star dust wrote:I know next to nothing of psychodynamics and Freudian psychology.
So can you elaborate?
Are you saying that the basic themes and conflicts of bpd and npd are extremely different so for that reason they can not truly coexist? Why can’t they? How and why? I’m just interested to know.
Are they really that different that a person can not suffer both equally severely?
Hmm I find its very hard to summarize, because both borderline and narcissism describe not primarily personality disorders but specific personality-organizations, or basic psychological setups. Borderline can be described as a setup where due to neglect, trauma or other problems the tree-network of the mind has [usually in certain places like attachment, love, sex etc] not developed very much so that very intense, yet largely unregulated emotions are at the forefront, and - what the psychodynamic people would call - primitive defense machanisms aka splitting, dissociation etc. are creating a very chaotic inner world, which is not yet psychotic but definitely not as high-level as the neurotic organization.
Narcissism on the other hand side means a sort of anti-dependent moving away from external relations, where need, dependency etc. is denied very often, and parts of the - again often primitively organized - self are hooked into instead. It gets complicated by the fact that thre is vulnerable narcissism and covert forms of both grandiose and vulnerable one, btu I'll just use the grandiose one here for sake of explanation.
So the outcome is a situation where borderliners are feeling very empty, while narcissists are feeling rather full [of themselves] inside. Narcissists project nothingness, borderliners identify with it. Borderliners victimize themselves, narcissists victimize others. Borderliners need perfect caregiving, narcissists need perfect mirroring. Borderliners are dependent, Narcissists are anti-dependent. Borderliners want a perfect other, Narcissist are unconsciouly identified with such.
Etc etc.
So yes with symptom lists, a person could experience enough symptoms of both severely enough to fulfil both criteria in the dsm. So how does psychodynamic theory say that they can’t coexist if both those sets of symptoms are affecting ones life with equal severity?
Basically because symptoms can have different reasons. Lets say a person has no will to live, is feeling down, has not much energy, is often tired, feels hopeless, might think of suicide.
The person might be devaluing everything as a defense and as a result everything seems meaningless (narcissistic position). Or the person might be attacking themselves, harshly judging themselves and therefore everything seems unachievable and pointless (introjective depressive position). Or the person might perceive others as bad and untrustworthy etc. due to experience (anaclitic depression). The symptoms might also be caused by chronic grief, withdrawal etc. So the symptom lists themselves might be quite useless at times in figuring out what a person has.
Ultimately tho I like the approach my psychoanalyst takes. Diagnosis comes from a greek word that basically means "knowing thoroughly" - so for him diagnosis is the whole process of therapy, aka getting to know and understand the patient.
Anyhoo, when youre interested in the BPD/NPD dynamic in a relationship, maybe grab a copy of Joan Lachkar "The Narcissist Borderline Couple."