I am Sam Vaknin, and I am the author of Malignant Self-Love, Narcissism Revisited.
The fact that borderline personality disorder is often found among women makes it a controversial mental health diagnosis.
Some scholars say that it is a culture-bound pseudo-syndrome invented by men to serve a patriarchal and misogynistic society.
Other scholars point to the fact that the lives of patients diagnosed with the disorder are chaotic and that the relationships they form are stormy, short-lived and unstable.
Moreover, not unlike compensatory narcissists, people with borderline personality disorder often display labile, wildly fluctuating sense of self-worth, self-image and affect. Their expressed emotions are all over the map.
Like both narcissists and psychopaths, borderlines are impulsive, they are reckless. Like histrionics, their sexual conduct is promiscuous, driven and unsafe.
Many borderlines binge eat, gamble, drive and shop carelessly, and they are substance abusers.
Lack of impulse control is joined with self-destructive and self-defeating behaviors such as suicidal ideation, suicide attempts, gestures of rage and self-mutilation or self-injury.
The main dynamic in borderline personality disorder is abandonment anxiety. Like codependents, borderlines attempt to preempt or prevent abandonment both real and imagined by their nearest and dearest.
They cling frantically and counter-productively to their partners, mates, spouses, friends, children or even in extreme cases, neighbors.
This fierce attachment is coupled with idealization and then swiftly and mercilessly devaluation of the borderline’s target.
Exactly like the narcissist, the borderline patient elicits constant narcissistic supply.
The borderline craves, needs and seeks attention affirmation, adulation and approval. She needs all these in order to regulate her gyrating sense of self-worth and her chaotic self-image, in order to shore up serious, marked, persistent and ubiquitous deficits in self-esteem, in order to get her ego functions going and in order to counter the knowing emptiness at her core.
Borderline personality disorder is often co-diagnosed. It is comorbid with mood and affect disorders.
But all borderlines suffer from mood reactivity. Borderlines shift dizzingly between dysphoria, sadness or depression and euphoria, manic self-confidence and paralyzing anxiety, irritability and indifference.
This pendulum is reminiscent of the mood swings of bipolar disorder patients.
But borderlines are much angrier and more violent than bipolar. They usually get into physical fights, throw temper tantrums and have frightening rage attacks.
When stressed, many borderlines become psychotic though only briefly psychotic micro-episodes. They develop transient paranoid persecretary ideation and they have ideas of reference. They harbor the erroneous conviction that they are the focus of derision and malicious gossip.
Dissociative symptoms are not uncommon in borderlines. They lose stretches of time or objects and they forget events or facts with emotional content.
Hence the term borderline, first suggested by Otto Kernberg.
The borderline personality disorder is on the thin border line separating neurosis from psychosis.
