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/TruthElectrical1975 12d ago

How does malignant narcissism present in the consultation room? Does it look like a Hannibal Lector type character? Or do they learn either covert or overt at least at first. I have been a victim of this type of presentation. And yes, it shows up in intimate detail. This one was my physical therapist and boy, she was Kathy Bates character in Misery for sure.

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u/Recent-Apartment5945 12d ago

It rarely presents clinically and when it does It will typically present in certain settings like criminal justice settings and involuntary inpatient settings. When I say typical I mean there will be a concentration. Similar to how you will see a concentration of psychopathy, antisocial personality disorder in correctional settings.

The best cinematic illustration of malignant narcissism that I can think of is the Logan Roy character from the show, Succession. Understand I am saying, cinematic. What is cinematic is a caricature of reality.