[Music] what is the difference between borderline personality disorder and narcissistic personality disorder here to talk about the differences as the expert dr. Romani I'm gonna make a confession to you I am absolutely fascinated with the topic of narcissism ever since we did those first videos on narcissism I don't know if that's good or bad I think it's a topic of our time I really do more than any other clinical issue it is the topic of our time because either you're dealing with it as a clinical issue and a client or you're dealing with the fallout
of it and everyone around you yeah you're not affected right and I did not fully understand it until I sat down and talked with you so if you think you understand our system go watch that video dr. roni will link it below then you were really fully understanding it was fascinating how is borderline personality disorder and narcissistic narcissistic personality disorder different is that that's the question of the day it's a brilliant question because there's a lot of overlap so when we look at the core of what narcissistic personality is it's characterized by a person who
lacks empathy for other people whose grandiose who's entitled who's very superficial who's always seeking out validation who's arrogant who's often prone to rage okay at the core of it's though a narcissist is one thing and one thing only and that's deeply insecure they're insecure so they want everyone else to feel insecure but they're just not in touch with her insecurities so it expresses and basically they just don't connect with anybody else but they're also very charming they're very charismatic they seem very confident so they're confusing little and I don't want to get to Google off
topic here because we can talk about this all the day but that's different from a sociopath very different sociopath big difference here's the main difference it's simple when a sociopath or psychopath does something bad they don't feel remorse narcissist does they feel shamed Wow they feel ashamed so there's your big difference okay now let's bring this back to borderline personality because for a lot of people with borderline personality at first blush they can actually look quite narcissistic as a rule they do tend to lack empathy they either over-identify with other people's feelings or they under
identify with them meaning that if their feelings are on the same page is that other person's it's as though they don't even see the boundary between them and the other person they get so immersed in them but if there's a time when that other person's feelings don't line up with theirs it's as though you're looking into a black mirror like there's nothing reflecting back so that can feel narcissistic you'll see an entitlement in borderline personality how come I can't have my way it'll feel like a tantrum and that will feel like almost like a childlike
entitlement they'll also be sort of a seductive feel we sometimes see in borderline personality which isn't surprising because they very much crave intimacy but they don't know always how to get it so seduction is often the easiest and fastest way to get their narcissism borderlines both are very seductive so you see some commonalities both you see a lot of that rage both of them are very prone to rage with the borderline it comes up very quickly the narcissist it can also come up quickly for the person with narcissistic personality though it's it's a threat to
their ego how dare how dare you tell me I'm not the best at this whereas for a person's borderline personality it's more of a it's a it's a hypersensitivity to the self so it's but it's still quick rage in either case that's so hard to diagnose yeah here's where the big differences are people would narcissistic personality don't have that identity disturbance they know who they are all the time they don't have that sense of am i this am i that they don't jump around in their identity yeah they're not changing their name they're not changing
their hair color every day they're not doing that in addition the the narcissist doesn't like being abandoned but they don't walk away frightened of it they don't walk around like oh my god I'm gonna be abandoned right they get angry somebody abandons them they get like you're doing what to me are you kidding me I'll break up with you first kind of thinking it's a much more of a swagger in your face in the face of abandonment nothing they like it but for the person with borderline personality it's a fear that's right almost infantile fear
so there is a greater fragile quality to the person with borderline personality versus the person with a narcissistic personality think of a person with borderline as more infantile and a person with narcissistic personality is more like a toddler that makes sense toddlers throw tantrums borderline scream when that mom leaves the room there's like there's almost like more of a need for more care with the borderline person than the narcissistic person who's almost behaving more like a mean-spirited spoiled child so someone cannot possibly be then diagnosed with both as a rule we wouldn't diagnose both what
we would do is we look and see where the traits overlap which we always see them overlap they live in the same group of disorders in the theatre in the same house they're in the exactly same house different rooms and so there's a greater vulnerability and borderline personality that overlaid what we see if a borderline personality some of the borderline personality disorder started dating someone with narcissistic personality disorder leave the room quickly it's going to be volatile it is going to be vindictive and here's what's a zero chance of success not only zero chance of
success it's heartbreaking I have consulted on these kinds of situations because what do you have a person with borderline personality who's terrified of being abandoned and a narcissist who's not empathic and who is cold I mean I mean it's just you know and ironically they attract each other yes they often attract each other so what's your advice for those people break up and find somebody I would say get into your if you get into your own individual therapy do lots of work on yourself but these are two clinical conditions where people often aren't drawn into
treatment especially narcissistic personality it is very rare for them to enter any form of psychotherapy unless something's going wrong in their life their marriage is falling apart they have issues with addiction they're having problems at work those are the things that will pull them in not hey I did something wrong but how come the world is so mean to me yeah it's very much that and so yeah they do find each other there's no accountability on either end or people with borderline personality will take that accountability as a way to keep that other person from
abandoning them it's almost like they'll try every technique they can to draw that person close a person with narcissistic personality tends to engage more in projection so they blame the other and for everything that's wrong in the relationship this is your fault you did this you did this you did this and the personal borderline personality will first scream now I didn't know I didn't and then they might cop to it just to keep that person close so in other videos we've talked a lot about what do you do to help this person who might be
BPD or might have may be a narcissist I want to flip the script and say what do you do for yourself if you are working with this co-worker you're not gonna recommend therapy to them it's not appropriate for whatever reason but you still got to deal with someone who's a narcissist or someone who has borderline personality disorder what are the tips easy - easy tips for listening to manage your expectations and maintain watertight boundaries that's it so when I say manage your expectations please don't expect that you're gonna come to work tomorrow they're gonna get
it that they're gonna understand your point of view they don't have empathy okay it's not wired there so no they're not going to understand your point of view there in fact if anything they're going to probably put the lion's share of the blame on you they're not going to take responsibility what that means is for example if it's a co-worker you better keep a really great documentation so when it comes down to brass tacks you can say no actually I did do it here's the email showing it kind of thing so you really do have
to again maintain boundaries but also cover your own bases but ultimately managing expectations means that you don't keep getting your heart broken a thousand times over these are very very difficult kinds of personality and behavioral patterns and they really are not particularly amenable to change in a big way can a really skilled therapist work with a motivated client a narcissistic personality and make some progress yes motivated being the key word however that's a therapist with a client and you may create these little changes that might actually happen help the client with narcissism or borderline personality
however the person who still has to live with them their ages are never going to completely go away the projection is never going to completely go away and I think that's the heartbreaking part of it for partners family members friends and co-workers so you got to do you well and I think some responsibility on those of us who do not have these disorders but are interacting with people who do that we understand it's a clinical diagnosis yeah it's not like they can fix it they just don't want to it's not like they're just being difficult
it's just part of what's right in them that's right but however other people don't need to be martyrs you know I think that where this gets to be a very tricky balancing act is I don't know and I don't believe honestly philosophically that one human being should become a human sacrifice in the face of somebody who has this kind of what do you know meaning that you keep enduring abuse you keep enduring rage you keep enduring having your reality tested on an hourly basis because they have this clinical pattern that's not right either I have
watched people lose custody of their children and they were good parents simply because our legal and justice systems that our family court systems aren't able to recognize these patterns I've seen too much hurt come from this so this is where I'm saying that while as a therapist I recognize and I very much welcome into my practice and the work I do to work with clients will have these personality patterns I do also work with people who are on the other side on the survivor side if you will to say you are not a human punching
bag and there may be a point at which you need to draw the line in the sand and step away for your self-preservation that's a very difficult journey and that requires a person who's sort of a survivor of one of these relationships you're on the other side to be in your own individual therapy to be guided and not maintained false hopes but be very realistic with expectations and boundaries I can see why your wait list for new clients is three months long that was so eye-opening wonderful dr. Romani is always such a privilege and an
honor to sit across from you talk thank you so much for being here thank you thanks for watching your next step is to head on over to med circle comm and sign up for the med circle digest what is it well med circle will send you the latest articles and the latest videos on the mental health topics that matter most to you so go to med circle comm sign up for that digest and let's keep this journey on better mental health moving forward [Music]
