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1. 00:00 No text professor Sanwakn day again and he is a pioneer of narcissistic abuse and the
2. 00:06 author of malignant self love and I hope this will be translated in Turkish soon
3. 00:12 and today we will talk about narcissism narcissistic personality disorder and borderline personality disorder because
4. 00:19 in society they are confusing these illnesses first can we talk about the
5. 00:25 narcissistic personality disorder and the differences between borderline yeah
6. 00:31 thank you for having me good morning Shanim and um a warning this is going to be a long
7. 00:39 answer because uh there's a lot to to say mhm you're completely right that
8. 00:45 there is a huge confusion between borderline personality disorder and narcissistic personality
9. 00:51 disorder and why is this important because many victims of narcissistic abuse actually have borderline
10. 00:58 personality disorder and many abusers actually have borderline personality disorder not
11. 01:05 narcissistic personality disorder and if you get it wrong as a clinician or as a
12. 01:11 member of a public or as a victim even then the whole attitude uh is wrong and
13. 01:17 the outcomes are wrong a proper diagnosis is the precondition for
14. 01:25 healing of course but also for management to manage a relationship to manage a therapeutic process to manage an interpersonal interaction to manage the workplace you need to diagnose people correctly mhm the differences between borderline personality disorder
15. 01:42 narcissistic personality disorder are not small they're pretty substantial so first of all um borderline personality disorder was first described
16. 01:53 by Adolf Stern in 1938 long time ago he didn't call it borderline personality disorder he called it the borderline group so this was adult in 38 then
17. 02:07 No text between the the 1930s and the 1980s there were many studies about borderline
18. 02:13 personality disorder was the heyday of uh these studies and so we had people like uh Otto Kenberg and others and we had of course Koh on the side of Nar
19. 02:25 narcissism and at that at that point in time um many prominent scholars believe that there is a deep
20. 02:38 relationship between borderline personality organization borderline features borderline traits borderline behaviors borderline dynamics and narcissism they believe there believe
21. 02:50 that there is a profound ethological connection in other words something that leads to both conditions emerging
22. 02:57 simultaneously kendrick suggested that borderline um is a defense uh sorry narcissism is a
23. 03:06 defense against borderline he said initially the person develops borderline and then it's terrifying and so the person defends against the borderline condition by becoming a narcissist then
24. 03:19 every narcissist can be also borderline we can say like this not every narcissist can be borderline because No text once you acquire the narcissistic defenses they take over and they
25. 03:29 eliminate the borderline okay there are of course people who are both borderline and narcissist mhm of course there is
26. 03:36 what we call a coorbidity all the line of narcissism it is not 40% like self-study experts are saying there's a lot of nonsense online one should be very careful but yeah
27. 03:48 there is a coorbidity of of this kindstein who was another psychonalist
28. 03:54 suggested that a child who is exposed to abuse and trauma becomes more and more
29. 04:01 borderline and then at some point the child says I cannot tolerate this borderline condition i want to become a
30. 04:07 narcissist mhm and the child attempts to become a narcissist if the nar if this
31. 04:14 transition from borderline to narcissism fails the child remains stuck in the
32. 04:20 borderline phase and will develop borderline personality disorder if it
33. 04:26 succeeds the child will eliminate the borderline defend against it very efficiently bury it in the unconscious and will become a full-fledged narcissistic person mhm and that's why
34. 04:39 Grotstein says that the borderline is a failed narcissist someone who tried to become a narcissist and failed so this No text is generally the general overview of the connection between it but when we when we look at the clinical picture when someone comes to a clinic Mhm to get
35. 05:00 some therapy or when someone needs to be diagnosed for example in court settings or in prison or when someone needs to be um um has undergone some kind of massive crisis and needs to be diagnosed what we do we look at what we call clinical
36. 05:16 features we look at behaviors we look at dynamics we look at emotions we look at cognitions and so on so forth and now I
37. 05:22 will go into the differences between the two conditions we start with the elements of borderline
38. 05:31 which exist in all types of borderline there is no borderline there is no
39. 05:37 borderline personality disordered patient alive without these features
40. 05:44 there are other features which appear in some border lines and don't appear in
41. 05:50 other border lines but the ones I'm going to describe right now appear in all border lines so the first thing
42. 05:57 is emotional volatility emotional disregulation um this is called
43. 06:04 effective effective instability that is when emotions negative and positive overwhelm the borderline disable the borderline the
44. 06:15 borderline becomes paralyzed mhm it's it's as if the borderline perceives emotions as threatening and then the borderline freezes she she freezes mhm
45. 06:28 and uh it's a kind of defense against this uh this situation so all border lines have this all border lines cope No text very badly with emotions emotions disable paralyzing the second element which is
46. 06:42 common to all border lines is mood moodability ups and downs cycle cycling and so on now this is not to be confused with bipolar disorder in bipolar
47. 06:53 disorder we also have cycling between depression and mania or elation or
48. 07:00 euphoria so we have this but there there massive big differences between bipolar
49. 07:06 disorder and borderline personality disorder they are not the same condition as many many Europeans so-called
50. 07:14 scholars and so-called clinicians they make this mistake very often i I was in Austria recently and uh I'm sorry to say but the pro the so-called professionals
51. 07:26 there confuse BPD and bipolar mhm so this is very serious confusion bipolar
52. 07:32 disorder is a mood disorder and the difference between bipolar disorder and BPD is that the cycles of
53. 07:40 depression and mania are much longer in bipolar they can last months sometimes years whereas in borderline personality disorder the cycles are much much faster
54. 07:51 and typically they are between 4 hours and 4 days but never longer
55. 07:57 second difference the sleep patterns in uh in bipolar disorder are dramatically
56. 08:04 different to the sleep patterns in borderline in borderline the borderline
57. 08:10 patient finds it very difficult to fall asleep finds difficult to maintain sleep
58. 08:16 as insomnia and so on whereas the bipolar patient simply does not want to
59. 08:22 sleep it's is against sleeping doesn't want to sleep they resist sleeping in the money No text phase the bipolar resists sleeping does not want to sleep and in the depressive phase of bipolar disorder the patient is hyperomniac in other words sleep this
60. 08:40 kind of patient sleeps 20 hours a day that is in bipolar mhm not in borderline
61. 08:46 in borderline there's a constant state of sleep dysfunction constant state of insomnia or you know the sleep is always disturbed in the same
62. 08:57 way so modability next thing is the intensity of the
63. 09:03 interpersonal relationships here is a major source of confusion both the borderline and the
64. 09:12 narcissist idealize Mhm over value and then devalue both of them the same cycle
65. 09:19 same cycle identical the rel the interpersonal pattern of relationship in
66. 09:25 borderline is indistinguishable totally identical to the pattern of relationship
67. 09:31 in narcissism they cannot be told apart mhm however what is different is the
68. 09:40 intensity whereas in narcissism the shared fantasy dictates the cycle of the
69. 09:47 relationship is very robotic very automatic mhm it's as if the narcissist is going through the motions is not really in it he's not
70. 09:58 really involved in it he's like acting it's like going through okay phase two okay phase three what can I do i have to
71. 10:04 go through it is it's it's as if the narcissist is one step removed from the
72. 10:10 relationship he's like observing maybe the relationship or so you could see in in narcissism a pattern of detachment whereas in borderline the relationship
73. 10:21 is super intense the intensity is enormous it's fire it's brimstone it's
74. 10:27 uncontrollable it's dramatic super dramatic it's so this is common to borderline actually not to narcissist and the intensity is a differentiating feature between narcissism and and borderline but in this relational
75. 10:44 disorder this is called relational disorder in this relational disorder the borderline also starts by love bombing
76. 10:52 devaluing idealizing and then devaluing the the partner in this sense it's the same
77. 11:00 um the splitting defense in borderline is the same as a splitting defense in narcissism so that's what allows the borderline to idealize you're all good
78. 11:11 you can do no wrong you're perfect you're amazing you're unprecedented i've never had anyone like you and so on and
79. 11:18 then immediately transition to I hate you you're horrible you everything you do is wrong and they're all real
80. 11:24 emotions at that time all this is perceived as authentic or or ego not ego alien ego congrent so the
81. 11:33 the borderline perceives all this as real coming from the inside and and so
82. 11:39 on and so forth but in her case in the in the case of the borderline it's much more as I said dramatic and intense than
83. 11:47 in the case of the narcissist and this is why it's very difficult for victims of narcissistic abuse because the
84. 11:54 narcissist treats treats you when you're the intimate partner treats you as kind of object you're objectified kind of he
85. 12:03 will love bomb you and idealize you and but you always have a feeling that it's not really about you the idealization in
86. 12:10 the case of narcissism is about the narcissist and about the about the process the narcissist is like invested
87. 12:17 in the process not in you it could be anyone there's a feeling that it could have been anyone it didn't have to be me
88. 12:24 as the intimate partner but it could have been anyone and and very often victims of narcissistic abuse discover that the narcissist repeats the same pattern with the same behaviors with the
89. 12:36 same sentences with the same words with multiple potentials at sometimes at the
90. 12:42 same time at the same time because there's no no attachment there's no what we call cexis there's no emotional
91. 12:48 investment whereas in borderline the emotional investment the cexis is very clear very powerful overwhelming
92. 12:55 consuming it the drama is oper opera oporatic you know like opera it's it's a production some major production and so on so forth
93. 13:06 um in borderline we have something that we don't have in narcissism and that is
94. 13:12 what we call the twin anxieties we have a combination of abandonment anxiety by the way abandonment anxiety
95. 13:19 is or separation anxiety is not the clinical term the clinical term is separation insecurity so we abandonment
96. 13:27 anxiety on the one hand and we have uh engulfment anxiety so what happens with
97. 13:33 the borderline she seeks intimacy she she wants love i say she let it be clear
98. 13:40 half of all border lines are men mhm and half of all narcissists are women mhm but I'm using she because of historical reasons so the borderline would look for love for intimacy for immersion for merger for fusion for symbiosis a a twin flame
99. 13:56 a soulmate you know a reflection a copy a clone she would look for something
100. 14:02 like that and then uh she would approach and she would exper she would
101. 14:09 experience this reaction from the partner mhm and if the partner
102. 14:15 No text reciprocates provides this intimacy affords this love Mhm the borderline
103. 14:21 panics she panics she feels suffocated she feels shackled imprisoned she feels
104. 14:28 she's dying and then she runs away avoidance so we call it approach
105. 14:34 avoidance repetition compulsion because it's compulsive she cannot help it so the borderline on the one hand has severe abandonment anxiety she's terrified of rejection of being ignored of criticism or exactly like the
106. 14:50 narcissist in in this sense but she has something the narcissist does not have engulfment anxiety and con consequently
107. 14:58 she cycles and so this is the famous uh I hate you don't leave me i hate you
108. 15:04 don't leave me yeah when relation is very good and very nice then one type of No text anxiety starts when the relation is going bad another type of anxiety she's always in anxiety always anxiety is the background background noise of um
109. 15:22 borderline borderline is constantly anxious she anticipates rejection
110. 15:29 humiliation abandonment and she panics mhm and then she behaves in ways that cause the abandonment because she becomes clinging or she becomes aggressive or she becomes demanding
111. 15:41 but if this doesn't happen if she has no reason to anticipate rejection and abandonment because the partner is in love and you know then she panics because that means she's going to
112. 15:51 disappear borderline is about merger about fusing with the partner becoming one with the partner like going back to
113. 15:58 the womb it's symbiotic it's creating a single organism with two heads this is a
114. 16:04 terrifying experience because it means that she has to disappear the borderline hands over outsources her
115. 16:11 mind to the intimate partner she tells the intimate partner from this moment on you have perfect control over me you can
116. 16:18 regulate my moods you can make me happy you can make me depressed i'm giving you this power you can regulate my emotions
117. 16:27 a smile from you would change my emotions uh if you criticize me you can change my emotions so you have total power over me she hands over agency total power mhm and that of course
118. 16:39 creates panic because if someone is in total control of you total ownership of
119. 16:45 you someone is your master that means you're the slave mhm means you're a slave and that is a terrifying uh No text thought because what if the partner suddenly loses interest or abandons you what if a partner is evil and is going to abuse this access and this power and
120. 17:04 torture the borderline there are all kinds of scenarios the borderline is enormous imagination all kinds of
121. 17:11 scenarios and she panics and she runs away she destroys she undermines the relationship she sabotages the relationship in a variety of ways she could cheat she could engage in
122. 17:22 infidelity she could triangulate she could triangulation means you introduce a third party into
123. 17:28 the relationship and in order to provoke the the intimate partner she could um
124. 17:34 she could literally undermine and sabotage the goals of the intimate partner she could even uh place the
125. 17:41 intimate partner in in at risk by I don't know going to the police or to the tax authorities and snitching on the
126. 17:48 partner there's no end to what she can do then she can give harm to the person No text also one way to get rid of the one way one way to get rid of the relationship
127. 17:59 is to get rid of a partner a border when you get rid of a partner there's no relationship it is the relationship that
128. 18:06 threaten that threatens the the borderline another thing in borderline which is
129. 18:13 less common in narcissism is anger not necessarily rage but anger
130. 18:20 with narcissism we have narcissistic rage but narcissistic rage is reactive if you disagree with a narcissist criticize the narcissist humiliate the narcissist and so on so forth the
131. 18:32 reaction might be might be not always narcissistic rage mhm in borderline the background is anger like anxiety exactly like anxiety the anger
132. 18:44 is always there very close to the surface is very easy to provoke the the
133. 18:50 borderline and she is constantly angry and this anger manifests in in outbursts
134. 18:57 but she can also be passive aggressive or she can be angry as a state of mind she could be constantly angry it's an angry person you know anger is a is a crucial element in u in No text borderline it's inappropriate and it's uncontrolled and it defines the
135. 19:16 borderline and finally another psychological feature of all border
136. 19:22 lines so everything I just described is is common and valid for all border lines basic border lines all types yes these are the the clinical features which are common to all border lines so um and the last one is emptiness the borderline
137. 19:38 feels empty inside she feels a void she she feels like she is a black hole and
138. 19:44 she has to fulfill this emptiness somehow so some of them fulfill the emptiness with theatrics and dramatics
139. 19:51 some of them feel fulfill the hope hope to fulfill the emptiness via the intimate partner this kind of borderline
140. 19:59 might say you are my world you are my life I'm living for you mhm you know uh
141. 20:05 the borderline develops a multiplicity of techniques to cope with the emptiness
142. 20:11 and to fulfill it somehow because the alternative is to experience the emptiness which leads usually to self harm self mutilation cutting and so on
143. 20:24 and suicidal ideiation depending on the population of border lines between 3% and 11% of No text border lines um die of suicide that's a huge number it means that one
144. 20:37 of every 10 border lines would end his or her life um and that is the leading
145. 20:43 cause of death among border lines suicide not cancer not hearted but suicide okay so these are the core features of
146. 20:54 border now let's talk about other clinical features which are common but you could be a
147. 21:01 borderline without them mhm these clinical features you could be diagnosed with borderline and not have these features you cannot be diagnosed with borderline unless you have the features that I mentioned until now these are um
148. 21:15 minimum requirements to be diagnosed but now there's many others and we'll talk about we'll talk about them um again i
149. 21:21 will compare all the time to narcissist yes okay number one is identity
150. 21:27 disturbance or identity diffusion uh the borderline's identity
151. 21:33 is not stable so on Monday she has some values
152. 21:39 she has some beliefs she's committed to a certain course of action she has plans for her life uh she has attitudes she has motivations that's on Monday on
153. 21:51 Wednesday she will be the exact opposite on Monday so on Monday she could she could say people who cheat on their spouses should be executed i hate cheating there's nothing worse than infidelity then on Wednesday she will go to a bar she will pick up a stranger and
154. 22:08 she will cheat with him uh she so that's an example of what we call axiological shift shift in
155. 22:15 values but also believes she can say on Monday I believe in God uh definitely
156. 22:22 God is managing my life i find solace and comfort in God and so on and then on
157. 22:28 Wednesday she will espouse the most extreme form of atheism and and so there
158. 22:34 no stability not in values not in beliefs not in attitudes not in motivations not of course her plans
159. 22:40 change all the time on Monday she wants to go to study agriculture on Wednesday she decided to be a mathematician and on
160. 22:47 Friday she would be a traditional wife and housewife of course until next Monday when she would want to become an
161. 22:54 astronaut yeah uh are they aware of the shiftings not really because u one major problem No text
162. 23:02 with borderline and that is opposed to what people believe is that border lines
163. 23:08 are egoonic in other words border lines feel comfortable Mhm with who they are no now that's very import uh important distinction a borderline might feel guilty or ashamed
164. 23:22 for what she had done she might also feel distressed disappointed and angry because of the
165. 23:29 consequences of her actions the outcomes but when it comes to herself
166. 23:36 she feels good with who with who she is she's egoic mhm she actually is grandio
167. 23:42 borderlands are grandios exactly like narcissist so she would regard herself as superior in some way super super
168. 23:49 beautiful drop dead gorgeous she's gorgeous and you drop dead um you know all kinds of she would aggrandise herself in her own mind and so she is egoonic and in her mind these shifts in
169. 24:02 identity this cataclysmic transitions are fully justified she would say for
170. 24:09 example yeah I wanted to study agriculture on Monday but then I did some search online and there's no future
171. 24:15 in this so that's why now I want to be an astronaut i think astronauts will go to Mars with
172. 24:21 Elon Musk and so I want you know this kind of thing they should invent some excuses very easily yeah some story No text okay so identity diffusion or identity disturbance is pretty common in border lines but not all in all next is
173. 24:39 dissociation more extreme border lines border lines where the personality organization is seriously disturbed
174. 24:47 seriously where actually the personality is not put together at all is kaleidoscopic broken shattered fragments
175. 24:54 you know this kind of borderline the extreme end of the spectrum would pro would usually have dissociation she
176. 25:01 would dissociate when she finds herself in a situation of stress or extreme anxiety for example when she anticipates um rejection or humiliation or experiences abandonment or in these conditions she falls apart she goes
177. 25:17 through a process called decompensation all decompensation all the defenses
178. 25:23 crumble or or disabled and she remains without a skin it's like she doesn't have a skin she's in direct touch with reality and has no defense no firewall nothing at that point she has essentially um only one option she acts
179. 25:41 out she externalizes aggression in some way there's a lot of aggression anger that boiling and building and so on there's a lot of fear anxiety and so to
180. 25:52 somehow get rid of these emotions she would act out she would do something crazy mhm but because whatever she is
181. 26:01 about to do is socially unacceptable and she hates some of her actions she would
182. 26:07 later feel bad guilty ashamed she knows it so she would do it and forget about it but I mean forget not she's not pretend pretending she simply is not
183. 26:18 there so we have three types of dissociation in borderline we have amnesia simply forgetting what happened so she could sleep with a stranger you know on a one night stand
184. 26:30 and she would not remember it even when she's confronted with evidence and so on she would be shocked she would not have
185. 26:36 no recollection of the event even when she's not drunk um she could derealize derealization is
186. 26:45 when she go she does something but it feels like a movie it feels unreal mhm mhm and depersonalization is when she No text does something but she feels that she is not there so her body is there and someone is penetrating her or doing something to the body she has left her
187. 27:05 body she is not there so these are all forms of dissociation and dissociation is common
188. 27:12 in more extreme cases similarly in more extreme cases we have a very dangerous process actually which is paranoid ideiation more extreme border lines
189. 27:25 become paranoid easily and then when they become paranoid and because borderline is a
190. 27:31 disorder of aggression when they become paranoid they become positively
191. 27:37 dangerous absolutely dangerous if they if the borderline identifies you as as a threat she may wish to take you out somehow poison you kill you do something you know just to reduce the anxiety so
192. 27:50 externalized aggression in extreme borderline is anxolytic it reduces
193. 27:56 anxiety mhm none of the things I described applies to narcissism narcissists don't have identity
194. 28:03 diffusion at least not in the borderline way they don't they they don't
195. 28:09 dissociate narcissists don't dissociate only under stress like borderline they dissociate all the time uh narcissists have paranoid ideiation but only when
196. 28:20 they collapse mhm the paranoia is a form of grandiosity i'm important people are
197. 28:26 conspiring against me people have malevolent intentions because I'm very crucial i'm very superior people envy me so they want to So this is the the No text narcissism type of paranoia but in narcissism paranoid ideation is pretty limited to the collapse and is never
198. 28:44 aggressive mhm paranoia would not lead the narcissist to act against
199. 28:50 anyone um and so the differences are very important next is the fact that both narcissists and border lines
200. 29:02 have a false self this is something that people don't know they think only narcissists have a false self it's not
201. 29:08 true the borderline also has a false self and similarly the borderline is
202. 29:14 grandiose exactly like the narcissist and similarly she has a fantasy exactly like the narcissist so what's the difference these are critical features in narcissism and if the borderline has
203. 29:25 all of them maybe maybe it's true that borderline is a narcissist the answer is
204. 29:31 no because the content of the false self and the content of the fantasy and the
205. 29:38 content of the grandiosity are very very different dear dear fantasy to narcissism yes whereas in narcissism the
206. 29:46 fantasy is about the narcissist the grandiosity of the narcissist the the fantasy in narcissism is what we call selfenhancing it's a fantasy that makes No text the narcissist bigger in some way more intelligent more so a narcissist could
207. 30:02 have a fantasy that he's a genius there will be a classical cerebral narcissist fantasy or a narcissist could have a fantasy that is sexually irresistible that's also a typical narcissistic
208. 30:13 fantasy but the fantasy is about self-enhancing the cognitive distortion
209. 30:19 the grandio narrative the grandio self-concept of the narcissist which is inflated and unrealistic and
210. 30:26 counterfactual in borderline the fantasy is about the partner not about herself
211. 30:33 the fantasy is not a reimagining of the borderline it's not about the borderline the f the typical fantasy of the borderline i found him i found the one
212. 30:45 he is going to be my rock now someone knows me like no one
213. 30:52 else someone um can therefore because he knows me and loves me because of course
214. 30:58 it's all dramatic the love is intense and amazing and never before and so on so now this person will be able to reach
215. 31:06 into my mind and regulate my emotions stabilize my moods and generally make me
216. 31:13 harmonious in harmony make me feel at peace with myself inner peace reduce my
217. 31:21 anxiety take away my anxiety i will not be anxious anymore wonderful i found instant therapy in the in the intimate partner so the border lines fantasy is
218. 31:32 exteriorized it's a fantasy about someone else can they fall in love very easily the narcissist can change their
219. 31:39 supply very easily can borderline do that too yes but uh both narcissist and border lines don't don't love this is not love it's their fantasy but as you
220. 31:50 said she thinks that she found the one she can find too many ones yes she can
221. 31:56 the difference between borderline and narcissist is the discard phase mhm whereas the narcissist discards
222. 32:04 off-handedly instantaneously and without any visible emotion just discards like so much trash you're no longer useful or you contradicted the shared fantasy or you criticized the narcissist or you deviated diverged from the internal object that represents you in the
223. 32:21 narcissist mind and so on so you're all bad you're devalued narcissist splits you your old bed and as an old bed corrupt object the narcissist throws you
224. 32:32 to the garbage the same way he would throw to the garbage a battery that is finished or a smartphone that's no
225. 32:38 longer working so the discarding narcissism is callous is cruel is cold
226. 32:45 is is is calculated objectifies the discarded person and so on whereas the borderline does not does not do it this way the borderline uh approaches and
227. 32:58 avoids and she would do it many many times before she gives up on the partner
228. 33:04 oh she would she would approach the partner and run away and come back and try again and she would doesn't give up on the partner very easily once she has
229. 33:16 given up on the partner she immediately finds an alternative exactly like the narcissist first they find someone and
230. 33:22 jump to another one not always they can give time sometimes yes