Tip: click a paragraph to jump to the exact moment in the video. Borderline Personality Disorder

1. 00:00 Could you speak to the cohort of of women and mothers who do not shed the diagnosis and whose behavior only intensifies as they age, which I find to be the case with adult children of my cohort, my generation and older and and I think a lot of this predates the the constant
2. 00:18 conversation in the culture of psychotherapy, cognitive behavioral therapy, dialectical behavioral therapy. What are the coping mechanisms for adult children of borderline mothers w when the mother’s behavior only solidifies and intensifies?
3. 00:33 When the mother’s behavior solidifies or intensifies, she is very likely not a borderline or at least not a pure borderline. As you have indicated, she’s likely to suffer from other co-orbidities which do worsen with age. Um so for example, she’s very likely to
4. 00:51 be a narcissist as well. Nar narcissism does not am ailarate or mitigate with age with the exception of antisocial behaviors. All other features of narcissism become worse. So fascinating. So it’s a it’s very extremely likely actually that this kind of person has
5. 01:10 actually shed the borderline part but has remained with the narcissistic part and now the narcissism is glaringly ostentatious and obvious. And that makes the situation a lot worse. We have an identical situation with dementia. You’ve mentioned dementia. Dementia. Yeah.
6. 01:28 In dementia, certain cluster B personality disorders become much worse. For example, if you are diagnosed with narcissistic personality disorder and then develop dementia, your narcissism would be accentuated and become much much more deletious and egregious.
7. 01:47 So this is exactly what happens with borderline. The borderline is reduced somehow, amilarated, mitigated softens, the soft edges while the narcissism, the psychopathy because psychopathy is also very common with borderline. Um other histrionic histrionic
8. 02:06 personality disorder which is also very common in border. All these all these survive the borderline and then fascinating. Yeah. The borderline is consider think of the borderline as an invisibility cloak. So there’s this invisibility cloak and when it’s tossed away what’s
9. 02:24 left is the wizard of oz behind the curtain. Then you see the true face of the individual. You know the narcissism, the histrionic personality disorder, the psychopath. Definitely. I see those in my own mom. Um and psychopathy. Can you just speak to a little bit of that as a
10. 02:41 co-orbidity? Because I think when people hear psychopathy they think one thing and that is the extreme end of psychopathy which is you are a hardened criminal if not a serial killer. But does psychopathy exist on a spectrum? Well, yes. The overwhelming vast
11. 02:59 majority of psychopaths have nothing to do with serial killing, not even as a hobby. And they actually um cope well. Um they they’re pillars of the community. There are chief executive officers. For example, there are stud studies by babyak and hair uh which have
12. 03:18 demonstrated that the prevalence of psychopaths among chief executive officers surgeons in operating rooms is much higher than in the general population. So most psychopaths are functional, pro-social, socially adaptive and so on so forth. The only difference between a
13. 03:37 psychopath and a healthy person is a psychopaths would tend to be goal oriented. They would lack empathy and therefore they would be callous, reckless, unscrupulous and immoral. That’s one reason why there’s a debate whether psychopathy is a mental illness at all.
14. 03:55 Oh, that’s fascinating. Yeah. Yeah. That’s fascinating. In in in the case of borderline personality disorder, coming back to the topic, the coorbidity with antisocial personality disorder, which is a clinical name for psychopathy, the co-orbidity is pretty
15. 04:09 high. Actually, there are some learned guesses that about one in three border lines would also be a psychopath. And I would love to talk to you about this a little bit just because you know again in the case of you know my mom is the template for the idea of the difficult
16. 04:26 mother, the borderline mother. She could be in public at events, at family gatherings, even dealing with strangers. The charm would just come on like that. Extremely charismatic, has a gravitational pull. people just wanted to be around her, be near her. Even if
17. 04:45 she could be outright, clearly mean, say something mean, people would laugh it off like, “Oh, that’s just Mary, you know, she’s that’s how she is.” And then the child becomes, I think, even more confused because they see the mother interfacing with the rest of the world
18. 05:02 as this lovely, charismatic, just magnetic personality. And behind closed doors, the child is acted to the opposite. And what what happens is the child becomes very confused. I’m speaking about myself. Who would believe me when I say that behind closed doors
19. 05:20 my mother can be a monster? Well, first of all, I hate to break it to you, but you’re describing a psychopath, not a borderline. Uh, one of the key diagnostic features and clinical features of psychopathy is superficial charm and glibess. It’s a key feature which
20. 05:38 it’s also a key feature of narcissism right uh to a much lesser extent really it’s actually the antisocial dimension in narcissism it’s definitely psychopathic um but coming back to to your question I tend to digress and I apologize but coming back to your question
21. 05:55 um the main message that such a mother conveys to her child is something’s wrong with you something is wrong with you other people love me you don’t you or other people behave one way, you’ll behave another way. You are incapable of making me feel good, you’re incapable of
22. 06:12 making me happy. You are. So there’s always a message, an underlying message of your failure, you’re constantly failing me, you’re a disappointment, you’re Mhm. And so if you happen to be the scapegoat and not the golden child, and these are
23. 06:29 transitory roles, by the way, but if you have Exactly. I was often a scapegoat. I was often a golden child. I will say my mom did a lot of things right with me and encouraged me in so many ways but there were other times where there was nothing
24. 06:42 I could do to satiate her need for love and attention that is what I’ve mentioned earlier the approach avoidance repetition compulsion that’s the inability to actually reach a plateau of intimacy and so on when you gratify when the child gratifies such a
25. 07:02 mother when the child meets the mother’s expectations and needs is she feels suffocated. She feels threatened because in her mind she’s expected to reciprocate and she’s unable to reciprocate and so she feels that she’s being set up for failure or that she’s being framed
26. 07:23 somehow or she and at that very moment she flips and she becomes she renders the child a psecary object. She renders the child an enemy in her mind. someone who is challenging her actually to be a good mother. And so wow, the child can never win. And con
27. 07:43 consequently the child develops what we call in psychology or in some schools in psychology an internalized bed object a voice or a set of constellation of voices in the child’s mind that inform the child that he is or she is unworthy inadequate a failure perhaps also ugly
28. 08:05 and stupid definitely disappointing and so on so forth. And this constellation of voices, they’re known as introjects. You carry them with you for the rest of your life. You may kid yourself. You may kid yourself that now you have you have recovered somehow. That you have a lot
29. 08:23 of self-esteem and self-confidence. You’re an accomplished person and so on. But these voices are inside you and they’re undermining you and they’re corroding you and they’re not letting you