are often most blind to our own dysfunctional family relating.

Someone who is not open to gaining greater self awareness and resolving these issues will be a bad bet no matter what their actual diagnosis. As a starting point, the person needs to be committed to growth and open to input.

Find Dr. Hatch on Facebook at Sex Addictions Counseling or Twitter @SAResource