Are the Diagnoses of Borderline, Narcissistic, Histrionic or Antisocial Personality Disorder Helpful or Harmful for Non’s?

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In August 2010 Tara Palmatier published a diatribe against women with Borderline Personality Disorder.

She was counter attacked by a disorderly rabble of women with BPD, bloggers and mental health staff in a series of blog posts and videos.

Palmatier reached for her Lawyer and all but one of the naysayers were threatened, sued and cajoled into silence.

Only Socrates, from the notorious New Republic blog, took a stand...

“When you allow a narcissistic woman to determine reality, you’re letting one of the inmates control the asylum”
Tara J. Palmatier

Still waiting for the cheque/check

Dr Palmatier has become something of a heroine and torch-bearer for what has become known as the "Men's Right Movement" (MRM). Here is a brief but well evidenced rebuttal of the MRM: Men’s Rights Movement Spreads False Claims about Women, from the Southern Poverty Law Center.


What’s in a Name?

When it comes to the Cluster B personality disorders (Borderline Personality Disorder, Narcissistic Personality Disorder, Histrionic Personality Disorder and Antisocial Personality Disorder), I sometimes question whether an actual psychiatric diagnosis is helpful or detrimental—detrimental to “Non’s” (the person without the personality disorder; not detrimental to individuals with the disorder[s]).

When mental health professionals use the terms HPD/BPD/NPD/APD; it’s mental shorthand. I hear the term “borderline” or “narcissist” and it conjures an immediate recognition and understanding. Just like when I use the word “chocolate,” I know what the general flavor, smell and texture will be, taking into account individual differences like quality of ingredients, cacao ratio and type of confection in which it’s used.

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The label “mentally ill” has been co-opted by Cluster B’s, primarily by Borderline Personality Disorder activist groups such as NAMI and, much to my horror, TARA, in a way that seems to enable the disordered individuals and perpetuate the abuse of Non’s. These organizations goals generally include:

educating the general public and friends/families of BPD’s about the disorder as they define it

painting a rosy and unrealistic picture of treatment outcomes

legitimizing and enshrining BPD’s professional victimhood status

instructing the Non’s on how they should behave lest they “trigger” the BPD’s myriad insecurities, fears, paranoia and jealousies (which pretty much absolves the BPD from any personal responsibility for her behaviors)

preventing self-identified BPD’s from being stigmatized

protecting the rights of BPD’s

BPD’s don’t want to be “stigmatized.” Okay. Then how about treating others with the same respect and consideration for their rights and feelings that you demand from everyone else? If I treated my loved ones the way most Cluster B’s treat their nearest and dearest, I would be profoundly ashamed of myself and deserving of social censure and stigma.

As for BPD’s insisting on having their rights protected—snort! That’s very rich considering that Borderlines/Narcissists/Histrionics/Sociopaths are the biggest offenders when it comes to violating the rights of others.

Giving these individuals the protective cloak of “mental illness” makes it far easier for self-identified Borderlines to manipulate and guilt others into enabling and tolerating their worst behaviors, which I believe are fundamentally sociopathic. Specifically, when we identify someone as physically or mentally ill, most people feel compassion and make excuses and adjustments for their strange behaviors and limitations.

When an individual’s strange behaviors and limitations include purposefully and maliciously hurting others (I don’t care if it’s because they’re feeling hurt or not validated), having zero empathy for anyone but themselves and consistently blaming others for their bad behavior we must not make allowances and excuses for them. We need to get as far away from them as we possibly can and stay away.

One of the hallmark characteristics of Cluster B disordered individuals is that they rarely see their own behavior as the problem. They don’t think there’s anything wrong with them—someone else is always to blame for their unhappiness and failures. On the rare occasions when they’re actually willing to admit that something they said or did was hurtful, it’s always followed by a “but,” which then reassigns their personal responsibility to another party.

These individuals typically only seek treatment if they’re a) court-ordered; b) trying to manipulate or gain a therapeutic ally to abuse their partner; or c) experiencing a severe consequence that they can’t blame away with their usual mental gymnastics. Therefore, if they’re not bothered by their behavior and you are, then it’s just too bad for you. You’re the one with the problem and you should be in therapy to learn how to accept them as they are. Is your brain spinning yet? Treatment resistant? You bet.

Are Borderlines, Narcissists, Histrionics and Sociopaths Really Mentally Ill?

Cluster B’s aren’t “mentally ill” like Schizophrenics and Bipolars are mentally ill. Schizophrenics and Bipolars can’t control their bizarre thoughts, behaviors, impulses and/or hallucinations without medication and deserve our compassion and sympathy. Many self-identified BPD’s and other Cluster B’s plaintively bleat the following statements with great regularity:

“But I can’t help the way I am!”

“I didn’t ask to be BPD!” (Reminds me of a disaffected teen shouting, “I didn’t ask to be born!” Yeah, well, you’re here now, so what’re you gonna do about it?)

“Don’t lump us all in the same category! We’re not all the same, you fraud! Boy, some woman must have really hurt you to make you so bitter, you misogynistic lesbian!” (Erm, by virtue of your diagnosis for which you’re a self-appointed spokesperson, you’ve already been lumped into a diagnostic category and, by the way, attacking people who don’t see things your way is, well, kind of proving my point. Oh, and not a lesbian and not bitter.

Just trying to help people protect themselves from predators, which understandably makes things more difficult for you, but I digress. Oh and one last thing; ‘misogynistic lesbian,’ seriously? First, have you ever heard of the term ‘oxymoron’ and, second, I’m ‘misogynistic’ because I believe it’s equally wrong when women abuse men as when men abuse women? Grow up, you perpetual infants, but now I’ve really digressed.)

Whenever a BPD offers up these two chestnuts (or some variation of them), what she’s actually saying is:

“Unlike other adults, I’m not responsible for my actions.”

“I don’t have to be responsible for my actions because I’m ‘sick’ (or in the case of NPD’s/HPD’s/APD’s, “because I’m special.”)

“You must tolerate my bad behavior because something you did or didn’t do triggered it.”

This is all nonsense, of course. Unless a Cluster B is actually experiencing a psychotic break, most are quite capable of controlling their bizarre and abusive behaviors when it suits them. Specifically, a Cluster B can control her external behavior when:

She is love bombing you.

She is trying to hoover you back into the relationship.

She is in the presence of people whom she fears and/or wants to impress.

She is trying to manipulate you into giving her money, paying off her debts, marrying her, letting her move in with you or putting her name on your house or bank accounts, for example.

Most Cluster B’s only mistreat and abuse people who they’re certain will let them get away with it. Validating their emotions, beliefs, assertions and accusations just because they’re having them, which often have no basis in reality, only enables them to continue to jerk you around.

Personality “Disorder” or Just Bad People?

Cluster B personality disorder individuals are not mentally ill. Many of their behaviors and beliefs are counter to societal norms, but they’re not crazy in the sense that they’re not responsible for their actions due to insanity. Having zero impulse control doesn’t make you insane; it makes you an out of control child. Why do we insist on referring to a woman who has no empathy, no conscience, no sense of fair play, no personal accountability, who takes malicious pleasure in deliberately hurting the people who are closest to her, who believes the people she harms or takes advantage of “deserve it” and who believes she is entitled to take the material assets others based on nothing more than an unfounded belief that she “deserves it” or that she is “owed it” because of some mis-perceived sense of “specialness” or victimhood as “sick” or “mentally ill?” These may be aberrant social behaviors and attitudes, but it doesn’t make them sick or incapable of controlling their outward actions.

Instead, let’s call them what they are; sociopaths. All the Cluster B disorders are just similar flavors of sociopathy. Giving Cluster B individuals and their ilk the protective cloak of “mental illness” provides them with a “get out of jail free card” and allays our existential dilemma on the concept of evil. Instead, we tell ourselves, “She has problems. She’s sick. We have to be patient and understanding.” Not so surprisingly, we don’t afford men with the same aberrant behaviors the same compassion, slap on the wrist justice and material and legal entitlements; we label them as sociopaths or deviants and put them in lockdown facilities where they can’t hurt anyone.

Cluster B’s, both male and female, are ultimately sociopaths (i.e., no conscience or empathy for those whom they have hurt). They lack the higher level brain functioning that makes having ethics, morals, empathy, good judgment, introspection and impulse control possible. Recent research shows that the lower brain (the old reptilian or “alligator brain”) is more active in sociopaths and borderlines than the neocortex. This means the “fight or flight” mode of thinking is perpetually on—eff over or be effed over; I win you lose. This is their world view and they see nothing wrong with it. They also believe everyone else thinks and feels the same, which seems to allow them to justify even their worst behaviors.

Furthermore, “sick” implies that there’s some cure. Last time I checked, no real illness was cured by the love and patience of a second, third or fourth party. People with anxiety disorders have to take active behavioral and cognitive steps to reduce their anxiety in order to treat it successfully. People with depressive disorders have to take active behavioral and cognitive steps in order to treat it successfully. Borderline activists insist that part of their “successful” treatment is to have their emotions validated. Even when they can occasionally acknowledge that many of their emotions, fears, suspicions and insecurities have no basis in reality, that’s when they claim it’s especially important for Non’s to validate their one-sided, chaotic emotional BS.

Validating Cluster B’s emotions that have no basis in reality and being tolerant of the spiteful acts that spring from their faulty emotional reasoning is collusion. When you do so, you become a willing victim and a participant in a folie à deux.

Is It Time for New Labels?

There’s a lobby of BPD activists who want the psychiatric community to change the term “Borderline Personality Disorder” to Emotional Dysregulation Disorder. Aside from having to edit all of my previous posts, I say a rose by any other name would still have nasty, hooky little thorns. Pardon my language, but I think the terms crazy asshole, mean jerk, toxic person or bad person are better than diagnostic labels. Why? Because everyone knows that you should avoid crazy assholes at all costs and whenever possible.

Fundamentally, Cluster B disordered individuals are primitive, predatory personality structures. I don’t even like the term “personality disorder.” “Character disorder” is better. These people have poor characters. It’s like my mom used to tell me when I was occasionally bullied at school, “There are just some mean, bad people in the world and you’re better off staying away from them. If you can’t find someone to help you, then run away.” She didn’t encourage me to try to figure out what was wrong with them or to have sympathy for them.

She basically said they’re jerks and here’s how to protect yourself. Same goes for Borderlines, Narcissists, users and bullies or whatever society wants to call them. Frankly, I’d rather spend time with schizophrenics. They’re typically not vicious and, unlike Cluster B’s, their pathology primarily affects them the worst instead of anyone who gets too close to them.

Postscript: Yes, I realize that many individual with Cluster B personality disorders were abused as children and I am truly sorry for that. However, that does not make it okay for them to abuse other people as adults. Their needs and feelings do not trump others because they were abused as kids. It just makes them another physical/emotional abuser in a long line of abusers.

by Dr Tara J. Palmatier, PsyD

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