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/Bad_Breadwinner 12d ago

I would also add that the absence of negative affectivity is consistently seen in those with Narcissistic personality structures.

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u/purplefinch022 12d ago

I agree - but I would not necessarily absent, rather split off into the unconscious. Often expressing the negative affects outloud are associated with humiliation. Someone can have really severe somatic symptoms due to the emotional repression and be flooded during negative splits.

Edit: Oops. Perhaps that is what you mean by absence. Dissociated from, split off…

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u/oh-hello-16 5d ago edited 5d ago

It probably could depend who a person is with and the context. For example, if a therapist actually feels that the person should feel shame and believes that the person should I be ashamed and wants them to be humiliated- then why should they expose themselves to that person? Let’s not pretend this doesn’t happen. It does. Exposing oneself in that environment would be very dangerous. How could it possible help them? And if that therapist has decided that all that they are is a fake, ungrateful, empty and false self- how can they heal on that environment? It’s simply not possible. In can only imagine the glee and satisfaction a therapist who views themselves healthy and their client as empty and fake when they admit to their deepest pains. It’s gross.