My name is Sam Vaknin, and I am the author of Malignant Self-Love: Narcissism Revisited.
I have made a series of videos about the borderline woman, the female patient with borderline personality disorder.
Of course, it is true that borderline is also diagnosable among men, but the weight had been defined and treated and studied and was pretty frankly male-shorinistic.
And several traits and behaviors attributable or attributed to borderline patients reflect cultural and societal mores of the 1950s, 60s, 70s and 80s when the borderline diagnosis was sort of coalesced around a group of scholars, all of them of course male.
There are also value judgments inherent in the diagnosis, etc. So consequently, 75% of people diagnosed with borderline personality disorder have been historically female. And that's why I'm dedicating much more attention to the female borderline patient.
Additionally, recent research, the bleeding edge research in psychology tends to demonstrate or to my mind prove conclusively that borderline personality disorder in women is actually another name for psychopathy, factor two psychopathy, not the male variant, which is factor one psychopathy, not primary psychopathy, but secondary psychopathy.
I discussed all these in previous videos, but in all these videos, I use one term repeatedly and people have written to me and justly saw that I haven't clarified. I haven't made this term that I'm using rigorous. I'm using interchangeably terms like rejection, humiliation, abandonment, this, that, and I didn't clarify what do I mean by rejection? How do various cluster B personality disorders perceive rejection and how do they react differentially to rejection in different ways?
So rejection is, of course, any situation where a trait, a behavior, an inner process, an external object, an internal object, an emotion, an affect, the expression of emotion, or a cognition, including an emotional cognition, for example, wishes. All these are not accepted by someone who has significance in the rejected person's life.
So it's not enough to be rejected. You need to be rejected by someone who means something to you. Someone whose presence in your life fulfills, caters to important emotional needs, facilitates or catalyzes important psychological processes, psychodynamic processes.
In all Cluster B personality disorders, there's a problem in relating to an intimate partner.
In some of them, there's approach avoidance, repetition, compulsion. In others, there's inability to interact with other people as full fledged human beings.
So these patients prefer to interact with internal representations of their intimate partners. In yet other Cluster B disorders, there's a problem of developing any kind of emotion, positive emotion like love, intimacy, loyalty, etc.
So that there are massive problems, almost intractable and foundational problems. In the way patients with Cluster B personality disorders relate to intimate partners.
And this is because in all these disorders, perhaps with the exception of psychopathy, in all these disorders, it's an intertwining of arrested development. The child's development was at some point stopped or seized.
And so many of these patients are actually children, psychodynamically speaking, psychologically speaking, they're children. A combination intertwining of this with attachment dysfunctions or attachment disorders, or at the very least dysfunctional attachment styles, an avoidant type of attachment, paranoid type of attachment, you know, attachment that doesn't go all the way, attachment that doesn't dare say its name.
Combine these two, a child with attachment problems, and you get a picture of the typical Cluster B patient.
Well, the only exception might be the psychopath. We'll come to it in a minute.
But first one, we say rejection by an intimate or significant other, significant intimate partner, we need to ask whether the rejection is real or perceived. Is it sufficient for the rejection to be merely imagined? Or anticipated? predicted?
The answer is yes. Because of magical thinking, in cluster B personality disorders, there is no real distinction. There is no distinction between reality, what's happening outside and what's happening inside. The patient's cognitions and emotions are perceived as external entities.
And in this sense, Kemberg was right when he said that some of these disorders are on the border of psychosis. There is no the boundary between out there and in here, this boundary is very blurred. And it's blurred because the child was not allowed to develop boundaries, was not allowed to separate from the parent and individually.
So people with Cluster B personality disorders are unboundaried, they have severe problems with boundaries. And consequently, everything is one big melange, everything is one big salad, the outside, the inside external logic, internally.
So when the Cluster B patient imagines abandonment, anticipates it or predicts it, in his mind or her mind, it had already happened. Whether it had really happened or not is meaningless to ask because the internal environment is perceived as reality, as real as reality.
And so the answer is yes, both real rejection, perceived rejection are of equal status and equipotent, they have the same power.
Now this creates enormous problems.
First of all, the patient reacts to internal processes, which are not transparent to the intimate partner, the intimate partner doesn't know what has happened suddenly. And this is of course the source of mood lability and dysregulated emotions.
The reactions of the Cluster B patient have to do as much within internal dynamics as they have to do with anything with any external trigger or stimulus.
So the intimate partner can be absolutely the same, can be nice and caring and loving and engulfing and even naming. And suddenly his Cluster B patient intimate partner goes haywire, goes awry and does crazy things, behaves recklessly, cheats on him.
And he doesn't know why. He doesn't know why because of course none of us has access to anyone else's mind. So he doesn't have access to, to his wife, for example, who is a borderline. He doesn't know what has happened to her. Why why has she changed so much?
And in some of these disorders, I mentioned borderline, the changes could be literally from one hour to the next. So it's very, very difficult to cope with this roller coaster.
That's in the intimate partner's point of view. From the patient's point of view, the patients needs to be consistently, constantly hypervigilant. The patient needs to have a kind of radar or always on radar, scanning for possible rejections, scanning for possible humiliation, monitoring, observing, supervising, controlling, making sure that no abandonment is forthcoming, no humiliation or insult.
And so this behavior is known as hypervigilance. Narcissists, for example, are very hypervigilant.
All these patients react to internal processes, the hypervigilance is directed not only at the outside, but it's directed at the inside.
The patient monitors his or her inner landscape as though it were reality and reacts to this inner landscape, magically, as though it had transpired in reality, even though no one else around the patient sees anything or observes anything or realizes anything. It's totally crazy making.
Now, each of the cluster B personalities reacts differently to actual or perceived rejection.
The narcissist reacts with narcissistic rage to what he perceives to be narcissistic injury.
Rejection, real or imagined, I repeat, rejection is, of course, an undermining of grandiosity, a challenge to grandiosity, because it implies, first of all, that the narcissist is not omnipotent. He cannot control everyone. He cannot micromanage behavior of people around him.
And they can reject him, which is an outcome he did not want. And it challenges his omniscience.
The narcissist thinks that he's all-knowing. But if he's all-knowing, how did he fail to predict the abandonment and the rejection?
So rejection challenges all the elements of the narcissist's grandiosity. It also challenges his perfection. He thinks of himself as a perfect being. He's a perfectionist, but also he thinks of himself as a perfect being like God. So being rejected is implied criticism. It's saying you're far from perfect. Not only are you far from perfect, but I have found someone who is better than you in the case of cheating, for example.
So the narcissist's grandiosity is undermined and challenged so severely and so profoundly that he reacts with panic, in effect, a panic attack converted into aggression in the form of narcissistic rage.
The primary psychopath regards rejection as a mere hindrance or obstacle.
Primary psychopaths are very goal-oriented. They're called calculating, scheming, heartless, reckless and callous machines.
And so they regard every rejection as a mere obstacle on the way.
And they obliterate rejection. They are very vindictive. So they punish the rejecting party. They convert immediately frustration to aggression. That's the Dollard hypothesis. They convert to aggression. And then they use this aggression coupled with impulsivity and defiance to punish the source of frustration and to, if possible, eliminate him or her.
So they go as far as needed. If the rejection is utterly detrimental to the interest of a primary psychopath, the primary psychopath will not hesitate to murder the source of frustration.
But usually it doesn't come to that. The primary psychopath simply damages the source of frustration and exacts retribution in order to restore the inner balance, restore the cosmic justice.
The psychopath is as grandiose as the narcissist, of course. The psychopath includes a very pronounced dimension of grandiosity.
The secondary psychopath is something completely different.
Remember that the secondary psychopath actually has empathy and emotions. As far as the secondary psychopath is involved, everything in life is a power play. It's about establishing power matrices. Who is on top? Who is winning? It's a competition. Who will subjugate whom to her or his will?
And so rejection is perceived as checkmate, exactly like checkmate in chess. And the secondary psychopath will then become primary having been hurt.
Rejection hurts the secondary psychopath the same way it hurts the borderline, which is one excellent reason to think that borderline is actually a secondary psychopath.
The secondary psychopath is hurt by rejection, is in agony, excruciating, life-threatening, existential pain.
And so to revert this, to survive, he becomes a primary psychopath. He or she becomes a primary psychopath and then acts as a primary psychopath would. Retribution, power, aggression, defiance, destruction, recklessness, hate.
So the secondary psychopath is the worst of all worlds. She's as grandiose as a narcissist, as aggressive, dangerous, violent, callous and reckless as a primary psychopath, and suffers miserably, is as labile and as emotionally dysregulated as a borderline.
That's by far the worst manifestation of Cluster B disorders.
A classic borderline personality disorder patient, let's say, for example, a shy personality, a shy borderline. She would experience rejection. She would translate rejection, even the slightest rejection.
Honey, I can't see you this evening because I have a work dinner. I have a dinner with my boss. Or I suddenly have to travel for three days to New York. I have some things to do.
She would interpret this as rejection and immediately catastrophize. She would project, extrapolate the rejection to full fledged abandonment.
So in the borderline's mind, every rejection, never mind how minimal, minute and justified, is abandonment. And she would react to it disproportionately, catastrophically, as if she were abandoned. She would split the object of frustration.
She would split, for example, if she has an intimate partner and she wants to talk to him and he can't talk because he's in a meeting. She would immediately interpret this as abandonment.
She would say, he doesn't love me anymore. He doesn't like me anymore. He thinks I'm bad.
So she splits him. She then sees him as a bad object, a persecutory object. She forgets all her love for him, all the caring, all the compassion. She hates his guts. She wants him dead.
Splitting is that extreme in classic borderline.
And then the splitting would be coupled with objecting inconstancy because he's far from sight. He's out of mind. He doesn't exist.
She will, in other words, erase him completely. She would convert him into an evil, dangerous, unsafe figure, a villain. Then she would delete him from her life, erase him completely.
And then she's capable of doing absolutely anything. She can undermine him, sabotage him, shame him interrelationally. In other words, for example, in work settings to his colleagues. She can cheat on him. She can purposefully, ostentatiously cheat on him and let him know that she's cheating, to hurt him. There's no limit to what a borderline can do once she perceives rejection and converts it counterfactually to abandonment. It's a cascade.
And she's not in control. It's not in control. It usually becomes so extreme that many borderlines dissociate because they know they're doing wrong. They know what they're doing is wrong. They know that they're hurting a person who loves them, but they can't stop. So they forget about it. They cut it off. They dissociate it.
And the next morning, the borderline can say, I don't remember what I've done. I don't absolutely don't remember. I really, I did this. I can't believe I did this. And she feels ashamed and guilty. And so it's very egodystonic.
The histrionic, another type Cluster B patient, which we increasingly think is actually a cycle.
Generally, we are looking now at Cluster B and we think that they are essentially, first of all, essentially there's a spectrum. And that most people have, most patients have a mixture of all what we used to call personality disorders. So most people are in a small way narcissistic, somewhat antisocial or psychopathic, somewhat borderline.
We believe there should be a Cluster B personality disorder. One with different emphases and dimensions.
Not like today, these distinctions, because the comorbidities are enormous. Most psychopaths are narcissists. So why, why the distinction? Why don't we say there's a narcissist who will go that far and there's a narcissist who will go much further. And that's a psychopath.
Or why don't we say there's a psychopath who can feel, who has emotions. That's a borderline.
Why don't we say there's a psychopath who regulates her self-esteem and self-confidence via flirtation and seduction and ostentatious displays of emotionality and her appearance. And that's the histrionic.
Increasingly, we think that all of them are actually one big soup, one big salad, but the histrionic would tend to interpret rejection as a blow to self-esteem. The histrionic interprets everything as having to do with her self-esteem and self-confidence.
She regulates her self-esteem and self-confidence via conquests, via the chase. She's a teaser. She's not really interested in sex or intimacy. She's interested in the process of getting there, getting to sex and intimacy.
Actually, most histrionic women are frigid. They don't like sex. So histrionic in woman is is the woman in the party who would appear half naked and then she would flirt with all the men, including married men in front of their spouses. And then she would try to seduce someone, also in front of the spouses. But then she would stop. She would tease them and stop.
She interprets rejection as a dysregulatory, dysregulates her sense of self-worth. It renders her sense of self-worth fluctuating.
So exactly like the narcissist, she would resort to men, for example, to seduction, to flirtation, to regulate her sense of self-worth.
In many ways, seduction and flirtation and so on are her narcissistic supply.
That's the way histrionics react to rejection. You reject a histrionic within seconds, she will find another man and she will seduce him and flirt with him in front of you, just to show you that she's desirable, that you are wrong, how wrong you were, and that she doesn't need you. She's independent. She can do anything she wants.
Now, all these types, all Cluster B personality disorders, somatize.
Let me talk about a bit about the concept of somatization.
Essentially, there are two pathways. Some people communicate with their minds through their bodies and some people communicate with their bodies through their minds.
In other words, some people first think they have cognitions, they have emotions, they analyze, they have memories, and then this has effects on their bodies, or they make decisions regarding their bodies, to drink, to exercise, whatever.
And some people are exactly the opposite. They have no access to their minds because, for example, the mind contains too much pain. So they don't want to go there.
They are dissociative. They keep forgetting everything. They are discontinuous. They have problems with the regulation of emotions. Their moods are labile.
So they don't want to go there. Their mind is like a dystopian alien universe and they don't want to enter it.
What they do instead, they use their bodies to communicate with their minds.
So these are the kinds of people who abuse substances, alcoholics, junkies. They introduce substances into their bodies so as to change their moods, so as to regulate their emotions, so as to provide them with certain traits, for example, sociability.
So they use their bodies and their body's reactions to substances in order to affect changes in their psyche, in their psychology.
Another example is, of course, overeating, or eating disorders. It's another way to regulate moods and emotions.
And then there is, of course, the whole class of what we used to call conversion symptoms. Medical conditions, apparently medical conditions, that have no medical reason. They are psychogenic. They are created by psychology.
So someone's arm suddenly becomes paralyzed. It represents something.
Freud was the first to describe, not the first, but popularized the concept of conversion symptoms. Of course, in hypnosis, in hypnotic sessions, we create, artificially, conversion symptoms.
So all Cluster B personality disorders, they use their bodies to communicate with their minds. They have no real access to their minds, ironically.
They live inside their minds. But they don't have real access to their minds because they keep confusing the mind with reality, and reality with the mind. It's exactly like the psychotic.
The psychotic is what we call hyper reflection. Psychotic is unable to tell what is his mind and what is reality. That's why he hears voices.
His introjects, internal voices, are suddenly projected and externalized. And he hears voices as though they were coming from the outside.
It's not very different in the case of Cluster B personality disorders.
They are also totally confused about in and out, external and internal. I mean, they are utterly befuddled.
So because of that, the only surefire path to regulation and access is via the body.
So you would find that most Cluster B personality disorders, for example, abuse substances, they drink or do drugs.
Many of them are focused on their bodies, somatic narcissists, histrionics, bodybuilding, sex. And when they are rejected, they also use their bodies to communicate.
So a typical reaction would be to get drunk or to do drugs or to go to the gym and have a five-hour fitness session or to run 10 kilometers.
They would use their body to regulate their internal environment.
This is the panopoly on the spectrum of reactions to rejection.
The human mind is by far the most complex universe there is. The physical universe is not a hint of a fraction of what an average person has here inside.
It's a powerful supercomputer. One million of them, actually, a typical brain is equal to one million supercomputers. It has more connections than all the atoms in the universe.
And it's inside each and every skull.
And we don't really respect and honor it.
And this is what psychology is all about, gaining this respect via getting to know this most amazing device at our disposal.