Tag Archive | personality disorder

PART II: WHAT HAPPENS WITH CHILDREN WHO WERE RAISED BY A NARCISSIST IN ADULTHOOD?

Family system good or bad influences our personality, the way we see the world and feel about ourselves. Unfortunately being raised by the narcissist parent is a tough spot to be in. You are probably dragging with yourself a very negative perception of you which influences a lot of areas in your life. In this article we will take a look on the hardships that comes from being raised by the Narcissist.

Pain from upbringing
Having to accept that your parent doesn’t love you like other parents love their children is the painful process. You have to grieve the loss of the parent you never had. Really grieve the fact that you didn’t get the love and support you needed. Part of that requires releasing the fantasy that your narcissistic parent can change and eventually give you what you need. They are unable to change. At least not to the extent that they would be able to give you genuine love. Sometimes accepting that can make your relationship with narcissistic parent bearable but there is nothing wrong with cutting all ties with your narcissistic parent.
Also we often forget about the other parent-the not narcissistic one. There is a lot of pain hiding there too. This parent was allowing the abuse to keep happening. He was the silent observer and didn’t protect you the way he should. Usually children defend this parent, because he was the safe haven while growing up. But in therapy after we deal with pain that was cost by narcissistic parent the new pain and anger emerge directed toward the other parent. Why didn’t you do something? Why you haven’t protracted me? “One of the most heart-breaking moments for me as a child was realizing that dad knew what was going on. After a bad beating from mom, he brought me a candy bar.”

Negative self-image
Children of narcissistic parents often wonder if they are really lovable. You distrust and devaluate your inner selves as nothing of value could come from inside. “I feel worthless and unlovable. If anyone shows affection, I know that they only do it because they want something in return.”
You are chronically unsure of themselves, and overly-worried about what others think of them. You feel insecure, because you never experienced unconditional love. “I fight the things I’ve been called almost every day, things like stupid, lazy, fat, drama queen, property, slightly mentally retarded, selfish, paranoid, hypochondriac, and more.”

Underdeveloped identity
Child raised in Narcissistic family is forced to ignore his own needs and desires. The boundaries between mother and child become so blurred. Not only that, the parent was not in tuned with the child and they labeled children’s emotions according to their own. That leaves behind the confusion of who I am, what am I feeling? Also child often don’t know how to read their own body because parent didn’t give the right words to emotions and body sensations. Person who is not connected with his feelings is puzzled by an ache in the heart, palpitations, shortness of breath and a churning in the stomach. They become dissociated from their feelings and bodily sensations and consequently often end up exhausted and ill.
Consequently, you don’t trust your instincts, and have trouble expressing your feelings. You worry that if you assert yourself you will risk losing love. Because you are so used to please others your identity don’t have the opportunity to fully develop. “I sense for a very long time that my body wasn’t my body. It could be abused, or I could be held down and tickled to crying point or made to dance for visitors. I’m still over-sensitive to being grabbed or pulled by anyone.”

Guilt and shame
Another major sign of being raised by narcissists is the constant feelings of guilt and shame. They are coming from inability to meet your parent expectations and being constantly humiliated. You can also experience chronic feelings of emptiness. To avoid this feeling you can escape to hyper sexuality or acting out (in a potentially harmful manner) for attention.

Avoiding error
Child of narcissist tries to avoid error even at a brand new or difficult activity. Some can be deadly afraid to go out of their routine.  Narcissistic parent teaches their child that there is only perfection or failure.  They believe that they should appeared perfect and with no need of help. Consequently they avoid taking chances because of the fear of (parental) judgment. They stay in the security of sameness.

Boundaries
Most likely you have poor interpersonal boundaries and inability to say “no”. People-pleasing is very common behavior. You are deeply afraid to speak up confidently or challenge others. You are going to need to discover boundaries, where you begin and your parent ends, to free your authentic self. When you choose who you want to be, rather than who your parents wanted you to be, you break free from their narcissistic grip.

Noticing the details
Like in Borderline families also child from Narcissistic family becomes attuned to the changes in the environment. “Changes in tone? Check. Micro-shifts in facial expressions? Noted. Gestures that contradict spoken words? Documented.” You had to be “emotion detective” in order to survive your childhood. You can be highly sensitive and intuitive to the needs of others, but you are also constantly on the lookout for what’s about to come. This can lead to taking on other people emotions and not being able to set a healthy boundary in adulthood. “I’m intensely aware of body language, and that comes from the ‘walking on eggshells’ life and trying to anticipate. It’s distressing when people are telling me one thing and their body language is telling another.”

Narcissist becomes Narcissist?
If you were a golden child there is a strong possibility that you will become a narcissist. You can turn out to be self-centered, have the compulsive need to be always right, you are unable to take criticism, demand perfection from others and yourself, you can become hypersensitive and continuous feel mistreated by others and you desperately need to be loved. If you grow up watching your parent exploit others, you can lack a strong moral compass and transfer this behavior to the people around you. “I’m ignorant. You may tell me things, and I will even ask you where you went on holidays, how long did it take you, who was with you – and 2 minutes later I won’t remember a thing. I learnt to block out the screams and nonsense that my mother tells me over and over again, and unfortunately, I now subconsciously do the same to the other people.”
Beside Narcissistic personality disorder, you can also develop other psychological disorder such as Borderline personality disorder, anxiety, depression, addiction or Schizoid personality disorder. “I self harm. During my life it varied, but included things like blade cuts, excessive masturbation, biting lips and gums.”
Beside psychological problems you can develop a bunch of (psycho) somatic issues like migraines, autoimmune disorders, chronic fatigue syndrome, and heart problems. Bottom line is trauma causes all kinds of physical and psychological problems. “I eat. I am morbidly obese. I would gladly trade for one of those addictions that don’t show so prominently, like workaholic or excessive exercising. But this is what I’ve got. I wish I could lay it down.”

(Romantic) relationships
Children from Narcissistic family often have unhealthy relationship. There are several aspect contributing to it:

  • All children are vulnerable in front of their parents but with horrible experiences child in Narcissistic family learns to keep to himself. The child is deeply hurt by the parent who uses his feelings for a personal gain. Consequently you learn that you can’t trust others with what is truly going on inside of you. “I can’t trust anyone. I don’t completely trust my girlfriend, I don’t trust my friends (I always think “Are they going to stab me while I’m asleep? Why does my girlfriend pretend to love me?”) even if there’s no reasons to think that. At work I do everything myself, even if there’s help available. Sometimes that means I’m a bit overloaded.”
    Often you are unable to tolerate your feelings as well. On the other hand children of narcissists have a tendency to overshare in the hopes that someone will see their pain and come rescue them. That normally ends up in another toxic relationship.
  • You are so used to be mistreated in the relationships that you don’t recognized when mistreatment is going on and you don’t know how to stop it.
  • Many are desperate for a love they never received. You can have idealized perception of romantic relationship. Usually the image is created from what you saw in the movies. This can also be one of the ways to avoid intimacy. Meaning that you are looking for something that doesn’t exist. Probably because you are joining for parent love that was never there. Going into the same destructive circle causes re-traumatization but you don’t know how to end vicious circle. “I ended up marrying an emotionally unavailable man. I was married 23 long years. I finally had the courage to leave. With my next relationship, I thought I’d finally found love! I thought I’d finally found my soulmate! I realized, after a year, that he was a covert narcissist of the exhibitionist variety!”
  • You form insecure attachment, mostly avoidant attachment, in which you deal with your fear by shutting people out. “I will never risk depending on anyone ever again!” or anxious attachment, where you chase after love. “Why won’t you pay attention to me!”
  • Some stays in the relationship just for the sake of settling down. Long-term relationships can provide an odd sense of comfort to someone who has always felt alienated. However most of those raised by a Narcissist have an intense fear of commitment, especially when it comes to committing to a person who may actually truly care for you. Commitment to you signifies another person having complete control over you and your emotions. As a result, you tend to defend your freedom whenever you feel it might be challenged and can withdraw when things get too intense. Even staying in long-term relationship that doesn’t work indicates the fear of commitment. “I rather be here and know what to expect than be in healthy relationship where I would need to deal with my fear of closeness.”
  • You have a tendency to become attached to toxic people and chaotic situations in early adulthood in a more intense. Unfortunately you internalized verbal and emotional abuse as a twisted sense of “normal” in childhood, so it’s no wonder that you rationalize toxic behavior in adulthood.
  • You often get into one-sided relationships where you get drained by the other person without getting any benefits in return (=codependency). This endless ‘giving’ is usually rooted in a deeply painful feeling of never being quite enough and having to work hard to receive love.

Being raised by a Narcissist causes a deep wound that takes a lot of time and determination to heal. Basically, you need to put your energy in to mothering yourself. Maybe that means getting re-parented by a therapist, to some extent by romantic partnership, friends or nurturing neighbors. All of these people can become part of your collective parent who gives you love, support, helps you through painful times and reminds you that you are worth it. With time you will internalize this nurturing collective parent that you didn’t have at the time of growing up.

PART I: BEING RAISED BY A NARCISSIST

Narcissism runs on a spectrum, from healthy narcissism to malignant narcissism, with a lot of gray in between. Narcissistic people suffer tremendously from their childhood trauma and this pain is too much for them to carry, so they pretend it’s not there or they keep lashing out on other people to ease their own pain. Narcissism doesn’t have to be absolute. It can show up in little ways and often under the guise of doing “what’s best” for your children. It tends to play out inter-generationally, with narcissistic parents producing either narcissistic or codependent children. Parents who are narcissistic share many traits with parents who have Borderline Personality Disorder. The traits of these two disorders overlap quite a bit. The difference between BPD and NPD is how they use manipulation. BPD is trying to prevent abandonment and NPD is trying to maintain the image of perfection.

Narcissistic trails in parenthood

Possessives
Narcissistic parent can be defined as someone who lives through their children and is possessive towards them. Typically, the narcissistic parent perceives the independence of a child as a threat. As long as you don’t represent a threat to your narcissistic parent, and are making them proud, they are OK towards you, or continue to ignore you. But the moment you become difficult or don’t meet their expectations, you become a problem. It is very hard for them to let their possession go. This typically shows when you get serious romantic partner. Your new girlfriend is viewed as a major threat. “My mum criticized my girlfriend to me when she wasn’t around. She was showing her disapproval through little things, like never included her name on any Christmas cart that she wrote.” In the eyes of some narcissistic parents, no romantic partner is ever good enough for their offspring.

  • “When you support her or don’t oppose her, she has this charming personality that’s very hard to resist. But when you oppose her, you can expect her to throw in every trick she has to make your life miserable.”

Boundaries
Within the realm of narcissistic parenting, personal boundaries are often disregarded with the goal of molding and manipulating the child to satisfy the parents’ expectations. They would go through your private belongings, without a thought, sometimes even using what they found against you. Asking nosy questions without noticing that you are feeling uncomfortable is also very common. You don’t have any truly private space even in the bathroom. Narcissistic parent crosses boundaries in many ways. Verbal and/or physical violent is common in their home.

  • “My mum has given away my property without my consent, sometimes even in front of me. Not to mention she expressed (her) opinions instead of me and make an appointments for me without even consulting me. “
  • “I told my mum she cannot bring her friends to my party but she showed up with them anyway. I couldn’t send them away because she told them they were invited. So, I either have to give in, or be the bad guy to these poor dupes on my doorstep.”
  • I came home from school when I was 15 or so, and found all my drawers dumped out on my bed, and my mother sitting in my desk chair, holding my diary. She was livid. Apparently, I hadn’t put my socks in the drawer right, so she decided to check all my drawers and closet. Seeing that none of my clothing was put away to her standards, she dumped it all out and in the process found and read my diary. That was a bad day. I wore long sleeves for weeks, and had to wear a sweat suit in gym to hide what she did to me.”

Lack of Empathy
Narcissistic parent is incapable to be mindful of the child’s own thoughts and feelings, and validate them as real and important. Only what the parent thinks and feels matters. Some of the most common issues in narcissistic parenting are due to the lack of appropriate, responsible nurturing which ultimately contributes to a child’s dysfunctional patterns. Consequently children feel little or no emotional attachment to their parent.

  • “My mum minimizes, discounts or ignores my opinions and experiences. Even when I talk about the subject that I am an expert on, she choose to demine the information. She never listens to a word that I say.”
  • My mother sees herself as a loving person. Nothing could be more far away from the truth in reality. She is incredibly cold-hearted, rude, ignorant, and callous with an inability to show compassion.

Manipulation
Narcissistic parent use manipulation to mold you the way they want you to be. The most common tactic used by the narcissist are:

  1. Ignoring: They can ignore you for days or weeks when you are not doing the things they want you to do. “When I didn’t do well in school my mum didn’t talk to me until I corrected my mark.” There is also one subtype of Narcissistic parent called “Ignoring Narcissists”. This parents have very little interest in their children. They take notice only when it is necessary. Usually when they need to portrait the perfect family picture or when they need to make sure that their child is taking the path that was chosen for him. “My mum showed interest in me only when it has something to do with school. The moment I tried to talk to her about something else she didn’t really listened.”
  2. Withholding love: Love is given as a conditional reward, rather than the natural expression of healthy parenting. On the other hand, the withholding of love is used as threat and punishment.
  3. Threatening: Narcissistic parent often use your personal information you told them a while against you when you don’t want to follow their direction. Child quickly learns not to share anything with their parents and hides everything from them.
  4. Guilt and shame: Narcissistic parent make you feel guilty and ashamed of yourself if you want to do something different from what they expected. “Ow, you are going to take the trip and I have to stay at home with your dad, how thoughtful of you” or ˝Because you can’t play the piano well, mummy looks like a fool˝.
  5. Being in the middle: Narcissistic parent uses their child to manipulate others-most likely their partner. Children are often expected to deal with adult issues and are put in the middle of disputes. This forces the child to make difficult decisions. Putting the child in the position where he needs to choose between one parent instead of the other leaves profound trauma. “How can I take my father’s side when my mother needs me more?”
    All of this manipulation tactics are preventing you to develop into a healthy individual with strong and clear identity.

Narcissistic rage
Their rage is based on fear. Anything that is threatening to expose their inner feelings of unworthiness needs to be destroyed. “My mom just flipped out when I said I am getting tired of pretending in front of my relatives that I am still studying to be a doctor. She started hitting me and screaming unclear sentences. I didn’t dare to tell my relatives the truth after that.”

Everything is about them
Narcissistic parent take all of the air in the room. Their profound need for attention and praise subverts everyone else’s needs. They turn others to be their listener. They don’t notice their boredom, exhaustion and desire to speak too. They love to show others how “special” they are (grandiosity). They enjoy publically parading what they consider their superior dispositions, be it material possessions, physical appearance, projects and accomplishments, background and membership, contacts in high places, and/or trophy spouse and offspring. They go out of their way to seek ego-boosting attention and flattery.

  • “My mother creates odd occasions at which she can be the center of attention, such as memorials for someone close to her who died long ago, or major celebrations of small personal milestones. She loves to entertain so she can be the life of her own party.”
  • “At the dinner table me, my sisters and my father were talking. My mother suddenly slipped from her chair and collapsed onto the floor, apparently unconscious. Shocked and concerned, we rushed to her side and picked up the phone to call 911, at which time she regained consciousness. The same scenario played out a few more times at the dinner table. If the conversation shifted away from her she would dramatically drop to the floor. We started to ignore her and talked over it. She continued to fall sometimes. She’d lie there for a bit and then pretend to wake up in confusion.”

Maintaining the appearances
They like to present a perfect family image to outsiders. They go to great lengths to ensure that others perceived your family as a loving, successful and enviable. Children are normally aware of this play, but kept silent for fear of wrath from their parent.

  • “I’m in therapy to deal with the effects of being raised by a narcissistic parent. I didn’t even realize until I was pretty well into adulthood that’s what it was. I thought it was me. I thought something was wrong with me. Everyone loves my mom. Everyone talks about how amazing she is, how charming, how much she sacrifices for her family, so I figured that if I was miserable at home it certainly couldn’t have been because of her. The truth is, everyone thinks so highly of her because she has carefully crafted that image and manipulated and lied to maintain it. She has used other people to make herself look better, and hurt others in the process. That’s the truth.”
  • The thing about narcissists that is the absolute worst is that no one else knows what’s going on. They have fooled everyone else because they are master manipulators. Everyone else in my family and extended peer group thinks my mother is this amazing, strong, dedicated woman who has raised two severely challenging children. What’s funny is, as much as I can’t stand my brother, we are a lot alike and have suffered a lot of the same traumas at the hands of my mother. We are both incredibly sensitive souls who have been abused and luckily, I found my way out of it. I moved 3000 miles away from her. My brother was not so fortunate, and depends on her to survive.”
  • She cares excessively about what people think. “What will the neighbors think”, is a sentence that I’ve heard countless times. If you actually have a genuine problem, don’t expect her to care about you, but about how it will appear to others. Keeping up appearances is key, regardless of whether you’re suffering or not.”

Everything is personal
Narcissistic parents take their children’s every feeling or action personally. These parents are easily angered when a child doesn’t agree with them or mirror them. They expect the child to be happy when she is and miserable when she is. If the child is happy when the parent is sad, it is taken as a sign of disloyalty and insensitivity. They are so sensitive to praise and admiration as fuel that it makes them overly sensitive to criticism. So children learn to tiptoe around these emotional minefields, trying not to trigger that anger, or worse, have their parents withdraw love. The child of narcissist parent is never seen as he truly is. Of course, there are moments when child objects to his parent, but even then he feels bad, wrong, and confused.

  • She also makes up ridiculous lies about trivial mistakes. Just to give one example: she once repaired a shirt, but put the button on the wrong side. I pointed this out to her — I wasn’t angry or anything, I thought it was funny, and she made up absolutely silly excuses like: “it just shot through”. She can never do something wrong and thus she will never apologize. I don’t think I’ve ever heard her say “sorry”.

Marginalization
Some narcissistic parents are threatened by their child’s potential, promise, and success, as they challenge the parent’s self-esteem. Consequently, they might make a concerted effort to put the child down, so the parent remains superior. They are nit-picking their child, they are judgmental and critical towards him, they constantly compare him to someone better and reject his success and accomplishments. Whenever someone complimented your achievements, your parent would jump in and shift the attention to themselves. “Yes, she gets it from me. I was always athletic as a child.”

  • “When I got married a few years later, she told me that my wedding was “not for the bride, but actually for her mother”. I made her my Matron of Honor and chose her favorite color for the bridesmaid’s dresses. She bought a dress the same color as mine.”

Grandiosity and Superiority
Many narcissistic parents have a falsely inflated self-image, with a conceited sense about who they are and what they do. Some children of narcissistic parents become the same: “We’re better than they are.” This sense of grandiose entitlement, however, is almost exclusively based on superficial, egotistical, and material trappings. They feel more important because of materialistic things or status they have in the society.

Dependency
Narcissistic person is strongly dependent on others. The dependency can be emotional, physical, or financial. They are trying to make you dependent on them (possessiveness, manipulation), so they can control you. One common tactic to do that is to infantilize you. This can be as direct as making you feel incompetent every time you try something new, or it can be as subtle as always stepping in and offering to do something you can clearly do for themselves. Unfortunately, this behavior rarely stops even after you become an adult. In fact, it can sometimes become worse as the narcissistic parent fears their children’s growing independence and the end of their narcissistic supply.
On the other hand some parents expect their children to take care of them for the rest of their lives.

  • “My mom expects me to support her financially on an on-going basis. She says that she can’t live without me.
  • “Walking into my office, (I managed the number 3 top Allstate office out of 900 agents) not respecting my employees and still undermining me on how I need to go back to school and finish my degree or I will never make it in life. She homeschooled me and deliberately kept me from finishing school in order to keep me locked in her web of abuse. She took me out of school when I was 11 because she was about to have another baby and “homeschooling was a great option!” She had me working two full-time jobs at 16 and I barely had a 9th grade education when I ran away at 17.”
  • “I grew up a text book co-dependent, always looking outside of myself for validation. Since I was solely focused on my mother, I did not develop my own identity – it was given to me by her. My identity was based on my role. I had an “underdeveloped self esteem (no boundaries) combined with an inappropriate caring for others (invading a boundary), and an inappropriate reliance on another’s response (invading a boundary), in a negatively reinforcing loop.”

 

Humiliation
Narcissistic parent berated, demeaned and harassed you on a constant basis. She often latched onto an insecurity of yours and used it to humiliate you. “My mom made fun of my birth mark on my face all the time.” Many of her putdowns are simply by comparison. She’ll talk about how wonderful someone else is or what a wonderful job they did on something you’ve also done. The contrast is left up to you. She’ll spoil your pleasure in something by simply congratulating you for it in an angry, envious voice that conveys how unhappy she is. If you complain about mistreatment by someone else, she will take that person’s side even if she doesn’t know them at all. It is impossible to confront someone over their tone of voice, their demeanor or the way they look at you, but once your narcissistic mother has you trained, she can promise terrible punishment without a word. Being constantly put down or told that you are in a wrong rubs off on you and lowers your self-esteem.

  • “When I was getting more independent 16+ according to my mum all my friends were bad influences, my boyfriend was horrible, my choices of clothing was also too grandma for my age. When I started working she needed a wanted a contract phone so I got one for her. She ran up the bill which I had to pay for over £400.”

Golden child doesn’t shine so bright
Narcissistic parent often choose the favorite child or so called golden child. A golden child can’t do anything wrong, is the smartest and the best at everything they do. This is what the narcissistic parent believes and will enforce in their child. The other child (scapegoat) is seen as the black sheep, and the cause of all issues. Everything the scapegoat does is wrong, not as good as it should be, and they always have to take the blame. The scapegoat stands for everything that is not perfect in the family. The roles of golden child and scapegoat can also switch frequently. Consequently all communication between siblings is superficial and driven by duty, or they may never talk to each other at all.
The narcissist also uses favoritism and gossip to poison her children’s’ relationships. While she may never praise you to your face, she will do that in front of your siblings. The end result is a family in which almost all communication goes through the narcissistic mother. Golden child can become narcissist himself but not necessarily. They can see the favoritism and feel guilty for it.

  • “It didn’t make any sense, my brothers were wonderful humans. They are much more talented than I am. I had very strong feelings of guilt. I watched the people I loved receive the rage. I felt like I should have been able to fix things. My mother would tell me to go to my room and be very, very quiet while she was taking her frustration out on them.”
  • “My brother was and is the Golden Child. He could do no wrong, he was the perfect baby, the perfect child, and when he wrecked 3 cars in a row while in High School, none of those accidents were his fault. I, on the other hand, was a disappointment. I “cried all the time when I was a baby”, my mother had to cut her college education short because I “cried at the daycare that she put me in”, I was “always losing things”, and she couldn’t have a pet “because the cat scratched me.”
  • “He was diagnosed with cancer a few years ago and given two years to live. He has been depressed about this, but not for the reasons you might think. When he cried the most was when he was telling me how sad he was that he wasn’t going to be around for my sister, as she didn’t have a boyfriend yet and she needed to be trained on how to be attractive to other men. He then went on to blame me for not teaching her how to get a boyfriend as I’m her older sister. He especially put me down for not convincing her to get plastic surgery for her face.”

PART IV: INTERACTION BETWEEN BPD MOTHER AND CHILD

In this article (Part IV) I want to take a deeper look at some of the research that was done regarding relationship between Borderline parent and children in comparison to mothers that don’t suffer from BPD.

Infants

Studies have found that interactions between mothers with BPD and their baby are characterized by insensitivity, high levels of intrusion, and low levels of positive response to infant distress. Mothers with BPD smile less, touch and imitate their infants less, and play fewer games with their babies. They often have difficulty identifying and appropriately responding to their children’s emotional state. These unmet psychosocial needs at critical moments of development increase risk of disorganized attachment and rob children of security, comfort, and safety from the very beginning of their lives. Newman and colleagues found that infants of BPD mothers aged 3 to 36 months were less attentive and less interested in interactions with their mother during a free-play interaction compared to infants of healthy control mothers.

Pre-school
Macfie and Swann examined mother-child attachment in 30 preschoolers (4-7years) in comparison to 30 children with healthy mother-child bond. They discovered that role reversal was significantly more likely to be present in the narratives of children with a BPD mother. More negative parent-child relationship expectations, such as the relationships characterized by danger and/or unpredictability were also found in the preschooler’s narratives. The children also exhibited greater fears of abandonment. Lastly, the children of BPD mothers also showed more incongruent (e.g. the child cleans his/her room then ruins it) and shameful self- representations (e.g. the child says he/she is bad) in the narratives.

School-age children
Different studies showed that children of mothers with BPD have more psychiatric diagnoses, such as ADHD and higher rates of BPD symptoms in childhood. These children also reported more cognitive and interpersonal vulnerability, such as a negative attributional style, ruminative response style, dysfunctional attitudes, self–criticism, insecure attachment style, and excessive reassurance seeking. Adolescents
Adolescents whose mothers had BPD exhibited more attention problems, delinquency, aggression, more anxiety, depression, and low self-esteem. In general BDP mothers reported that they feel less satisfied, less competent and more distressed with their parenting abilities.

DSM IV criteria for Borderline Personality Disorder

  1. Frantic efforts to avoid real or imagined abandonment.
  2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
  3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
  4. Impulsivity in at least two areas that are potentially self-damaging (e.g., promiscuous sex, eating disorders, binge eating, substance abuse, reckless driving).
  5. Recurrent suicidal behavior, gestures, threats, or self-mutilating behavior such as cutting, interfering with the healing scars (excoriation) or picking at oneself.
  6. Affective instability due to marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
  7. Chronic feelings of emptiness and worthlessness.
  8. Inappropriate anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
  9. Transient, stress related paranoid ideation, delusions or sever dissociative symptoms. (APA, 2000, pp. 292-293)
BPD can often occurs together with other psychiatric problems, particularly bipolar disorder, depression, anxiety disorders, substance abuse, and other personality disorders.

My movie recommendation for understanding BPD dynamic: 
Mommie Dearest

PART III: TYPES OF BORDERLINE PARENT

Experts wonders whether there are actually distinct types of borderline personalities. The minds are divided but experts still try to distinguish between the different types of BPD in academic literature as well as in popular one. In Part III we will take a look at both of them. Please note that this list of types serves as a guidelines and person who suffers from BPD can have a mix of everything.

Popular Literature
Dr. Christine Lawson in a book Understanding the Borderline Mother introduces 4 types of borderline mothers that fall into high functioning or low functioning category:

High-Functioning BPD Mothers

The Witch
The Witch is someone who acts out viciously when they feel threatened, rejected and criticized. This type of mother seeks power and control over others, and reacts with unpredictable rage. Family members live in fear of triggering her. Unconsciously she is consumed by self-hatred and tends to be extremely hostile and cruel towards their children. She tends to be self-obsessed and has little or no concern for others. The Witch has no remorse and will not apologize for hateful acts she has done to her child. At the base of their need for power and control is their intense desire to prevent abandonment. This particular sub-group of BPD is very resistant to treatment. It is not uncommon for their children to develop depression, shame, insecurity, Post-traumatic Stress Disorder.

  • “There was a problem with my report card, showing I had a 0, even though I knew for a fact I had done the assignment. I didn’t have enough time to tell the teacher about it, so I would do so the next day, in order to fix my grade. I showed my Mother, trying to explain it to her, and even though I had a simple solution to fix it the next day, she proceeded to slap me across the face and scream at me for getting a 0, as well as proceed to call me lazy and not caring about my education. Yeah, I had the proof to show her I had done the assignment, could easily get my grade changed, and even then, I was still getting yelled at, grounded, and getting my things taken away. And slapped across the face.”

The Queen
The children of a Queen Mother are supposed to be her loyal subject. Queen needs to be the center of attention and uses her children to fulfill her own needs. “Pay attention to me! Love me, love me, prove to me you love me and do everything as I say!” If you disagree with her, don’t do as she says or you have your own needs, you don’t love her. Children are not permitted to have their own needs or opinions, and are not encouraged to become individuals in their own right.
She pretends to be a perfect woman who has it all together, independent, powerful, and in control of everything. They can be manipulative and vindictive and have a strong sense of self entitlement. They cross boundaries without recognition or regret. Inside they experience chronic feelings of emptiness and inability to self-soothe when distressed.

Low-Functioning BPD Mothers

The Waif

The Waif portrays the helpless victim, exhibiting how everyone is treating them and how they need protection. They can suffer from depression, anxiety, irrational fears, and feelings of vulnerability, helplessness, hopelessness and are prone to deep despair. But they are rejecting attempts by family members to help them. In this way, they passively control others and are generally unable to nurture anyone. 
They expect from the children to “save her” and believe that people are out there to get them and do not trust others. Children may feel that they can help if only they do more, learn more, and give more. Unfortunately the Waif continues to stay helpless as a means to control and avoid abandonment. She neglects her children, often they feel angry and alone and may develop codependency issues as adults.

The Hermit
Hermits may have a tough exterior and a superficial image of being confident, determined and independent. Except, they’re actually terrified of the world, and distrust everyone and are prone to rage and paranoia. They feel constantly betrayed by others and take criticism as a condemnation of who they are. Perfectionism is a hallmark of the Hermit, and they can rage or criticize (which they often do) when others fail to meet their expectations. They have no desire to go out in the world and have close friends outside of their family, especially their children. They gain their self-esteem from work or hobbies.

  • “My mother often said that as she got older, she became afraid of everything. We could never get her to try and go out with friends unless we took her out for coffee or shopping. We were the only real “friends” she had. And honestly, we were because we had to, or else, who else would she have?”

BPD types in academic literature

There were quite a few attempts to find different subtypes of BPD in academic research.

In The Essential Family Guide to Borderline Personality Disorder, Randi Kreger grouped BPD into:

  • Lower-functioning/conventional types is described as engaging in a lot of self-destructive behavior that requires frequent hospitalization. They are very low-functioning, meaning they may not be able to work or go to school. The author calls this self-destructive behavior “acting in,” an idea that correlates with the concept of internalizing symptoms.
  • Higher-functioning/invisible type is described as functioning well in most contexts, but engaging in a great deal of “acting out” behavior, such as verbal abuse, criticizing others or becoming violent. This description correlates well with the concept of externalizing symptoms.

One study examined types of borderline personalities based on a personality disorders that co-occur often with BPD. They categorized person in one of the 3 clusters:

  • Cluster A tended to engage in more paranoid thinking and eccentric behavior.
  • Cluster B tended to have more dramatic or arrogant personalities.
  • Cluster C tended to be more fearful.

Another study examined BPD subtypes in adolescent boys and girls. Interestingly enough study found reliable BPD subtypes in girls, but not boys. Girls with BPD tended to fall into one of the following categories:

  • high-functioning internalizing
  • depressive internalizing
  • histrionic and angry externalizing

Another study found three BPD subtypes:

  • withdrawn–internalizing
  • severely disturbed–internalizing
  • anxious–externalizing

Individuals with different presentations of BPD may respond differently to the treatment. In this study, individuals from the severely disturbed-internalizing subtype did not see symptom improvement with treatment, where those in the anxious-externalizing and withdrawn-internalizing subtypes did.

The last subtypes of BPD I want to write about is from T. Millon. He lists 4 subtypes of BPD:

  • The Discouraged Borderline looks like individual with Dependent Personality Disorder (codependent). They tend to be clingy, go along with the crowd, and walk around feeling somber and somewhat dejected. Deep inside however, there are often angry and disappointed with the actions of those around them. Scratch the surface, and that anger could explode, but they are much more likely to do harm to themselves by self-harming or even suicide. 
Some of the symptoms common to this subtype are: excessive dependence upon others, cycles of withdrawal and aloneness, passive, permissive, recurrent depression including tearful episodes (more common than rage episodes), anger can feel sudden and surprising to others, paranoia and self-persecution, more likely to deprive rather than indulge oneself, victimized, tendency to evoke sympathy, feelings of abandonment can invoke psychotic episodes, trigger desperation and suicidality, irresponsible behavior, uses drugs, alcohol, food, money, or sex for self-soothing, tendency to use fantasy to escape reality, gives away or destroys belongings, suffers from chronic or recurring illness or somatic complaints.
  • Impulsive Borderline seems to be a first cousin to the Histrionic Personality Disorder. These individuals tend to be flirtatious, captivating, elusive and superficial. They are highly energetic and seek out thrill after thrill. They are easily bored and seem to have it never ending appetite for attention and excitement. As their name implies, they will often act without thinking, getting themselves into all sorts of trouble. Such individuals can often be very charismatic and it’s easy to get caught in their spell. This type of person is in constant conflict with society. Bouts of violence are not uncommon. This person may have antisocial personality disorder as a co-occurring diagnosis. This person is operating in an Abandoned Child mode–a plea for attention, any attention–as well as an Angry Child mode. The Angry Child believes that other people deserve to be punished for his/her pain, and behaves accordingly. This type of person with BPD may have poor impulse control, abuse substances, or self-harm. On the other extreme he or she may not care about himself/herself, it’s all about what the other person thinks. This often results in extreme efforts to avoid disapproval and abandonment.
  • Petulant Borderline is unpredictable, irritable, impatient, and complaining as well as defiant, disgruntled, stubborn, pessimistic and resentful. They are torn between relying upon people and at the same time keeping their distance for fear of disappointment. They vacillate between feelings of unworthiness and anger. This anger can be quite explosive. This is a passive-aggressive person. He or she will injure himself or herself, either physically or emotionally, in an attempt to get needs met. This person has an unstable sense of self, a frantic fear of abandonment. They operate in an Angry Child mode. He or she is angry and will hurt friends and family as a result. They often doesn’t recognize the anger-the world is the problem, not them. They don’t know how to express their needs in a healthy way, so relationships seem to be a game of “If you really loved me” or “You should know what I want”.
  • Self-Destructive Borderline is marked by his constant sense of bitterness which they turn inward. They will often engage in self-destructive behaviors whether it is conscious or unconscious. Their levels of self-hatred can often reach monumental proportions leading them into all types of self-destructive behaviors, ranging from poor healthcare to reckless driving to performing humiliating sexual acts. This person often suffers from depression as a co-occurring diagnosis and is a self-injurer. This is a person who feels that no one cares, and reacts by not caring about himself or herself. They operates in an Abandoned Child mode. Since they don’t feel loved, they reacts in self-destructive ways in an attempt to feel something instead of nothing. They lives in terror of abandonment, is self-loathing, and has no idea who they are inside. Thoughts of self-injury or actions are a given in this type.

PART II: DAMAGES OF GROWING UP IN BORDERLINE FAMILY

In the title of this article I used the word “damage”. This word is a good description of how children that grew up in Borderline Families feel inside – damaged. Let’s go into details, what kind of emotions, feelings and actions are hidden behind this word. Many people in counseling who were raised by a borderline parent end up struggling with anxiety, low self-esteem, issues with trust and intimacy and difficulties being vulnerable with others.

Mind reader
Children of BPD parents routinely become overly sensitive to the moods and needs of others. They needed to adjust to their mothers mood and predict how she would react. Many grew up being afraid of their mother. They are constantly doing “risk assessment” monitoring their mother’s moods so they can manage the situations and protect themselves from anger and drama.
In adult relationships they are responding to these invisible demands from other people. The problem is many times they are adjusting to something that other (healthy) person doesn’t expect them to. The “secret” demand is not really there like it was in their childhood. It is really difficult for them to go out of this mode and trust that nothing bad will happen if they don’t please the other. The realization that we are all adults, responsible for ourselves doesn’t come “naturally” to them.

Are my emotions real?
It is extremely hard not to doubt their perception for the children of BPD parent. Their perception was always questioned and their emotions were invalidated. This may lead to children who deny or question their emotions and emotional responses. If you are constantly told that what you are experiencing is not real you star doubting your feelings and your views of reality.
Children have a very difficult time expressing their feelings because they can rarely distinguish between their feelings and their mother’s feelings.
This doubt is also shown in the perception of their childhood. Did it really happen? A part of them doesn’t believe it fully because it was always denied by their Mothers who never took the responsibility. Furthermore in calm periods, when the parent is behaving better they begin doubting whether the bad things actually happened. 
In adulthood this can be triggered every time someone is disagreeing with you. If you are not a 100% sure into what you wish to say you rather pull back and doubt your truth. More over even if you are a 100% convinced that what you are seeing is a red picture, you can become convince you may be seeing it wrongly, perhaps it is orange after all. You need a constant reassurance from others that what you are feeling and thinking is valid and right.

  • “I’d been so entrenched in that fog throughout my childhood and early adult life that I was unable to see clearly the reality around me.”
  • “When I found out, in 2006, that she’d drained my trust fund, I was horrified. But on some level, I was also relieved: so much of the nightmare of my relationship with my mother had happened in secret that I struggled to know if it was even real. But now I knew it was. Now, I had proof, and I could finally leave her, with a clean conscience.”

Hard to leave
Children of BPD parents have a really difficult time to physically or/and emotionally move away from their parents. Because they were hearing how bad of a child they were when they wanted to be independent they have trouble moving away or cutting their mothers off. This guilt is binding them to their mothers and it is really hard to cut it off for good. In my practice I mostly see emotional bond that is the hardest to let go. They feel obligation to visit their Mom, speak to her, make sure that she is O.K. Although it is apparent that they are not doing this because they want to but because it is expected from them.

Overly critical

They act and feel like they are never good enough. Lack of self-esteem is very common with them. They are really hard on themselves and at times even brutal. It’s like they internalized their Mothers criticism and now they are treating themselves the same way.

  • “I grew up hating myself and relying on my mother for all of my self-worth.”

Illusion of love
The adult children of borderlines struggle with the illusion that they were loved when they weren’t. They feel lack of love towards their parent but they blame them selves for that. This loop is created because a Borderline parent gave them the constant feeling that they are not loving towards them because they are a bad, ungrateful children. They often ask “I must be crazy if I feel like this about my mother right” or “maybe I’m not a good enough child, if only I try harder, she will love me” not realizing they will never measure up in their mother’s eyes.

  • “I feel like a horrible daughter for having bad feelings towards my mother. Sometimes I even think it would be easier if she was just dead. I try to explain my feelings to my boyfriend or a friend and everyone seems to think she is the nicest person ever. She manipulates everyone. They all think I am just being dramatic.”

Fantasy World
Many escape to fantasy world during the childhood and if they don’t resolve what was happening to them while growing up also in adulthood. It is very common that they fantasize the death of a parent. Only children who were severely physically or/and emotionally abused have these types of fantasies. The fantasy is the only way to get out of the toxic environment.

  • “I escaped my childhood like most traumatized children do, by disassociating from reality and fleeing into fantasy. There were window ledges and shade trees that called to me, closets and woods—places I could get away to dream.”
  • “I remember playing Tom and Jerry cartoon nonstop in my head before going to bad. This way the only way I could calm down and fall asleep.”

Anger

Unadorned the guilt, doubt, feelings of unworthiness bring to a lot of anger towards Borderline Parent and their Childhood. They find it unfair (and it is) that they had childhood like that and all the problems that are coming from it. They feel angry that they need to go through the therapy while their Mother is not taking the responsibility. They feel angry that they need to face the pain while somebody else was the one who FUCKED UP.

  • “I’m angry that I didn’t have a childhood, that I witnessed horrible things, was abused in many ways, and that my relationship with my siblings took a toll. I’m just pissed. But more than anything, I’m angry that my mother will never really “get it.” She’ll never see or understand the pain she has inflicted. Really all I want is an acknowledgment of what she has done and the amount of work I’ve had to do to dig myself out of this bottomless pit she dug for me. I want an apology. And then I want to be left alone. I’ve had to try to come to terms with the fact that I will probably not get that from her. Which just fuels my anger. Ugh. ”

Fear of becoming like Mother
The fear of becoming just like your parent can increase with age. Some even deny their wish to become a parent because this fear is running so high. They are trying to prevent the pain that they were feeling when growing up. Maybe comparison to you parent is not that obvious at first but it can occur in small everyday stuff like “I am not drinking coffee like my Mom did.” To overcome comparison and realize that same or similar features don’t make you your parent is really challenging.

  • “I resigned to spend my life proving that I was not her. I’d place a mental check mark in the “not-my-mom box” when I hit a milestone. Attain a college degree. Check that box! Still speaking to my dad after age 21. Check! Not addicted to alcohol or painkillers. Check. In retrospect, being on constant red alert for mom-like tendencies was concerning.”

Relationships
Children of BPD parents have trouble with interpersonal relationships. It is very often that they develop codependent tendencies. They can also use manipulation to maintain relationships or over pleasing behavior. It is not uncommon that they find themselves in destructive relationships which bring them pain. They are being unable to create a true intimacy. They are preventing it through constant fighting, distance (emotional or physical), manipulation, codependency etc.
 Because they were often told that the World is a bad place and they have trouble to trust people. Also to trust that they are worthy of love.

  • “I just realized why all my relationships (platonic and romantic) are superficial and hence not long-lasting. I have constructed an invisible armor around me for protection. If they don’t get too close, they won’t hurt me.”
  • “I have a hard time voicing my opinion and saying when I think I’m right. I’ve been in a relationship for 4 years and I’ve changed a lot during therapy. At the beginning of this relationship, I was pretty submissive and didn’t want to cause any conflict. I am now becoming more confident in myself and feel okay with a little bit of conflict.”

Realistic expectations
Perhaps the most difficult thing to accept is that Borderline mother is not capable of insight and will never truly understand why her child avoids her or sets boundaries with her. She is not taking responsibilities for her actions and is making you feel like you are overreacting or she was doing you a favor. It is really hard to accept that your mother will never acknowledge your feelings or agree with you when she is in the wrong. Yet alone apologize .

  • “Why do you act guarded around me?” Child “Because you have hurt me in the past and I don’t want to be hurt again” “I hurt you! I don’t remember that. When?” Child “You used to hit me with a belt when I was a child”
  • “I don’t remember that. You are making it up. You lousy shit”.
  • “My mother could not apologize. She could not take criticism. When it came to discipline and power struggles, she had to win.”

What the future holds?
Unfortunately being raised in BPD Family makes you prone to the development of psychological disorders like depression, anxiety, Post Traumatic Stress Disorder (PTSD), Narcissistic Personality Disorder and also Borderline Personality Disorder. Recovery from being raised by a borderline parent is often a lifelong process. Although it really gets better with time if you work on yourself. Being psycho-educated about what is going on is important first step towards understanding. You can only work on what you’re aware of.
I would recommend working with the therapies to help you deal with all the emotions, pain and feelings and give you the corrective experience. With time and many positive experiences you will be able to move away from the toxic dynamic. On that note it is also important to say that Borderline parents suffer as well. They have their own past traumas. That being said, parents are not off the hook for abusing their children. As an adult it is your responsibility that you take care of your own wounds before you become a parent. And it is very important that you start to take care of your childhood wounds, to stop the destructive cycle.

PART I: MY PARENT HAS A BORDERLINE PERSONALITY DISORDER (BPD)

In this series of articles I won’t talk about BPD but I will focus on the dynamic that is created when you are raised by someone who is struggling with BPD. Until now there was a belief that more women than man suffer from BPD. That’s why I will talk about mothers in this articles. But lately there have been studies that have shown misdiagnosis in male population. It is now believed that percentage between man and women with BPD is close to equal.
From the birth on, the connection between you and your child is very important. It is crucial for physical survival but equally important for psychological well-being of the child. Unfortunately not everyone is having luck with their parents which can lead to serious mental disorder.
Most people would not believe what goes on in Borderline families. The dynamics are intense, destructive, subtle and not readily apparent to the casual observer. BPD is fragile and unpredictable personality. They can be very successful but they struggle with interpersonal relationships. These may be associated with episodes of impulsive aggression, self-injury, and drug or alcohol abuse.
People with BPD are often described as a child in an adult’s body. These individuals can be incredibly immature and seem to be stuck at an early age of psychological and emotional development. Consequently BPD parents frequently parentify their children-meaning they make them responsible for their emotional and physical needs which is a form of a child abuse. While a person with depression or bipolar disorder typically endures the same mood for weeks, a person with BPD may experience intense bouts of anger, depression and anxiety that may last only hours, or a day at most.
A mother with personality disorder often lacks empathy, feels entitled, rejects personal responsibility for her behavior, engages in bullying and intimidation, is dishonest, has the relative morality of a small child, has chaotic and extremely dysfunctional relationships, has no sense of fair play and is completely self-obsessed. The borderline parent lacks insight and believes that she is the fine parent of an ungrateful child and goes to any length to prove that this is the case. But how is it to be on the other side? On the side of a child?

What dynamic is in BPD Family?

No space for you
Children of BPD learn to sacrifice their true selves because they need to be focused on her BPD parent in order to survive. They are emotionally or physically abused if they feel differently as their mothers. If they reject her offering (advice, suggestion, emotion) they are portrayed as a bad, ungrateful, disloyal children. Because of the attachment issues borderline mothers tend to smother their children and treat them as small extensions of themselves. Child learns quickly that it is best to get along otherwise there will be a conflict or the emotional cut-off. For a child who is dependent on their mother there is no other way then to sacrifice his identity and go along with her. The child interacts out of obligation. Autonomy, the freedom of self-direction and self-expression, is not welcome. The following examples shows how every situation turns out to be about her:

  • Teenager child is telling her Mom that he feels depressed. Her response: “What do you have to feel depressed about? You know what I was going through when I was your age”. The feelings and potentially serious condition of a adolescent are ignored and denied. “Mom, I cannot make it to dinner tonight, I don’t feel well.” Mother: “You don’t feel well? I am still suffering from the Cesarean Section they gave me so that you could be born.”
  • “Even when trying to confront the issue, any issue, it gets made all about her pain.”

Splitting

Common defense mechanism of BPD is splitting. Which means that a person splits off the good and the bad in themselves and projects bad onto others. This can also be a reason why your mom is denying all the bad she has done and has chosen to see only the good in her. 
In families splitting often occurs by having a good and a bad child. Borderline mother forced teams with the good child whom is required to behave like her. The all good child often feels guilty that they survived the abuse especially relative to a no-good child. This dynamic causes a toxic, estranged relationship between siblings. The lack of closeness is creating isolation, every member of the family is on it’s own. 
The splitting also occurs by being good one moment (idealized) and being completely bad the next.

  • “In our family my brother was always priced by my mum. He could get away with everything. Everything that was wrong felt on me and my sister. We were taking her emotional abuse. But to think about his relationship with our mom. He needed to be there for her in every moment, listening to her, defending her and sleeping in her bed till early teens.”
  • “My Mom always priced me when I brought home the good note. She couldn’t stop giving me the compliments. How smart I am, how she admires my determination and motivation for school. The moment I brought home a bad note, well it wasn’t really bad, but it was not the best, I needed to sit and listen how lazy I am, how I will never become anything.”
  • “I sometimes wonder if she will ever be able to have a conversation with me without saying something along the lines of, “You’ve hated me since you were a little girl.” And then she just calls up one day and all is well, as though she hadn’t just threatened to end our relationship a day before. Usually, I get split back to the light side (as I call it) when she needs something that she knows I can provide. Then I’m back to being a good person.”

She loves to help
With borderline dynamic there are three kinds of things connected to help.

1. She is often a valid member of a community. Willing to help everyone and give all she has to them. Sometimes she can literally give your things to somebody else in a name of help.

2. When it comes to helping you it often comes with a high price. The problem is the help is not being offered for truly altruistic reasons, but rather it is being offered to support the mother’s desired image of being a good mother. In case you reject her help it can be taken as an offense. Once you ask for help they can control you with that and try to win a fight with throwing it at you even years after. “oh, you can’t do this for me but I could help you get a job during collage.” The child quickly learns not to ask for help and tries to avoid his/her mom helping them because they know they will have to pay for it at some point or they will be paying for it forever.

  • “Besides the fact that she’s done this so many times it’s turned into crying wolf at this point, her method of asking for help “with a knife to my throat” also takes away any of the warm feeling that I might get from helping her.”

3. She expects of her children to help her or better said save her from every emotional or physical problem she is having. They often play “I am your mother” card. “oh, you don’t want to do this for me but I am your mother. You should take care of your parents.”

Neglect
Physical and emotional neglect is very often in Borderline families. People with BPD can be so absorbed in their own pain that they are incapable of taking care of their child. They can also escape to substance abuse or other addictions while leaving the child to take care of him/herself.

  • “My mom locked herself in her room for days. I was very afraid that she will do something to herself. I was forced to take care of myself and younger siblings and also spending my energy to convince her to come out of the room.”
  • “She rarely showed affection. She would also get onto my brother and me if we said, “I love you”, as she would scold us and say to only say that phrase if you REALLY mean it. She would never come to you and show affection. We would go to her for hugs and kisses. I remember trying to hold her hand in the movie theater and her pulling her hand away, looking at me funny.”

Rage
Rage outbursts are very common in BPD families.

  • “Once my father moved out and I became a preteen, something changed. My mother and I started fighting. We fought the way I remembered my parents fighting: brutal, out-of-control arguments that would last for hours. I couldn’t tell if this was normal or not.
  • “My mother would fly into rages, telling me how awful I was for hours, and then, moments later, would coolly ask me what I wanted for dinner, appearing to not even remember that it had happened. She acted like I was crazy, and so I assumed that I was. She took me to a child psychologist to deal with whatever supposed defects I had that led to us fighting so often. Then she pulled me out of therapy after a few sessions, when she got into a screaming fight with the receptionist.”
  • “My mother could turn her rages and sadistic behavior on and off like a light switch. She would instantly become “normal” the moment another person entered the room. My mother could be nasty as a snake to my brother and me and then turn it off and be sticky sweet to whoever is at the door or on the phone. Even at a young age, this behavior made me sick.”

Criticism
Mothers with Borderline Personality Disorder often put-downs, insults and criticize their children.

  • “This is a woman who criticizes everything about me. From my “boring, plain, unadventurous” taste in clothes (not boring, just not enough like her), to my “annoying, inconvenient” pescetarian diet, to my need for a spiritual life (“religion is for weak, stupid people who need a crutch to get through life”). Although I am gifted with artistic talents that have won awards and put me on famous stages, nothing I do is ever done without a touch of criticism on my performance.”
  • “I became keenly observant of her methods, never questioned her authority, and strived to be the best at everything, because anything less was a massive disappointment in her eyes.”

But on the other hand they are unable to accept the criticism. They can even go against the law of physics if necessary.

  • “She didn’t see reason to change course if her direction conflicted with the instruction manual, or, say, the natural laws of physics.”
  • “In college, I finally grew brave enough to tell her she had a drinking problem, but after three pointless attempts at an intervention, my efforts seemed futile. Her reality, no matter how factually incorrect or emotionally unjust, was all she could see.”

Blame and guilt
BPD parent can use guilt tripping for many different occasions to achieve what they want. Often they use it because they are afraid of the separation and are making their child feel bad every time s/he wants to do or go somewhere on their own. They of course don’t forget to mention “how alone they feel and how bad of a child you are because you are not spending more time with her”. Although the time that is spend with her is mostly in conflict.
Consequently you grow up blaming yourself for everything-for your mothers mood, for unsuccessful relationships that you are having, for wanting to have time for yourself, for eating too much, for eating too little, for not being “more” successful, for…

  • “I proceeded to ask her why she always has to twist things to make me feel bad, and she proceeded to tell me that I should be ashamed of the way I treat her, and blamed me for making her feel bad. The meeting ended with her throwing her Christmas present, a check for the wedding (which she initially refused to contribute to in any way, and wanted me to invite about 5 of her personal friends) and some of my stuff through the window of my car, and tell me that she’s done.”
  • “Out of the blue my mom asks me what I think about my new Mother in Law. I tell her that I’m very happy with her, and that she is a kind, patient, gentle woman, who listens and gives good advice, and always roots for me. Well, I might as well have crashed the car at that point, because my mother’s reaction was horrific, and completely manipulative. She said, “Oh good. You must be so happy to finally have a mother that cares for you.”

Abandonment
Abandonment issues are at the core of borderline personality disorder. They view separation as betrayal. They can use many forms of manipulation to try to prevent it. One of the most common manipulations is playing a victim, making you feel guilty, threatening with suicide and having an angry outburst. Abandonment doesn’t have to be real it can be something completely normal for child’s development. Like having a sleep over at a friend.
There are also other ways that BPD mother tries to prevent abandonment. One of them is to make the child her best friend. They develop a relationship with a child that is preventing him/her to become an individual. She may look to this child for comfort and validation rather than the other way around. It’s difficult to tell where the boundaries are between the mother and the child. Both tend to cling to each other in fear that the other one will leave.
It can also take the form of infantilizing their children. The mother is unable to tolerate her child’s developmental growth toward healthy independence. They find it difficult to adjust their parenting strategies to match the developmental needs of their children. Oftentimes, children who are being infantilized may develop depression, anxiety, developmental delays and may even be misdiagnosed with an autism spectrum disorder. In the extreme form infantilization can lead to Munchausen by Proxy.

  • “My mother always had a problem with either my Dad leaving (business trips, trips to see his family, extracurricular athletics) or her present husband (my step-father) going away. She stays home all the time, and presently has little to no friends.”
  • “There will usually be some kind of message or voicemail that doesn’t leave you the option of ignoring her, sometimes over-dramatizing what is going on to the point where it will make me panic, or at the very least, make it clear that I’m a horrible child if I don’t respond right away.”

Parental alienation
A mother with BPD may not be able to tolerate a loving relationship between her kids and their father. It is not uncommon for these mothers to speak poorly about their dads in an attempt to turn their children against them. The child can be used as a weapon to carry out her push/pull relationship with the father.

  • “Throughout my life, she looks for signs that I am “betraying” her with my Dad. She asks leading questions or comment about how I should or shouldn’t do something that might involve my Dad, testing me to see where I stand.”
  • “When my Dad showed me attention or gave me money to buy something nice for myself. She always punished me for it by silence for days or not giving me lunch money: “because your father already give you some.”

Jealousy
Mother with BDP is often jealous of her own children and sees them as a competition for attention, love, admiration and resources. The possibility that her child may be smarter, more attractive or popular can be very threatening to her.

  • “Even before that I could never bring anyone around my mom because she’d always find a way to make it seem like she was the perfect mom. The sickest part is that people would think she was this wonderful Christian women that could be the mom they never had. These people would confide in her and tell their deepest secrets and she’d share them with me. Trying to hurt me by showing me how much everyone loved her and wanted her.”
  • “I understand jealousy all too well. My mother actually slept with my first boyfriend to break us up. And she had a hand in my marriage crumbling as well.”

Control
There is a high need of control with BPD parents. They believe that they are entitled to unilateral control over the children. It is common that BPD mother sees the children as her property. She feels that everything that is going on in the family needs to go through her. In BPD families there are times with over-involvement, intrusive behavior and periods of withdrawn, avoidant behaviors. These behaviors may also manifest as oscillations between hostile control and coldness. It is quite common for parents with BPD to attempt to control their children’s behaviors, feelings, and actions to a degree that inhibits their child’s ability to develop independently.

  • “I always thought I had a great and loving mother who only wanted the best for me until I recently went to college. I realized it was more about controlling my life than actually wanting to help me. She was practically living through me. Every time I tried to tell her that she needed help, she became the victim and talked about how horrible of a daughter I was and all the lies I create.”
  • “I can’t make my own decisions because she always made them for me.”
  • “She always told me what to do and how to do it. How I should dress, who I should visit, with whom should I be friends, how should I prepared the food. She always corrected me in every way possible.”

Distraction
It is very common for BPD personality to find a way to distract themselves from reality of life. They turn to any kind of substance abuse and addictions, overspending, workaholism. Basically they can make every item their current obsession until they move on to a new one. They distract themselves from being left alone with their thoughts. It is very common that they struggle at nights when everything calms down.

  • “My mother is a shopaholic, and buys incredible amounts of stuff. She has purchased hundreds of hat boxes but she doesn’t wear hats. She purchased hundreds of shoes but she rarely leaves the house. As far as the eating, she is very, very overweight and binges on food through the night. She stays up all night and sleeps all day.”
  • “She also tends to really focus in on things that can distract her. When she was working, she obsessed with her work and left no time for any social life, and when she retired, she found new ways to stay constantly distracted”.

Center of attention
BPD personality demands attention at all times. They often creates high drama in order to get and keep the attention.

  • “On my wedding day my mother make it all about her. How her daughter is leaving her. She wept so loudly that we needed to stop the ceremony in order to calm her down.”

In Part I we saw what kinds of dynamics can occur in Borderline Families. In the second article (Part II) we will take a look at what kind of psychological burden a child who was growing up in Borderline Family takes with him/her.

NARCISSISTIC PERSONALITY DISORDER (NPD)

  1. Definition of Narcissistic personality disorder (NPD)

The term narcissism was first used in relation to human psychology by Sigmund Freud in his essay “On Narcissism” after the figure of Narcissus in Greek mythology (Golomb 2003: 18).
The Myth: One day Narcissus was walking in the woods when Echo (mountain nymph) saw him, fell deeply in love, and followed him. Narcissus sensed he was being followed and shouted “Who’s there?”. Echo repeated “Who’s there?” She eventually revealed her identity and attempted to embrace him. He stepped away and told her to leave him alone. She was heartbroken and spent the rest of her life in lonely glens until nothing but an echo sound remained of her. Nemesis, the goddess of revenge, noticed this behavior after learning the story and decided to punish Narcissus. Once, during the summer, getting thirsty after hunting, the goddess lured him to a pool where he leaned upon the water and saw himself in the bloom of youth. Narcissus did not realize it was merely his own reflection and fell deeply in love with it, as if it was somebody else. Unable to leave the allure of his image, he eventually realized that his love could not be reciprocated and he melted away from the fire of passion burning inside him, eventually turning into a gold and white flower (Source: https://en.wikipedia.org/wiki/Narcissus_(mythology))
Narcissism is “a pattern of traits and behaviors which signify infatuation and obsession with one’s self to the exclusion of all others and the egotistic and ruthless pursuit of one’s gratification, dominance and ambition.” (Vaknin 2003:18) The narcissist constantly tries to repair his injured self-esteem by adoring and admiring his gilded self. (Golomb 2003: 18)

  • Diagnostic criteria

There is a whole range of narcissistic reactions, styles, and characteristics – from the mild, reactive and transient to the permanent personality disorder. NPD is commonly diagnosed with other personality disorders, such as Histrionic, Borderline, Paranoid, and Antisocial Personality Disorders (Vaknin 2003).
The ICD-10 (International Classification of Mental and Behavioural Disorders) defines NPD as “a personality disorder that fits none of the specific rubrics”. It relegates to the category “F60.8 Other specific personality disorders”, together with eccentric, “haltlose” type, immature,        narcissistic, passive-aggressive and psychoneurotic (ICD-10).
American DSM-IV-TR defines NPD as “an all-pervasive pattern of grandiosity (in fantasy or behavior), need for admiration or adulation and lack of empathy”.
The DSM specifies nine diagnostic criteria. Five (or more) of these criteria must be met for a diagnosis of NPD.
Proposed Criteria:

  • ‘Feels grandiose and self-important (e.g., exaggerates accomplishments, talents, skills, contacts, and personality traits to the point of lying, demands to be recognized as superior without commensurate achievements);
  • Is obsessed with fantasies of unlimited success, fame, fearsome power or omnipotence, unequalled brilliance (the cerebral narcissist), bodily beauty or sexual performance (the somatic narcissist), or ideal, everlasting, all-conquering love or passion;
  • Firmly convinced that he or she is unique and, being special, can only be understood by, should only be treated by, or associate with, other special or unique, or high-status people (or institutions);
  • Requires excessive admiration, adulation, attention and affirmation – or, failing that, wishes to be feared and to be notorious (Narcissistic Supply);
  • Feels entitled. Demands automatic and full compliance with his or her unreasonable expectations for special and favorable priority treatment;
  • Is “interpersonally exploitative”, i.e., uses others to achieve his or her own goals;
  • Devoid of empathy. Is unable or unwilling to identify with, acknowledge, or accept the feelings, needs, preferences, priorities, and choices of others;
  • Constantly envious of others and seeks to hurt or destroy the objects of his or her frustration. Suffers from persecutory (paranoid) delusions as he or she believes that they feel the same about him or her and are likely to act similarly;
  • Behaves arrogantly and haughtily. Feels superior, omnipotent, omniscient, invincible, immune, being “above the law”, and omnipresent (magical thinking). Rages when frustrated, contradicted, or confronted by people he or she considers inferior to him or her and unworthy.’ (Vaknin 2003: 19)

1.1.2. Short comparison with other personal disorders
As mentioned earlier NPD is commonly diagnosed with other personality disorders. In this chapter I will introduced short comparison with four other personality disorder.
Opposite from patients with the Borderline Personality Disorder (BPD), the self-image of the narcissist is stable, he or she is less impulsive, self-destructive and concerned with abandonment issues. Also they are not as clinging as BPD patients (Vaknin 2003). Borderline and narcissistic patients both idealize and devalue others. But there is a different between them. BPD patient alternates between idealization and devaluation. For example, first they will idealize you, you will be the best therapist they ever had, and in the next session they will devaluated you, you will be the worst person they had ever know.  Nevertheless, the borderline patient cares about others. The narcissistic patient is more exploitative. Idealization is connected with expectation to satisfied patient’s grandiose fantasy. The minute expectations are not met, narcissist abandons you and looks for another one who will meet his grandiose fantasies (MacKinnon and others).
In short, on surface functioning of the narcissistic personality is much better than that of the average borderline patient. In general, NPD individuals are more capable of high, sustained achievement and will have more successful work history than the person with Borderline Personality Disorder. Both kinds seek attention, but unlike borderline, who seek nurturing attention, narcissist feel they deserve admiring attention because of their superiority (http://www1.appstate.edu/~hillrw/Narcissism/differentialdiagnosis.html).
Histrionic Personality Disorder (HPD) and NPD: Both personality types tend towards the demonstrative, exhibitionistic, dramatic and seductive in their behavior. Contrary to the histrionic patient, the narcissist is achievements-orientated and proud of his or her possessions and accomplishments. Narcissists also rarely display their emotions as histrionics do and they hold the sensitivities and needs of others in contempt. While the characteristic distinguishing feature of Histrionic Personality Disorder is coquettishness, the feature of NPD is grandiosity. Person with HPD is warm, playful, and spontaneous and can be dependent on others. These individuals are capable of love, empathy whereas those with NPD are not (Vaknin 2003; look at http://www1.appstate.edu/~hillrw/Narcissism/differentialdiagnosis.html).
While persons with NPD and Antisocial Personality Disorder (ASPD) share tendencies to be tough-minded, glib, superficial, exploitative, and unempathetic, NPD are less impulsive, less aggressive, and less deceitful. All ASPD are assumed to have a narcissistic personality structure, but not all narcissists are ASPD. Unlike a person with ASPD, the person with NPD has not learned to be ruthless or competitively assertive and aggressive when frustrated. A critical distinguishing feature is that in ASPD, there are no feelings of guilt or remorse and as opposed to ASPD, few narcissists are criminals (Vaknin 2003; see http://www1.appstate.edu/~hillrw/Narcissism/differentialdiagnosis.html).
Patients suffering from the range of obsessive-compulsive disorders (OCD) are committed to perfection and believe that only they are capable of attaining it. But, as opposed to narcissists, they are self-critical. However, someone with NPD is more likely to believe that he has actually achieved perfection. Shortly, the OCD seeks perfection, the narcissist claims it. The value systems of these two personality types differ as well: person with OCD has deeply held, rigid but genuine moral and socio-political beliefs. In contrast, the person with NPD might exposed such deeply held values but actually lacks any true commitment to them (Vaknin 2003; see http://www1.appstate.edu/~hillrw/Narcissism/differentialdiagnosis.html).

1.1.3. Defense mechanism
Over all narcissists intended to protect true self from hurt and trauma. He creates False Self which is omnipotent, invulnerable, and omniscient, through which he regulates his self (Vaknin 2003). To maintain that state, narcissists develop different defense mechanisms. There are three defense mechanisms that are the most common for narcissists: splitting, graciosity and isolation/distance.
Graciosity: narcissist creates relationships only with people who admire them or who he admires. Consequently he is afraid that others will disappoint him or demand attention for themselves. When attention is turned away from them, they distance themselves and leaves the relationship (Praper 1996: 180).
Distance and isolation: narcissist doesn’t realize that he is hurt and wounded. When they got the feeling that others don’t see them as perfect, feeling of inferiority is awaken in them. They are unable to take criticism and take a distance when this happens (Praper 1996: 180).
Splitting or black and white thinking can be seen as a developmental stage as well as a defense mechanism, which is also common in NPD. Narcissist believe that they need to be admired by others. The ones who don’t admire them are categorized as bad. Their ego is not capable of accepting good and bad objects in one person (Praper 1996, see http://en.wikipedia.org/wiki/Splitting_%28psychology%29#Narcissistic_personality_disorder).

1.1.4. Types of narcissism
We all go through narcissistic developmental stage in our lives. As infants and toddlers we all feel that we are the center of the Universe and it is impossible to imagine that our needs wouldn’t be met (Praper 1996). Here we talk about primary narcissism, where toddler doesn’t separate the mother from himself and he depends on her to satisfy his primary needs (Lasch 1979: 79). Both self and others are viewed immaturely-as idealizations (Vaknin 2003). Gradually toddler gains experiences that everything cannot be the way he wants. He realize that there are obstacles in the world, which brings him little disappointments and make him overcome primary narcissism (Praper 1996).
Secondary or pathological narcissism is a pattern of thinking and behaving in adulthood. It manifests in the chronic pursuit of personal gratification and attention, in social dominance and personal ambition, bragging, insensitivity to others, lack of empathy and/or excessive dependence on others to meet his responsibilities in daily living and thinking (Vaknin 2003). Lasch says that this type of narcissism tries to destroy painful disappointments in childhood and cover the childs rage towards people that hurtled him. (Lasch 1979: 79)
Manfield differentiates the exhibitionist type and cover narcissism, both belonging to secondary narcissism (Praper 1996: 178):
The first type is exhibitionistic type. Children during childhood get a lot of support in their grandiosity but there is no room for individuality and true feelings. This type is common for families with one child. Investment in one child raises grand expectations. The child should be born genius, and should use every opportunity to demonstrate this to others. When not acting as expected, he can be roughly rejected by his parents. Avoiding rejection, he continues to be brilliant, perfect, sweet. He also requires that others treat him as special (Praper 1996: 178).
The second type is the disguised type. The child has experienced that grandiose ideas are unacceptable. He learns to hide any such feeling and behaviors. However, he still develops perfectionism and hypersensitivity to criticism. The need for superiority is suppressed while suffering from feelings of inferiority. The truth is that he in fact doesn’t believe that he is inferior (Praper 1996: 179). The disguised type appears humble and modest, so impressively weak that it isn’t difficult to overlook the hidden grandiose self (Praper 1996: 223).
Also Millon distinguish 4 subtype of secondary narcissism in the following photo:

Table: Narcissistic Personality Subtypes (available at: http://www.millon.net/taxonomy/summary.htm)

  1. Origins of narcissism 

NPD has been considered as pathology of self as formation of pathological development of identity (Praper 1996: 175). Considering the work of Otto Kernberg, narcissism is an ego distortion. Ego functions enable us to observe our self and environment. With narcissism, the ego is unable to develop observations from environment in to cohesive picture of self (look Praper 1996: 176). Kernberg sees narcissism as a defense against feelings of individual anger and abandonment, stemming from the child’s rejection. As a result narcissists are distrustful and incapable of relying on others. Their relationships are marked by jealousy, control, and withdrawal (Žižek 1987: 118-119).
By Kerenberg, pathological narcissism originates from the serious frustrations in separation phase (Praper 1996). Kernberg points out that narcissism is a result of permanently cold parental figures, which express indifference or hostility towards the child. This inadequacy is reflected in their tendency to inflate their self-image (Otway and Vignoles 2006).
Kohut believes that narcissism is a normal aspect of infantile development. The child’s self-grandiosity is supported by mirroring and idealizing relationship between child and parent. If these needs are not met, the child as an adult may appear poorly adapted to adult forms of narcissism (Otway and Vignoles 2006). He also believes that the loss of the object that would allow binding and idealized mirroring force the person to direct fantasy only to himself. Therefore, the NPD is looking for a person who would idealize him. Hoping that through the binding with others, he will achieve the feeling of coherent self. In reality he is looking for mother’s admiration that was not there (Praper 1996, 177). The secondary narcissism happens because the process of archaic infantile narcissism to a healthy adult narcissism is interrupt. (Otway and Vignoles 2006).
By Winnicottu, the reason for narcissism is the lack of empathy and harmony between parent and child. Another reason can be overly intrusive behavior from the parent. Child develops a false self, which protects the true self from intrusion and damage. Therefore, narcissists always offer impeccable false self and protect himself against feelings of inferiority (Praper 1996:177).
Millon’s theory opposes to mentioned theories which believe that negative relationship between child and parent is reason for narcissism. Instead, Millon says that the reason is the excessive attention of parents, over-pampering, forbearance and admiration. Parents show unrealistic judgment of the child’s abilities, thereby increasing children’s self-image, which the environment does not necessarily support. Despite the differences in the theories, all believe that narcissism is a result of dysfunctional childhood experiences. (Otway and Vignoles 2006)

  1. Personal attributes

Main personal characteristics which are normally found in NPD:
Sensitivity to criticism: patients with NPD feel injured, humiliated and empty when criticized. They often react with devaluation, rage, and defiance to any5 real or imagined criticism. They are incapable to tolerate setbacks, disagreement, and criticism. (Vaknin 2003)
In personal relationships narcissist is not capable of attachment to others. He depends only on recognition from others. He doesn’t t trust people because he has pathological fear of over-dependency on others. That’s why he usually have short love relationships that in his mind shouldn’t be too stressful or emotionally demanding (Žižek, 1987). The relationships are typically impaired due to their lack of empathy, disregard for others, exploitativeness, sense of entitlement, and constant need for attention (Vaknin 2003).
Narcissist is unable to enjoy because he connects enjoyment with others. Enjoyments starts when others notice his enjoyment. A narcissist is totally external, which indicates inner emptiness and loss of their identity.
Narcissist is incapable of mourning. They are not able to converting rage, because of the loss, to the mourning. He is only able to forget the lost object, or to determine that in fact he didn’t like them anyway. After that he directs his energy towards new person.
For narcissist, the availability of people is taken for granted. To this type of person you are not a person with feelings, you are a ‘thing’ to feed off and sustain their existence.
Narcissist use manipulation to get what he wants. He knows exactly which manipulative tactic is going to work best in which situation. When he wants something from us he pays attention to us but the moment he doesn’t need us anymore he acts indifferent toward us. Narcissists work within win-lose strategy. They believe their world is positioned to serve their insatiable needs. (Žižek, 1987; Tonia Evans 2008)
Being perfect: narcissist has a fear of failure, for example loneliness and aging. That’s why they take care of their body, trying to stay young  and be under the spotlight-so they won’t get lost in the crowd of average people (Žižek, 1987).  They are either “cerebral” (intelligence or academic achievements) or “somatic” (physique, exercise, physical or sexual prowess and romantic or physical “conquests”) (Vaknin 2003). Which means they are trying to be perfect in physical appearance or in intellectual accomplishments.
Narcissist in society: narcissist sees himself as some kind of an exception. He seems adapted to the social norms but he doesn’t take them seriously. He plays this game just to avoid punishment and be successful in the society. He is convinced that everybody else is doing the same-“everyone is wearing masks, social life is just a game” (Žizek, 1987). A narcissist sees the admired person as “an extension of themselves.” If that person refuses them, they “immediate experience hatred and fear, and devaluate previous Idol” (Lasch 1979: 155-156). A narcissist avoids intimacy and associates only with people who are, like himself-perfect (Praper 1996: 180). Žižek mentions three types of other people, separated by the narcissist:

  1. The ideal-other: they expect approval and recognition, he identified with them
  2. Enemies, who are preventing his narcissistic affirmation, so they must be destroyed
  3. All the rest, the mass of people, ”suckers”: a grey average, which is here only to take advantage off and then reject them (Žižek 1987: 111).

 

  1. Narcissist as a patient

Several different approaches to individual therapy have been tried with NPD patients, ranging from classical psychoanalysis to Gestalt therapy. The emerging consensus is that therapists should set modest goals for treatment with NPD patients. Most of them cannot form a sufficiently deep bond with a therapist to allow healing from early-childhood injuries as a matter of fact they rarely turn to therapy at the first place (Frey, 2010).
“As of 2002, there are no medications that have been developed specifically for the treatment of NPD. Patients with NPD who are also depressed or anxious may be given drugs for relief of those symptoms (Frey, 2010).
Kerenberg noticed that narcissistic patients shows excessive self-centeredness, over dependency on admiration from others, prominence of fantasies of success and grandiosity. They avoid facts that are contrary to their inflated image of themselves. A narcissistic patient due to the pain of isolation protects himself with a position of self-sufficiency. They don’t let people emotionally close (Kerenberg, 2007, 505; Praper 1996:223).
They suffer from inordinate envy, which is conscious and unconscious. They show greediness, exploitative behavior, entitlement, devaluation of others, and incapacity to really depend on others. But ironically they need the admiration of others. They show a remarkable lack of empathy, shallowness in their emotional life and lack of capacity for commitment to relationships and goals. Also their self-esteem is regulated by severe mood swings. They have chronic sense of emptiness and boredom which they try to escape through eating, drug and alcohol use. In addition, their tendency to criticize and devalue their therapists (as well as other authority figures) makes it difficult for therapists to work with them (Kerenberg, 2007, 505, Frey 2010).
Patients with NPD may present typical complications of this disorder, including sexual promiscuity or sexual inhibition, drug dependence and alcoholism, social parasitism, severe (narcissistic type) suicidality and parasuicidality (=their aim is not to die). For instance, a patient with NPD tends to become depressed when his feelings are badly hurt, when his defenses have let him down and when he believes his world is collapsing. When wounded, he is at the greatest risk of acting out, either against himself or others. A patient experiencing a narcissistic rage may become homicidal, particularly if he has a need to seek revenge. Under conditions of severe stress and regression, a narcissist can experience significant paranoid developments and brief psychotic episodes (look Kerenberg, 2007, 505; http://www.lmars.com/n-personality-disorder.htm).
Using Heinz Kohut’s self-psychology model, the goal of therapy is to allow the patient to incorporate the missing self-object functions into his internal psychic structure. This process is called transmuting internalization. In this sense, these patients’ psyches are “under construction” and therapy is their building time. Empathy is being the key for making changes in therapy. Without it, the patient whose self is too weak to tolerate more aggressive interpretation, would not benefit from therapy and in fact may suffer more damage (McLean, 2007).
Therapists can recognize narcissistic patients by contratransfer. By feelings of boredom and emotional desertion. The therapist may become sleepy, absent, experiencing shame. He can react as all-knowing expert on life, competing with all the therapists that client had left earlier. When the client devalues him, he feels inadequacy and helplessness (Praper 1996:223).
“The prognosis for younger persons with narcissistic disorders is hopeful to the extent that the disturbances reflect a simple lack of life experience. The outlook for long-standing NPD, however, is largely negative. Some narcissists are able, particularly as they approach their midlife years, to accept their own limitations and those of others, to resolve their problems with envy, and to accept their own mortality. Most patients with NPD, on the other hand, become increasingly depressed as they grow older.” (Frey 2010)

References