Treating "Borderline Woman - Psychopathic Man" Couples | Clinical Challenges

This video answers the question: Can I describe a romantic relationship type where an individual with borderline personality disorder is with an individual who has antisocial personality or psychopathy? I've also heard this question asked where one person had narcissism. For this video, I'm really going to focus on borderline personality disorder on one side and psychopathy on the other side, because psychopathy really covers a lot of these other characteristics we see with antisocial personality disorder and that we would see with narcissistic personality disorder.

Borderline Personality Disorder.

In the Diagnostic and Statistical Manual (DSM), we see nine symptom criteria for borderline personality disorder and five have to be met for a diagnosis. The symptom criteria include frantic efforts to avoid abandonment, unstable relationships, identity disturbance, impulsivity in two areas that are potentially self-damaging, suicidal behavior, affective instability, chronic feelings of emptiness, inappropriate or intense anger or difficulty controlling anger, and paranoid ideation or dissociation.

Psychopathy:

There are two types of psychopathy: Factor 1 (primary, interpersonal affective) and Factor 2 (lifestyle, antisocial) psychopathy. Factor 1 psychopathy has characteristics like grandiosity, pathological lying, manipulation, a superficial charm, callous, unemotional, low neuroticism and lack of guilt or remorse. Factor 2 psychopathy has a parasitic lifestyle, being prone to boredom, sensation seeking, impulsivity, irresponsibility, a failure to have long term goals, poor behavioral controls, and criminal versatility.

Narcissism:

There are two types of narcissism: With grandiose narcissism we see characteristics like being extroverted, socially bold, self-confident, having a superficial charm, being resistant to criticism, and being callous and unemotional. Vulnerable narcissism is characterized by shame, anger, aggression, hypersensitivity, a tendency to be introverted, defensive, avoidant, anxious, depressed, socially awkward, and shy.

Love, A., & Holder, M. (2016). Can Romantic Relationship Quality Mediate the Relation Between Psychopathy and Subjective Well-Being? Journal of Happiness Studies, 17(6), 2407–2429.

Bhatia, V., Davila, J., Eubanks-Carter, C., & Burckell, L. A. (2013). Appraisals of daily romantic relationship experiences in individuals with borderline personality disorder features. Journal of Family Psychology, 27(3), 518–524