Lecture by Sam Batnin on Borderline Personality Disorder and Psychopathy

Introduction

• Sam Batnin, author of Malignant Self-Love, Narcissism Revisited
• Focus on Borderline Personality Disorder (BPD) and its relation to Psychopathy

Key Points

• Borderline Personality Disorder vs. Psychopathy

  • Common belief: Borderlines are the opposite of psychopaths (emotional, empathetic, dysregulated vs. unemotional, goal-oriented)
  • Emerging view: Borderline and histrionic personality disorders may be female manifestations of secondary psychopathy
  • Secondary psychopathy: A variant of Antisocial Personality Disorder (APD)
  • Factor 2 in the PCLR test measures secondary psychopathy
  • Recent studies support this view

• CPTSD Survivors and Psychopathic Behaviors

  • Survivors of Complex Post-Traumatic Stress Disorder (CPTSD) also display psychopathic and narcissistic behaviors
  • Psychopathic behaviors in CPTSD survivors are transient, unlike in BPD individuals

Characteristics of Borderline Women

• Intimate partners observe traits such as:

  • Impulsivity
  • Defiant grandiosity
  • Antisocial and aggressive behaviors
  • Manipulativeness
  • Dysregulated emotionality, paranoia
  • Lack of object constancy (out of sight, out of mind)
  • Attachment dysfunctions, hostility
  • Splitting (black-and-white thinking)
  • High levels of anxiety, depression, and substance abuse

• Gender Roles and Behavioral Norms

  • Borderline women often defy traditional gender roles
  • Exhibit more masculine behaviors and ideologies

Dissociation in Borderline Women

• Borderline women dissociate under stress or inner turmoil (guilt, shame, abandonment fears)
• Dissociation includes depersonalization, derealization, and amnesia
• Behavior becomes malicious and malevolent during dissociation
• Partner interactions can become abusive, devolving into cruel mind games and sadism

Similarities with Dissociative Identity Disorder (DID)

• Dissociative reactions are common in BPD, DID, and PTSD
• Dissociative experiences can feel like being on autopilot
• BPD may be viewed as a form of DID with mood lability and emotional dysregulation due to changes in self-states
• Triggered by abandonment or perceived rejection
• Severe dissociation included in BPD diagnostic criteria (criterion 9)
• BPD can lead to antisocial, impulsive, and aggressive behaviors

Differences Between Borderlines with Psychopathic vs. Non-Psychopathic Self-States

• Borderlines with psychopathic states are often lone wolves, more avoidant, and lack social contacts
• Borderlines with grandiose states seek company and cannot survive without an intimate partner

Control Over Behaviors

• Individuals with BPD and DID can control their alters' behaviors
• Courts worldwide do not accept BPD or DID as a defense

Reactivity to Sexual Situations

• Narcissistic and histrionic individuals may react with psychosis to unwanted sexual advances or unmet sexual desires
• Acting out includes reckless behaviors like unsafe sex, binge drinking, and reckless driving

Integration of Diagnoses

• Dissociation and trauma are foundational in BPD, narcissism, and psychopathy
• Need for a unified diagnosis model focusing on trauma and dissociation
• Suggesting a consolidated diagnosis: Personality Disorder with various emphases (grandiose, psychopathic, histrionic, dysregulated)

Conclusion

• BPD, psycopathy, and narcissism are post-traumatic conditions involving dissociation
• Future research and models should focus on trauma and unified diagnostic criteria