My name is Sam Vaknin, and I am the author of Malignant Self-Love, Narcissism Revisited.
Borderline personality disorder is often diagnosed together, is comorbid, with other personality disorders. Most commonly, histrionic, narcissistic, and antisocial, or psychopathic.
All these four personality disorders form together the Cluster B.
So, cluster B personality disorders often coexist in the same diagnosed patient.
The majority of persons diagnosed with these comorbidities of personality disorders are actually women. Women are predominantly the main segment of the histrionic personality disorder population and of the borderline personality disorder population.
Borderline personality disorder is a post-traumatic state. It is repeatedly triggered in later life by neglect, abandonment, withholding of sex and intimacy, verbal and psychological abuse, and by life's circumstances, dangers and chaos.
When borderline personality disorder is comorbid with histrionic personality disorder, such women react by seeking comfort, acceptance, validation, sex and intimacy from other men.
But the comorbidity creates conflicting inner voices in the woman. There are three voices to consider.
Histrionic voice, the antisocial voice or psychopathic voice, and the borderline voice.
The histrionic voice in such comorbid women says, men will make you feel better, men will help you restore your self-esteem.
The psychopathic or antisocial voice in such a woman says, don't feel guilty about cheating, don't feel guilty or bad about being a "whore". It is fun. You deserve sex. It is not your fault. No one gets hurt if you keep it a secret. Go for it.
The borderline voice says, your sexuality is bad, mad and dangerous. Don't take it too far or it will end calamitously.
When such a woman with comorbid histrionic and borderline personality disorder, when such a woman experiences a narcissistic crisis or a narcissistic injury, when such a woman is hurt, humiliated or frustrated, when her femininity is doubted or challenged, her histrionic side forces her to reach out to men in order to make her feel better and to ameliorate her frustration.
When such women fling with men, they use men to self-medicate. Men become a kind of anti-anxiety drug.
These women restore their self-esteem and self-confidence. They regulate their labile sense of self-worth by having sex or engaging in sexual acts with with men. These women contact men with the intention of having intimacy in sex with them.
When this happens, the antisocial or psychopathic voice of the woman legitimizes her histrionic behavior. It says, as I said, don't feel guilty about cheating. Don't feel guilty about being a whore. There's nothing wrong with it. It is fun. You deserve sex. It is not your fault. No one gets hurt if you keep it a secret and so on and so forth. Go for it.
But at that point, the borderline voice interjects.
The woman's borderline aspect feels stressed and panics by the sheer prospect of imminent sex.
When the woman is faced with a man's expectation to have sex with her, and when this woman is also faced with her own sexual desire, she freaks out.
Sex is perceived as traumatic. These women perceive sex to be associated with pain and hurt, kind of punishment.
The following negative thoughts, negative automatic thoughts, prevail in these women's minds.
Sex is dirty. Men are evil, dangerous, one track-minded, they want only sex, and then they will discard you.
Sex inevitably results in pain and hurt. You should feel guilty about cheating. You should feel ashamed for being so whore-ish, etc.
These sentences, negative automatic sentences, play again and again in the woman's mind, as her histrionic side pushes her to engage in sex with strangers and her psychopathic side legitimizes this behavior.
So there's a conflict, an inner conflict, comprised of two or three conflicting and competing voices.
When faced with the prospect of sex, borderline patients panic because of these negative thoughts.
The panic, sometimes, leads to depersonalization. The woman splits from herself. She enters a kind of paralyzing trance. She goes autopilot. She lapses into a dreamlike or nightmare-like state.
If such a woman crosses the line and has full-fledged sex, she experiences dissociation. She forgets certain sexual acts that conflict with her values and boundaries, especially so if she finds them enjoyable.