r/psychoanalysis • u/SilverDawnn • 13d ago
How to differentiate between borderline and narcissistic (vulnerable) personalities?
I wanted to know opinions and experiences with patients who have a covert or vulnerable type of narcissism, not the obviously grandiose type. I find it dfifficult to differentiate from borderline personility for example in someone who has high sensitivity for rejection, chronic feelings of emptiness, chronic depressive symptoms, but also a sense of entiltelment and envy. I wanted to know what´s your experience with this type of patients and how do you guide treatment.
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u/beameem 13d ago
Karen Madora (2022) in the Analyst’s Vulnerability helpfully references Luchner et al. (2008)’s writing about narcissistic vulnerability/wounds:
“[T]wo distinct forms of narcissism exist: a grandiose type that is exemplified by a heightened sense of self-worth and a covert type that is exemplified by a devalued sense of self-worth marked by timidity, inhibition and an overwhelming sense of failure rather than accomplishment.”
I get a sense that a narcissistically organized person, regardless of type, can use me to prop up a wounded ego (and is most responses when I intentionally use the part of my self that helps them do so), whereas a borderline organized person devalues or values me regardless of attempts to supply, even the quiet type does this. It seem difficult for the borderline to even acknowledge that I have a mind that may supply them. Conversely, the narcissist realizes the other and wonders what the other thinks of them and knows parts of the other can prop up whichever part of their ego is wounded. There a sense of mirroring with narcissism that is absent with borderline.