How to Differentiate between BPD and NPD

DISCLAIMER#1: I’m not a therapist or clinician. 
DISCLAIMER#2: The entire post is based on Elinor Greenberg, PhD, CGP’s Quora Answer! (Its brilliant and I wanted to spread, however I dont really agree with the last part about comorbidity.)

How to Differentiate between BPD and NPD

The easiest way to understand the major differences between Borderline and Narcissistic Personality Disorders is to compare the two side by side with regard to their major issues, goals, defenses, and approach to life. For ease of explanation, I am comparing two things that do not really exist: The “typical” person with Borderline Personality Disorder and the “typical” person with an Exhibitionist Narcissistic Disorder. In reality, everyone is unique. The following is an oversimplified generalization that is useful as an introduction to this topic.

Note: I am using the word “Borderline” as shorthand for someone who adapted to their childhood home situation by adopting a “Borderline Pattern” of thinking, feeling, and behavior. Borderline is the name for the pattern of adaptations, not a label for the person. The same is true when I say “Narcissist.” That is shorthand for the adoption of a typically Narcissistic pattern of adaptations.

MAJOR ISSUES

Borderline: Their continual desperate search for reparenting in the form of love, romance, and nurturing leads them to choose and cling to inappropriate people and neglect other areas of their life. They spend very little time planning for the future, taking care of their health, managing their money, and attending to normal day-to-day chores. They would like other people to take on all the adult responsibilities that they prefer to ignore. There life is littered with unfinished projects. They have difficulty setting realistic goals and staying motivated long enough to succeed in reaching them.

Narcissist: They are continually seeking ways to enhance and stabilize their self-esteem and ward off shame-based self-hating depressions. In the process, they often alienate those around them by their grandiosity and their need to be the center of admiring attention. They are overly sensitive to negative feedback and may devalue anyone that they believe is criticizing them. They are low on empathy. They have a very limited capacity for true intimacy, which makes it very hard for them to form successful love relationships.

MAIN GOALS

Borderline: They want to be seen as lovable, receive unconditional love, find their “Soul Mate,” and get reparenting for everything that they missed in childhood. They would also like someone else to do all the hard adult things that they find intimidating

Narcissist: They want to be seen as perfect, special, unique and entitled to special treatment. They want to attain high status; get continual admiration and recognition from others; and always be right.

DIFFICULT TIMES

Borderline: When they are required to self-activate, structure their own time and lives, and act independently.

Narcissist: When they have to work with others and treat them as equals; loss of status, aging, or rejection; having to apologize or admit that they have made a mistake.

MAJOR DEFENSES

Borderline: They use “splitting” (seeing people as all-good or all-bad), denial, and a variety of acting-out behaviors to distract and distance themselves from their pain — substance abuse, cutting, binge eating, video gaming, gambling, etc. When they start to feel negative feelings, instead of dealing with what is coming up, they may quit their job, take a sudden trip they cannot afford, sign up for college courses, or find a new lover. These new activities rarely lead to anything positive, because their main appeal is that they are distractions from what the person is feeling or a way out of a situation that is not going well.

Narcissist: They become grandiose, devalue others, use others to help manage their self-esteem, and try to associate only with high status people or things.

SECRET FEARS

Borderline:

  1. They are unlovable
  2. They will be abandoned or rejected;
  3. 3 If they self-activate and become a fully adult, independent person, they or their mother will die or go crazy.

Narcissist:

  1. They are intrinsically defective and worthless; 
    and
  2. they will be publicly exposed as a fraud.

CONTRIBUTION TO THE WORLD

Borderline: Borderline individuals bring passion and liveliness into the world. Their clinging is the glue that holds many families together. Many of our greatest love songs and most expressive music are creative expressions of Borderline issues.

Narcissist: Because they have such a strong need for public recognition, Narcissists start many of the organizations, training institutions, and political bodies that make our society possible. They are often willing to devote enormous energy to causes as long as their work or their financial contribution puts them in the spotlight. Many of our most beloved entertainers are Narcissists. Many of our hospitals would not have been built without the work and funds of Narcissists.

INTERPERSONAL GESTALT

The Interpersonal Gestalt (or IG for short) is a concept that I developed that looks at what repeatedly becomes figure for the client during one-on-one interactions.

Borderline IG: They tend to notice interpersonal cues that involve the potential to be loved and nurtured or, conversely, abandoned or engulfed.

Narcissistic IG: They tend to notice those details that reinforce or contradict their sense of being special, perfect, unique and entitled. They are also highly sensitive to cues that relate to the possibility of being humiliated.

LIFE MOTTO

Borderline: You do it for me; it’s too hard.
Narcissist: If I can’t be the best, it isn’t worth doing.

Punchline: BPD and NPD are entirely different disorders. A person either has one or the other, but not both at the same time. What is usually mistaken for an overlap is the fact that some very low functioning individuals who grew up in extremely chaotic households will sometimes present in therapy with symptoms of many different disorders. This to me is a very different (and worse) situation than having made a clear Borderline or Narcissistic adaptation.

Elinor Greenberg, PhD, CGP

In private practice in NYC and the author of the book: Borderline, Narcissistic, and Schizoid Adaptations: The Pursuit of Love, Admiration, and Safety.

www.elinorgreenberg.com