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The Three Voices: Histrionic, Psychopathic, Borderline

Uploaded 9/23/2017, approx. 3 minute read

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.

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Over-sexed: Histrionic Personality Disorder and Narcissism

Histrionic personality disorder is more commonly diagnosed in women, leading to questions about whether it is a real mental health problem or a reflection of a patriarchal society. Histrionics crave attention and are uncomfortable when not at the center of it, similar to narcissists. They are preoccupied with physical appearance and sexual conquests, and often act flirtatious and seductive. Histrionics are enthusiastic and emotional, but their behavior can be exhausting and off-putting to others.


Attention Whores, Impulse Control, and Munchausen by Narcissist

Attention-bores, mostly women with histrionic and borderline personality disorders, use male attention to regulate their sense of self-worth. They become flirtatious, seductive, and trade sex for even the most inconsequential signs of attention from a man. Male attention serves a few important psychodynamic functions with these women, including reassuring them of their irresistibility and attractiveness, reasserting control and power of a man via her sex, and adrenaline junkies. Impulsive behaviors are addictive, and recurrences and recidivism are very common. As these women grow older, most of the signs and symptoms of borderline and histrionic personality disorder recede, unfortunately only to be replaced with dysthymia, background depression.


Labile: Borderline Personality Disorder and Narcissism

Borderline personality disorder is a controversial diagnosis that is often found among women. Some scholars believe it is a culture-bound pseudo-syndrome invented by men to serve a patriarchal and misogynistic society. Patients diagnosed with the disorder have chaotic lives and stormy, short-lived, and unstable relationships. Borderlines are impulsive, reckless, and display wildly fluctuating self-worth, self-image, and affect.


How Borderline Sees YOU ( Intimate Partner)

Professor Sam Vaknin proposes a new diagnosis called covert borderline, which better suits men as it combines borderline and narcissism. Borderlines have two anxieties: abandonment anxiety and engulfment anxiety, which lead to approach and avoidance behaviors. In the approach phase, the borderline sees their partner as their savior and regulator of emotions, while in the avoidance phase, they become paranoid and view their partner as an enemy. This creates a roller coaster of emotions and pain for both the borderline and their partner.


Narcissist: Socially-anxious, Schizoid

Schizoid personality disorder is characterized by a lack of interest in social relationships and interactions, limited emotional expression, and a preference for solitary activities. Schizoids are often described as robotic and uninterested in social bonding. While there are similarities between schizoid and narcissistic personality disorders, the two are distinct in that schizoids are uninterested in bonding, while narcissists are both uninterested and incapable due to their lack of empathy and grandiosity. Narcissism is not about self-love, but rather a broken ego or self that withdraws from society to protect itself.


Engulfment Anxiety Tips Bad Vs. Good Voices In Borderlines, Codependents, People Pleasers

Borderline Personality Disorder (BPD) is commonly associated with abandonment anxiety, but there is another type of anxiety that is less reported in literature, which is engulfment or enmeshment anxiety. This anxiety is triggered when a Borderline gets too intimate with someone, and it creates a feeling of being controlled from the outside, leading to a fear of being assimilated or digested. This anxiety is caused by the Borderline's bad object, which is a collection of internal voices that inform them of their unworthiness and inadequacy. To cope with this anxiety, Borderlines should establish a people-free time and zone, introduce structure into their lives, and stop being emotionally invested in the past or future.


How Borderline Lures, Captivates You

Professor Sam Vaknin discusses the strategies that borderline personality disorder women use to keep their partners hooked. He explains that the borderline woman is multifarious, ephemeral, and shimmering, and that she uses drama, approach avoidance, idealization, triangulation, and other tactics to keep her partner addicted to her. He also notes that the borderline's neediness and clinging cater to the partner's grandiosity, and that the borderline's ability to impair the partner's reality testing is essentially unlimited. Finally, he warns that relationships with borderlines are exceedingly destructive for both parties.


Borderline Seeks Fantasy but Flees to Reality

Professor Sam Vaknin discusses borderline personality disorder, which is diagnosed among men and women almost equally nowadays. Borderlines vacillate between two anxieties, separation insecurity and engulfment or enmeshment anxiety. These twin anxieties create an approach avoidance repetition compulsion. During the avoidance phase, the borderline seeks to become more grounded in reality, but she again tries to do this through the agency of someone. During the approach phase, the borderline merges with her significant other, becomes a single organism, outsources her mind to him, and then feels engulfed and enmeshed.


No Intimacy Without Personal Boundaries (Q&A)

Intimacy skills are inextricably linked to the capacity to maintain and enforce personal boundaries. People with personality disorders don't have personal boundaries, which makes it impossible for them to do intimacy. Intimacy is a balancing act between separateness and togetherness, sharing commonalities and having a private life separate from the partner. The younger generations have tremendous deficiencies in relationship and intimacy skills because they don't have the chance to experience even intimacy in relationships.


Borderline Personality Disorder Patient Therapy Notes

Do is a 26-year-old female diagnosed with borderline personality disorder. She struggles with maintaining a stable sense of self-worth and self-esteem, and her confidence in holding onto men is low. She has had six serious relationships in the past year, all of which ended due to violent fights over trivial matters. Do admits to physically assaulting three of her ex-partners and has suicidal ideation, which sometimes manifests in minor acts of self-injury and self-mutilation. She also struggles with drug use, shopping addiction, and binge eating.

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