Narcissists wrongly diagnosed as Borderline?

My therapist thinks my friend is a narcissist and he's been diagnosed with BPD. How common is it for these disorders to be "mixed up". I recently read that 25% of those with BPD also have NPD. I suppose it's possible he has both, but I don't want to believe he has NPD. He recently displayed a complete inability to show empathy or look beyond his own needs, but that can happen with BPD as well. Cluster B is very confusing....

Anybody know someone with both BPD and NPD? I'm wondering if those with BPD would be far less likely to admit their narcissistic traits. It seems like those with the AsPD/NPD combo are much more willing to face their N side, maybe as a source of pride? He's come to terms with the BPD and is knowledgeable about NPD and thinks his brother and former roommate have it. He gets that glazed look in his eye when he's confronted about something he did and completely shuts down if I show any kind of vulnerability or hurt feelings. He talks about how good looking and fit he is quite a bit as well. My therapist based her assessment on just a few stories (I tempered the stories a lot with self-blame and defended him a lot) and a long email string I forwarded to her. I wanted to give her an idea of how I respond to blame and emotional blackmail (not well). I'm not sure if she was too quick to throw out the diagnosis... I think the stories may have triggered her own experience with narcissistic men. She is also protective of me like a mother (not sure if that's healthy?) so the stories made her understandably angry.

There are no rules with cluster B PDs. Most will have traits of the others. It is about looking for what dominates. If someone is fully into the blame game then Borderline is the usual dx. The relationship is dynamic, more like a roller coaster. There will be a push pull- I love you, go away thing happening. Borderline Personalities tend to blame others for their problems and how they feel. It is generally thought that Borderlines are about protecting themselves from the unconscious pain of abandonment and so project their thoughts and feelings onto others.
The narcissist is all about control and getting admiration. A narcissist will have different stories for different people so as a partner you will not be aware that you have been devalued behind your back. To your face you might be told how selfish and self absorbed you are a couple of times. Then you will have some idea when you open the door and find they are gone. They need your admiration for how good they are acting right up to the end.They need to feel they are better than you. Of course if they are the arguing type, then they can wipe the floor with you. This is likely if they get out of control. The lying and general fake front erodes trust. The partner is likely to recognize control and limiting as part of the dynamic in their relationship. It is generally thought that narcissists have an empty feeling inside and so constantly need to see admiration in order to feel self worth.
Hope you can see what camp you fit in from this.

By your explanation, he fits into the BPD camp, but my therapist thinks he's a narcissist. She dropped that on me via email without a whole of explanation, but I'm seeing her tomorrow and will hopefully get some more info. Right now all she has to go on is a short breakdown of events and an email string that I forwarded to her. I think she's more interested in my reaction to him than what his diagnosis is. I respond to his whining and demands with complete tolerance and subservience, it's frightening.

is knowledgeable about NPD and thinks his brother and former roommate have it

NPD is quite rare. It's very unlikely all these people have it.

Twistedmister wrote:
NPD is quite rare. It's very unlikely all these people have it.

This is why I usually describe people as having traits rather than calling them narcissists. However that statistic about 25% of those with BPD also having NPD is pretty compelling. That's a lot of people walking around with two extremely debilitating Cluster B disorders. Scary.

(Sorry, this was supposed to be a new thread, so deleted it.)

Now my therapist is saying she's not sure he's a narcissist. She says that borderline's can be very narcissistic, but she takes all Cluster B diagnosis with a grain of salt it seems. I'm reading a book by Alexander Lowen that groups all Cluster B conditions under the umbrella of narcissism. It's an interesting idea, but I don't think most BPDs would appreciate the association especially because many of them have been victims of Ns.

So I guess my question is, what is the mechanism that makes someone incapable of comforting another person in distress? It's not just that they don't coddle and comfort, they actually turn cold as ice and recoil in disgust. He was able to comfort me when my cat died, but once my distress was associated with him, it made him lose respect for me and I became an annoying burden. So is it that I no longer served a purpose for him because I suddenly had needs and expectations that inconvenienced him?

I'm reading a book by Alexander Lowen that groups all Cluster B conditions under the umbrella of narcissism. It's an interesting idea, but I don't think most BPDs would appreciate the association especially because many of them have been victims of Ns.

I haven't been keeping up with my reading recently, but from what I understand, Cluster B disorders are now considered more under the model of Borderline: which is to say they are caused by emotional maladaption to long-term childhood abuse/nelect/dysfunction.

(If the book you're reading is "Narcissism: Denial of the True Self", it was published in 1984 and is waaaaay out of date to what psychological theory is nowadays. Still interesting and worthwhile, though, to gain perspective.)

So I guess my question is, what is the mechanism that makes someone incapable of comforting another person in distress? It's not just that they don't coddle and comfort, they actually turn cold as ice and recoil in disgust.

You already know the individual has difficulty dealing with their own emotions...so once your emotion becomes "theirs", they suddenly recoil from it, reverting back to their typical function. Maybe try looking into stuff on Attachment theory, too?

Yes, that's the book. I guess I should have read the publish date. I like to get used books and that's the hazard, but I will still read it because it's interesting. It makes more sense to me for BPD to be the umbrella disorder since it's way more common than NPD. However, sometimes the differences seem really extreme. Just from jumping between the NPD and BPD forums, it's like going from one planet to another. The perspectives, moods and interpersonal styles of NPD vs BPD are so vastly different. The main overlap I see is how they respond to criticism.

I think I will read up more on attachment theory because attachment problems are at the root of my problems and why I'm drawn to cluster B types. My mom is BPD with NPD traits and I'm drawn to people with similar profiles. I need to stop the cycle and/or learn how to deal with this personality type in a healthier way for them and myself.