2 thoughts on “Men Can Have Borderline Personality Disorder, Too

  • March 7, 2014 at 1:23 pm

    To me, the descriptive approach to diagnosis without consideration of etiology or causes of mental illness is responsible for the field to be devolving into disrepute. My approach to personality disorders relates much more to personality development and behaviors that cause other chronic symptoms. Specifically, the most direct way to get a sense of Borderline Personality Disorder (BPD) is by recognizing primitive defense mechanisms, for example projective identification, denial, fantasy, and other forms of magical thinking. Clearly, these are also common in men. I am certainly far more likely to give a diagnostic impression of BPD in a man than most of my colleagues. Have been for a long time. But I think this article muddies the waters.

    The distinction between BPD and Antisocial Personaltiy Disorder (ASPD) is stark, even though the two are otherwise nearly identitical. The difference is self-criticism. The BPD is unbelievably self-critical. Sure, he or she may have moments of denial, but the overall pattern is one of a person who is so hard on himself, hates himself so much, that he often will resort to self-harm and uber-passive behaviors. With occasional vascillations.

    The ASPD, however, has almost no capacity for self-criticism. His or her defenses may be so thick that he does not allow himself to feel guilt or remorse. His presentation tends to be glib and rather flat (unless he is not getting what he wants), and the thought of self-abuse would be a rarity. Suicide is possible, but any warning would be unlikely. It would merely reflect a nihilistic outlook in which suicide is a possible, but extremely rare choice.

    In terms of drug abuse, the difference between the ASPD and the BPD is also stark. The individual with BPD will admit that he “does not use drugs, rather the drugs use him.” The individual with ASPD will invariably use drugs, but he does not relinquish control, not indefinitely and not totally. Typically, the ASPD who uses drugs is also a drug dealer and does not hit the same kind of uncontrolled bottom that the BPD hits.

    In terms of treatment, the main goal of treating these ingrained patterns of personality is a) helping the BPD to be a little bit less self-critical, to give himself a break and b) helping the ASPD to learn to be more objectively self-critical. I tend to like a 12-step approach with BPD, as the 12-step group cannot abandon the alcoholic/addict. I tend to like Motivational Interviewing with the ASPD, as this is a way to ease in self-criticism that the ASPD may actually own.

    Just some thoughts. So, yes, men can be BPD, too. But while BPD and ASPD are both cluster-B personality disorders (i.e. they are in many ways quite similar), I believe they are incompatible in a parsimonious differential diagnosis.

    Reply
    • July 30, 2015 at 5:53 pm

      I agree. Not rear do I come across opinions on BPD comorbidtality to ASPD traits taken a little bit too far. I think it can occure some anti social behaviour in many male bpd’s, but to compare and relate this two diagnosis is a bit contradictious in my belife. (Pardon my inglish..)
      Emotionally its two totally different minds. And the basic here is caracteristics like owerwhelming not-copeable emotions in the former… And lack of most interpersonal feelings in the latter.

      You discribe it well in your comment. But I Get a little confused when you at the same time mention
      That the two are much the same..
      I wont contradict your Professional opinion, but isn’t a fear of abondonment much the opposite of being anti social? I dont propose that BPD s are not egosentric to an estate. But its fair to say the predominant motivation in a BPD is hardly to intercept, destroy or “use” (play with.. Stomp on.. Deceit or torment..) interpersonal relationships, like the ASPDs tend to crave.. Even though BPDs (like my self..) tend to skrew it all up and Often ends up hurting those around them. More Often then not tends to panic, and ocasionally to abuse and violence. — I think what differs subwearly is the motivation and grandiosity.

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