Monday, April 14, 2008

The Borderline Lover as The Narcissist's Drug

Extensively revised and enhanced April 17, 2008.

The excitement-seeking, male narcissist's attempt to use the exciting, female borderline to kill emotional pain rarely works well. Here’s why.

The millennial world is not the one we grew up in. Nor, even more surely, is it the one our parents grew up in. Today’s man may continue to be the self-involved, self-seeking narcissist of his father’s day. But today’s woman is having no more of it, even if she cannot stand even the thought of trying to deal with the upshots of her "liberation."

This article will use the principles of Steven Karpman’s Drama Triangle, Millon’s descriptions of the narcissistic, borderline and other personality disorders, Erikson’s notions of developmental path, Kernberg’s (and many other) ideas about “object relations,” Sullivan’s grasp of interpersonal relations, and many other key ideas from 20th century psychology to explore one of the most pervasive phenomena in the fin de siecle of post-war American society.

For those who wish to understand why their lives are so painful and their intimate relationships are so relentlessly wretched, and who are unfamiliar with the concepts listed above, I strongly suggest a cursory exploration of these ideas at…

Drama Triangle

Personality Disorders

Developmental Path

Object Relations,RNWE:2006-06,RNWE:en&q=Kernberg+object+relations+&sa=X&oi=print&ct=result&cd=1&cad=bottom-3results

Interpersonal Relations

The Two Essential Forms of Narcissism

The narcissistic male wants things to go his way. We all want things to go our way, of course. But if things either began to go our way too much – or too little – in childhood, we are likely to develop a case of either entitled or compensatory narcissism, respectively (see Ekleberry; Millon, 1998 and 1999; and Vaknin). The entitled narcissist expects things to go his way because they pretty much always have; he was king in his family of origin. The compensatory narcissist needs to have things go his own way because they haven’t; he was a frustrated pawn in his family of origin. The entitled narcissist had parents who taught him he was special no matter what. The compensatory narcissist had parents who taught him he could only be special if he lived up to their demands and commands.

Hugh Hefner knew and understood both types of male narcissists. He built an international publishing empire and self-gratification scheme on that understanding. He gave us 27-inch-long / 12-inch-wide photos of the perfect women of our dreams. The entitled narcissists saw opportunities for entitlement out there in a world of beauties they felt every right to possess and exploit. The compensatory narcissists saw a hope of getting the sexual fulfillment and gratification from lovers and peers their parents had denied them.

Both types of narcissists like to parade their women around for the sake of peer-reinforced ego gratification, but it's crucial -- rather than elective -- for the compensatory narcissist. This type of narcissist is really dependent upon the projection of himself as "okay," "cool" or "part of the gang" by displaying the possessions he has at the moment, subconsciously figuring he will lose them in time... because he usually has in the past. The entitled narcissist counts on obtaining more possessions as he goes along and isn’t all that dependent upon those in current stock.

The problem, of course, is that over time, the entitled narcissist may no longer be able to capture new possessions with the stimulation maneuvers like a nice ride, his physical attractiveness, charm or the abdominal six-pack that worked so well when he was 30. If he fails to move on, he may have to resort to outright purchase of his narcissistic supply (see Ekleberry, Millon, and Vaknin). At this point, he will begin to convert from entitlement to compensation and become as dependently addicted to the narcissistic supply as any alcoholic is to ethanol.

This, of course, is when things get uncomfortable and ugly.

There is a developmental explanation of male narcissism that's also worth a look. Erik Erikson was the principle figure in developmental psychology for a half century. The first five of Erikson's eight stages of human development describe one version of a path to functional adulthood as well as the two separate paths to dysfunctional narcissism (see Erikson).

For Erikson, the entitled narcissist may well Trust, but his Autonomy is too great, his Initiative and Industry are contaminated with cockiness, and his Identity, however fraudulent it may be, is unduly secure. The compensatory narcissist cannot Trust, has weak Autonomy, Initiative and Industry rooted in self-denied uncertainty, and an Identity that is fraudulent and insecure. In both cases, the sixth of Erikson's eight stages is wrecked: Intimacy is largely impossible.

Left uncorrected, this will lead to a corrupted Generativity and very painful failure to achieve Integrity in late middle age. I have seen this over, and over, and over again.

There are, of course, numerous other developmental explanations for narcissism -- especially the more common variety of compensatory narcissism -- in the immense and very wide-ranging literature on child abuse (see Anonymous on Adult Children of Alcoholics, Black, Copeland, Davison and Neale, Dong, Ekleberry, Gillespie et al, Heim et al, Kaufman et al, Mellody, Miller, Millon, Perry, Sroufe, US Dept. of Health and Human Services, Vaknin, Widom, Winnicott, and Woititz). Physically and or mentally abusive, invalidating, neglecting, over-permissive, irrational, confusing, hyper-authoritarian, molesting and/or incesting parenting have all been demonstrated to lead to narcissistic outcomes by these and other authors.

Regardless, Erikson's notions explain the developmental pathway leading from such unfortunate early life experiences to adult narcissism as well as any I have seen.

The Conflicts and Confusion of the Borderline

In my view, there are (besides all the afforementioned early life stressors that set women up for the following; see them above, and Lang et al, and Stovall-McClough et al) two major culprits here. One is the sadly misunderstood Betty Friedan; the other is Helen Gurley Brown. Friedan wrote The Feminine Mystique, published five years after oral birth control hit the market in 1960. Helen Gurley Brown began publishing the Hearst Corporation’s Cosmopolitan magazine at about the same time, and authored Sex and the Single Girl, another, more utilitarian, feminist book read more widely than Friedan's.

All of these socializing (see Dacey and Travers, and Sarason and Sarason) tracts advanced the notion that women were no longer required to be like their mothers or grandmothers. Women were no longer the prisoners of their reproductive organs, nor were they dependent upon men as partners in the high calling of child-rearing. They could now run right out there and be narcissistic right along with Hefner’s -- and later Guccione’s and Flynt’s increasingly antisocial see Ekleberry, Hare, Meloy, and Millon) -- self-obsessed, excitement-addicted young men.

The Feminine Mystique convinced tens of millions of women they ought to throw off the shackles of male domination, sexual and home-making servitude, and other obligations to perform as their husbands' mothers had performed. Unfortunately, Cosmo and Sex and the Single Girl convinced many of the same women that they had every right to be as self-obsessed and pleasure-bent as the boys, and gave them monthly instruction on how to go about it.

To be entirely fare, Friedan did not know what she was doing and very likely would have thought again about such social intervention if she had known. (In later years, she espoused a balanced feminism, but calls for balance are usually unheard in the screaming of social passion.) Like Hefner and his followers, however, Brown was in it for the excitement and money. If the haters of the West had wished to dismantle a society, they might have had a hard time finding a better way to do it than to stimulate that society to death.

The use of chemical stimulants by the middle class was growing by leaps and bounds in the ‘60s and ‘70s. The popular media (music, television and film) became increasingly sensational and stimulative. Even sports became more energetic as slam-bang professional football and auto racing replaced comparatively sedate baseball as America’s number one sport... and boxing, once the most violent of sports, has given way to cage fights (see Bozarth and my article on Bozarth's work at ).

Pardon me if I sound either shrill or patent, but I will assert that the mass merchandizing of relentlessly violent excitement has been the single most destructive influence upon Western society since The Christians vs. The Lions at the Roman Circus. If you wish to try to build a case that popular music, the visual media, drugs and alcohol, and the Internet are not all tied together in the narcissistically greedy, self-serving advancement of excitement for the sake of self-enrichment, knock yourselves out.

Excitement changes the brain, often irreparably. The newer hippocampal circuits to and from the "centers of reason" become less able to manage the older emotional circuits to and from the amygdala. The new wave of neuropsychologists have built a pretty solid case for this (see Akiskal et al, Kaszniak, LeDoux, Panksepp, Pinker, and Watt). The humans who could have been are being turned into the animals they always have been.

Or one could get a job as a "psych tech" at any local mental hospital. (These jobs are very easy to get; the educational requirements are very low.) Then watch and listen carefully. See why most of the patients are there. In the more than 20 years I have been "on the floor," it appears to me that pretty much everyone who is there for everything save truly biogenetic bipolar and/or schizophrenia (maybe ten percent of all admissions) is there because of the role confusions they developed from trying to make sense of an over-stimulating world pitching the narcissistic imperative via every media channel. The majority of admissions in the post-millennial era involve the misuse of chemicals of one sort or another.

There is, of course, no excitement like the sexual variety. I can assert this because in the era of the real-time brain scanning, which gives us the opportunity to see the brain respond to preset stimulation of any kind, the neurobiological evidence for that assertion is too widespread to refute (see Carlson et al, Kaszniak, LeDoux, Panksepp, Pinker, Rosenzweig et al, and Watt).

The female who has tried hard and failed to make sense of all the confusing messages in her head about sexuality, feminist imperatives and parental values is very often suffering from the borderline personality disorder. Some will argue with me, I am sure, but having studied it for as long as I have, borderline looks to me like a splitting of the mind into distantly polarized, warring fragments of the New Narcissism and the Old Dependence. These are, in my view (see my numerous articles on borderline on this blog), women who are trying to be Betty Friedan’s free, but responsible, spirits... and Helen Gurley Brown’s wild-haired wantons.

That's not going to be easy, but if the same women are also be trying to be the “good little girls” their fathers and mothers (and priests and ministers) told them to be, the conflicts will likely overwhelm them and break their Identity (and the capacity for Intimacy that would have followed; see Erikson) into pieces. Given that it is pretty much impossible to be a “good little girl” anymore without living in an igloo on the melting ice cap, locking oneself away in convent, or setting up shop somewhere south of Tierra del Fuego, the media-manipulated, “civilized” world is, as John Lykken aptly put it in 1995, simply raising a society of very confused, frustrated, anxious and angry people (see Lykken in Millon 1998).

How does a woman "be" a good little girl, a competitive careerist, and a wild-hair?

Karpman was able to diagram the interpersonal results of trying to do just that in his simple but highly revealing Drama Triangle. The Victimized, Covert Controlling and Abusve Persecuting corners of the Triangle describe the borderline's relentless, narcissistic supply-seeking, persona-switching, and I strongly suggest it as a memonic reference for those who deal with borderlines (see above).

Narcissism in Collision with Borderline

The stimulation-seeking narcissistic male seeks the borderline because parts of his sexual object are, after all, conditioned to be… stimulation-seeking. No longer prevented from over-arching concerns about cranking out and raising babies, the (semi-) liberated women of the ‘70s (who are today’s mothers and grandmothers, after all) went increasingly narcissistic themselves.

This might have been fine had it been a phenomenon in an otherwise empty universe, but it was not. Brown (and all her opportunistic followers) may have offered the promise of gothic romance and longer orgasms with the sexy men at the office or the cruise ship to Mazatlan, but the Old Order was still pitching aprons and disposable diapers while Friedan and her legions were proposing taking over the ships or state and commerce. Which way to go?

Female role confusion of this sort was all but unknown in Freud’s day. The women Freud saw in his office were there because they couldn’t adjust to being good little wives and mothers they had been socialized to (attempt to) be. Such difficulties often arose after (narcissistic) dad had sexualized these women as small -- or even not so small -- children. That hasn’t changed much, but owing to the prevailing role opportunities of the time, those women had simple, rage-driven depressions that could be dealt with fairly easily if their only marginally narcissistic husbands could be convinced to go along with the program.

In the 1970s and ‘80s, however, many females were so soaked in feminism, sexualism and childhood religiosity, that their minds -- and identities -- began to split apart. The occasional cases of “split personality” (see Kluft and Martinez-Taboas) described by the shrinks of the ‘40s and ‘50s came to be called “borderline,” and later, “dissociative” or “diffused identity” disorder. Call it whatever you wish, by the mid-‘80s, the trickle of splitters trying to reconcile their sexual obsessions, their careerism and the pronouncements of the gods (in their heads; see Jaynes) had grown into a raging river.

Today, we’re seeing the daughters and grand daughters of the Hefner, Friedan and Brown generation. Today, we’re trying to hold back a tsunami.

There are surely problems here for any male who engages with a borderline, and finds himself in a parataxical integration (see Benjamin, Sullivan in Evans, and my article at ), but most men will not remain engaged with a borderline for long unless the men are…

1) shame-soaked co-dependents who still believe their parental injunctions that they were the source of their mothers’ emotional discomforts, or…

2) (on the opposite end of Millon’s entitled-compensatory spectrum) compensatory narcissists who are narcissists because they must continue to struggle against being overwhelmed by the current versions of good old ma they encounter in the new borderline, or

3) entitled narcissists who simply see the latest hyper-sexual borderline to turn up as a momentarily stimulating play toy.

As noted before, the problem for the entitled male narcissist is that he is likely to become a compensatory male narcissist as he loses his capacity to distance from his increasing addiction, as well as the fraudulent image he created that fascinated the female borderline when she was looking more for Mr. Goodbar than for Mr. Cashbox. As she moves along in life, however, her concerns with Mr. Goodbar are more likely to be met by younger and younger men (or other females; borderlines are very often bi-sexual; see Masterson, Meissner and Millon)… but her concerns with Mr. Cashbox are something else again:

When the borderline moves on to expressions of the rage she feels toward the narcissistic males of her youth (like dad), she will begin to (usually unconsciously, but often semi-consciously and socipathically) seduce for the purpose of psychologically castrating the present narcissist in her life (see Gunderson, Masterson et al, Millon et al, and Stone).

I have heard a good hundred tales of woe from narcissists who insisted on trying to hang in there with the borderline of their (former) dreams. These men hope that they can do something to "make her come back to how she used to be." One can see such tales in films like “Basic Instinct,” “Casino, “Fatal Attraction” and “Of Human Bondage.” Trying to stand in there with them is really tough, but men will do so because they are addicted to their earlier (stimulating) memories of these women and all the drama they offer for the sake of remaining in denial about the compensatory narcissist’s own anxiety. He is hooked because he needs to be hooked (see Bozarth, Frances, and my recent article on sex addiction on this blog, linked in the next paragraph).

He might as well be shooting "speedball," though cocaine and heroin may actually not be as harmful to his nervous system. Functional recovery from speedball addiction takes six months to a year (see Stanton and Todd). Recovery from any prolonged “battle with a borderline” rarely takes less than 18 months, and often much longer. In the narcissistic sex addict, the unbalancing of the dopamine, norepinephrine and serotonin neurotransmitter chains in the autonomic nervous system appears to be at least as extensive as it is in the speedballer (see my article at ).
Her confusing, abusive behavior is not something the borderline can help. She has a script to follow. She learned it when she was little. She knows it by heart. She cannot possibly divert from it unless or until she…

1) sees that her life is going south because her capacities to manifest her own narcissism are falling away to the ravages of advancing age;

2) senses that her anxiety and anger about losing her prerogatives is going to drive her to suicide (either rapidly, or slowly, as with bottles of pills or booze);

3) accepts that she has some sort of problem, regardless of her present degree of understanding of it; and

4) commits – and remains committed – to a lengthy program of recovery.

(This sequence is built on Terry Gorski’s notions about recovery from any form of addiction. In order, the five stages of recovery are denial, pre-contemplation, contemplation, acceptance and commitment. See Dodes, Frances, Gorski, and Stanton and Todd.)

The same, of course, goes for the narcissistic male. Many are motivated by their continuing supply-seeking (see Vaknin online and in print) to continue the campaign to Rescue the borderline from her Victimized and/or Persecuting self (see all the material on the Drama Triangle).

My experience with female borderlines, however, is that they cannot be Rescued at all, and that they can only recover from their hyper-confusion with the assistance of extremely well-trained, emotionally detached and really brave mental health professionals. (Working with borderlines is never fun; sometimes it is truly dangerous because of the combination of seductive talent and long-festering rage. The women's facilities at Chino and Chowchilla, California, are full of them. The smarter they are, the more dangerous their recovery may be for the therapists involved.)

Moreover, it is my direct and second-hand experience with borderlines that recovery to anything like "complete romantic functionality" or "a reliable capacity for interpersonal intimacy" may well be impossible. Those few I have seen recover to that state, are usually Kernberg / Meissner Level One or Two borderlines, as opposed to the more severe Level Three or Four. The Level One's and Two's require three to five years of very sophisticated, relationship-free psychotherapy to do so (see Bockian et al, Gabbard, Gunderson, Kernberg, Linehan, Masterson, Meissner, Preston, and Stone).

The narcissistic male must also recover. But the truly entitled narcissist rarely shows up in treatment. His addiction is still working for him, and he rarely experiences sufficient emotional pain to drive him to confront his delusions. The compensatory narcissist experiences plenty of pain, however. When he becomes depressed enough -- when he becomes sufficiently "sick and tired of being sick and tired" -- he may break through his denial, pre-contemplation and contemplation to treatable acceptance. Commitment is often just around the corner, or at least down the road a short distance. I have seen many move more quickly from denial to acceptance by reading Evans's Controlling People, Mellody's Facing Codependence, Wilson's Alcoholics Anonymous, and/or the recently published "big red book" from Adult Children of Alcoholics.

Vaknin's wonderful Malignant Self Love works well with those at acceptance, and possibly contemplation, but will almost surely be rejected out of hand by those in pre-contemplation or denial.

Separate for Success

Recovery from male narcissism, because it is generally more ego-integrated (and "syntonic") than ego-diffused (or "dystonic"), is a two-to-five-year effort under the best of circumstances, which is to say in a relationship-free group environment with other recovering male compensatory narcissists. (Male and female narcissists simply do not appear to mix well in "uncovering" -oriented therapy groups.)

In fact, after years of asserting that female borderlines and male narcissists could recover together (to some extent) in co-educational, group circumstances, I am coming rapidly to the following notion: Combined, co-educational, group therapy, even in the hands of skillful, male and female co-therapists -- much less professionally un-facilititated, self-help modalities like Co-dependents Anonymous, Alanon and Adult Children of Alcoholics -- is probably not a functional therapeutic mechanism for "deep cleansing" or "thorough recovery" in most circumstances.

This notion is based upon may years' observation and awareness that therapy groups and 12 Step meetings are full of people who remind each other of their early life perpetrators. These groups can, and very often do, become parataxically integrated, albeit at a more subtle and less obvious level than a marriage, sibling or co-worker relationship, or narcissist-borderline "furball romance."

My views are always subject to further evidence, of course, but I now see the co-educational setups as useful only in early recovery (so that the narcissists and borderlines can see their effects upon each other). It appears that males and females should be separated for effective exploration of their mutual resentments. The anathema is usually largely unconscious, or semi-conscious but highly defended, and manifests as smoldering resentments, lingering hostilities, repressed rage and parataxical reactivity. My sense is that this is especially true if the males were overwhelmed, invalidated and/or psychologically castrated -- let alone physically abused -- by their early life female caregivers… and the females were battered, molested, incested or serial-raped by their early life fathers, grandfathers, male siblings or babysitters.

When early life abusers are members of the same gender, the interpersonal dynamics may be less volatile. But if narcissistic mothers and borderline fathers are the culprits behind the curtains in such parataxical integrations, the dramatic upshots and interpersonal dynamics with intimates are likely to be similar regardless of the opposing gender of the original players.

The therapeutic separation of domineering male and reactively passive-aggressive, female spouses has been an industry standard in "marriage counseling" since the late 1980s that I know of. I see no reason to ignore it in a group setting. Sullivan’s parataxical integration can be a problem between siblings, co-workers and over-stressed but otherwise healthy marriage partners. The parataxical integration of narcissistic males and borderline females may well be the number one cause of spousal and romantic partner homicide, however (see Millon et all 1998, and Sullivan in Evans). In my own investigation, I have seen it more often than any other relational concept, even including patent sadomasochism. Ask any police officer who has responded to a dozen or more 9-1-1 domestic violence calls.

Entitled and compensatory narcissists will almost always assert that they can “handle it,” and stay locked in the denial phase. This is because the...

1) entitled narcissist learned at a young age that he was either regularly considered by one or both parents to know -- though not be responsible or culpable for -- what he was doing, and the
2) compensatory narcissist was told that he had to know all the answers or suffer the painful consequences.

We see this in the workplace when CEO's hand over too much responsibility to stylish but incapable "Peter Principle" managers, as well as when managers are given responsibility without attendant authority to manifest it (see Ruth).

The entitled narcissist truly believes his fantasies of certainty; the compensatory narcissist forces himself to believe his fantasies of certainty to mask off his fundamental fear of those who will punish him for his uncertainty. The compensatory narcissist does not dare show that he is out over his depth; the entitled narcissist doesn’t know he’s out over his depth (see Beck and Freeman, Bockian, Millon, and Vaknin).

(The antisocial narcissist doesn't know or even care, but that's another story; see Ekleberry, Hare, Meloy, and Millon et al.)

The narcissist must learn that he is personally responsible, that has the capacities to be personally responsible and can do so (see Perls, Rotter, and Selgiman).

Treatment and Recovery

Once they have moved from outright denial through pre-contemplation and contemplation into acceptance, compensatory narcissists will have to learn to face their fundamental misapprehensions of interpersonal reality (see Benjamin, and Sullivan in Evans). These are well-described by Albert Ellis and Aaron Beck, and provide the basis for the cognitive / behavioral therapies (see Beck, Beck and Freeman, Benjamin, Ellis, Wessler, Young, and ) that must be utilized early on in combination with increasing dependence upon the psychodynamic and object relations approaches (see Benjamin, Bion in Symington, Fairbairn, Fonagy, Gabbard, Harris, Kernberg, Klee, Klein in Mitchell, Kohut in Siegel, Masterson, Meissner, Millon, Searles, Stone, Sullivan in Evans, Winnicott in Dodi, and ).

Beck and Freeman (1990) assert that the narcissist tends to believe the following 14 ideas:

1) I am a very special person.
2) Since I am so superior, I am entitled to special treatment and privileges.
3) I don’t have to be bound by the rules that apply to other people.
4) It is very important to get recognition, praise and admiration.
5) If others don’t respect my status, they should be punished.
6) Other people should satisfy my needs.
7) Other people should recognize how special I am.
8) It’s intolerable if I am not accorded my due respect and don’t get what I am entitled to.
9) Other people don’t deserve the admiration or riches that they get.
10) People have no right to criticize me.
11) No one’s needs should interfere with my own.
12) Since I am so talented, people should go out of their way to promote my career.
13) Only people as brilliant as I am understand me.
14) I have every reason to expect grand things in life.

There are many other notions that the narcissist hangs onto, of course (see Ekleberry, and Millon 1999), but these 14 ideas provide sufficient suggestion of the narcissist’s cognitive appraisal of the world around him.

There are a number of ways to do cognitive / behavioral therapy, of course. I favor the “five-step thought questioning” I have developed for the CDDCR Therapeutic System (see , , and ) because it is the simplest I have seen, and can be memorized for instantaneous mental use without resort to complex diagramming on paper. This method also provides a system of reality-checking and affect management the patient can use all by himself.

Most recovering compensatory narcissists will also need to acquire the competent use of the “drop drill” to manage the uncomfortable emotions that come up for them during the lengthy withdrawal and required period of abstinence from sex and romance. An essential part of the CDDCR Therapeutic Method, the drop drill is described in detail at .

Long-term, peer-group follow-up is usually required for ongoing prevention of a return to the cycle of abuse (see Dodes, Frances, Gorski and van der Kolk). I am myself a recovering narcissist (sorry, "poindexters": it’s increasingly common as one moves up the IQ scale) and find that I am given to slipping back into the compensatory narcissistic imperative when I feel threatened by figures who remind me of my own abusive parents.

I use the various CDDCR tools, but also spend a fair amount of time addressing the issues with other recovering narcissists. It seems to me that the peer (or modified "therapeutic community" approach; see Dolan in Millon et al 1998) may as work well for recovery from narcissism as it does for recovery from alcoholism, drug abuse and less violent forms of antisocial personality disorder. Were there a 12 Step "Male Narcissists Anonymous" meeting close by, I would at least investigate it. (Vaknin's Malignant Narcissism Revisited might well serve as the "big book" for a time.)

Most narcissists will have considerable difficulty with “complete abstinence” in such a stimulation-obsessed universe, but find that they can jump off the sinking ship of parataxical integration as soon as they reconnect to something like the principles of the 12 Step Co-Dependents Anonymous program, Sharron Ekleberry’s Seminar on Addiction and the DSM Axis II Personality Disorders, Patricia Evans’s Controlling People, Steven Karpman’s Drama Triangle, Ann Schaef’s Escape from Intimacy, Sam Vaknin’s Malignant Narcissism Revisted, Bill Wilson’s Alcoholics Anonymous, and/or other touchstones.

Attendance at firmly structured Alanon Family Groups, Co-Dependents Anonymous or Adult Children of Alcoholics (and Dysfunctional Families) 12 Step book studies may also be useful, but only if the recovering narcissist does so with firm support from several other recovering male, compensatory narcissists. Decades of observation confirm for me that the skew toward demonstrations of female seduction, seething rage and castration imperative is considerable in co-educational, 12 Step environs.

Because narcissistic personality disorder is so often seen in conjunction with bipolar (manic-depressive) disorder (see Akiskal et al, Davison and Neale, Hirschfeld et al, Maj et al, Munich et al, Sarason and Sarason, Schore, Suppes and Dennehy, and , and ), I feel it irresponsible to fail to attend to the matter here.

I have known several hundred entitled and compensatory narcissists. I have run values clarification matricies (see Simon et al) in Microsoft Excel on nearly a hundred. Many of them appeared demonstrably bipolar, at least at the lower order of intensity described by the APA's Diagnostic and Statistical Manuals III and IV (see below) as “bipolar II.” The vast majority appeared to be at least "impulsive," a bedrock trait of bipolar. Effective treatment of bipolar -- almost always a matter of a medication regimen, exmaination of anxiety, and cognitive restructuring -- may be required for recovery from narcissistic attachment to borderline females (see Suppes and Dennehey).

In response to an inquiry requesting further explanation, I wrote on May 14th:

Most of us have conflicts. Neurotics have conflicts, but they are conscious of the two (or more) postions of their conflicts, and mostly assert from one position or another knowing they are doing so. They can see the opposing positions (or appraisals of reality) because their egos are strong enough to do so, even if not strong enough to resolve the conflicts. Borderlines have conflicts, but they are UNconscious of the two (or more) positions of their conflicts, and assert from one position or the other WITHOUT knowing they are doing so.

This is because the two (or more) compartments of the borderline mind that contain the opposing positions are dissociated from each other, and their egos are too weak to see the opposing positions (or appraisals of reality), let alone that they are stored in discrete, disconnected compartments of reality appraisal.

The neurotic has a single, wholly connected system of memory, cognition, symbolic logic and reality appraisal. The borderline has at least two, dis-connected systems of memory, cognition, symbolic logic and reality appraisal. This is why they FLIP... and FLOP. (See Bockian, Kernberg, Linehan, Masterson, Meissner, Millon, Preston and Stone.)

It's likely that something happened to your friend over and over and over again when she was quite young (probably around age two to five in Piaget's post-sensory-motor but pre-cognitive stage of mental development) that was more than her child mind could process, and it began to split her mind into discrete processing compartments. Her birth order and what you have told me about her siblings suggest that they may have had something to do with overwhelming her developing capacities for cognitive processing. When older children are themselves abused, abandoned, ignored, under- or over-limited, invalidated or otherwise de-realized by parents, they often do the same thing to younger siblings. (See Adler and Bowen.)

The temptation for guys like me (and maybe you; you have to decide for yourself) is that we want to save these women for the sake of obtaining our own (understandable) narcissistic supply of re-mothering from them to make up for whatever it is we believe we didn't get when we were little. And we are just compensatorily narcissistic and disconnected enough from reality ourselves to fail to see that women who are flipping and flopping cannot reliably do that.

We keep returning to an empty well... or at least one that only pumps water some of the time... and squirts us in the face with vinegar the rest of the time.

Resources & References

Adams, G.; Gullotta, T.: Adolescent Life Experiences, 2nd Ed, Belmont, CA: Brooks/Cole, 1989.

Adler, R.; Rosenfeld, L.; Towne, N.: Interplay: The Process of Interpersonal Communication, 6th Ed., New York: Harcourt Brace, 1995.

Akiskal, H.; Benazzi, F.: Delineating Depressive Mixed States: Their Therapeutic Significance, in Clinical Approaches to Bipolar Disorders, 2003, 2.

Akiskal, H.; Pinto, O.: The evolving bipolar spectrum, Prototypes I, II, III and IV. North American Journal of Clinical Psychiatry, 22(3) 1999.

Allen, J.; Bleiberg, E.; Haslam-Hopwood: Mentalizing as a Compass for Treatment, Houston: Menninger Clinic Press, 2002.

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders: DSM-III-R, New York: APA, 1987.

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR, New York: APA, 2000.

Anonymous: Adult Children of Alcoholics: Alcoholic / Dysfunctional Families, Torrance, CA: ACA World Service Office, 2006.

Anonymous: Co-Dependents Anonymous, Phoenix, AZ: Co-Dependents Anonymous, 1995.

Bandura, A.: Self-Efficacy: The Exercise of Control, San Francisco: W. H. Freeman, 1997.

Barbay, S.; Zoubina, E.; Nudo, R.: Neural Plasticity in Adult Motor Cortex, Kansas University Medical Center website and CRC Press, 2005.

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