Borderline PD vs. Narcissistic PD vs. Complex PTSD: What Are the Differences?
There are clear distinctions among all of these.
Photo by Andrej Lišakov
Written by Shahida Arabi, MA, trauma and psychopathology expert and researcher
An earlier version of this article by this same author have appeared in different publications since 2023. Copyright is retained by the author, Shahida Arabi.
As a researcher who specializes in narcissism and psychopathy, I have often heard stories from individuals who have been in romantic relationships with narcissistic or psychopathic partners reporting that they experience PTSD symptoms that “mimic” patterns of BPD even though they do not have BPD. This is due to the natural trauma reactions that arise in response to the abusive cycles and trauma bonding in these relationships.
Some therapists have noted that individuals can also be misdiagnosed with BPD when they are actually experiencing more temporary traumatic symptoms resulting from abusive relationships or when they are actually suffering from Complex PTSD. Many of the same symptoms – such as the emotional ups and downs due to the “mean and sweet” cycle of abuse and frantic attempts to avoid abandonment can occur in these tumultuous relationships.
In those specific cases, such symptoms tend to improve and heal after exiting the abusive relationship and with appropriate trauma treatments.
Separately, there are also cases of individuals who do have BPD having a pattern of being in relationships with narcissistic or psychopathic individuals or being targeted by narcissistic or psychopathic individuals due to their pre-existing emotional vulnerabilities, making them especially susceptible to provocation. Such relationships can exacerbate any pre-existing symptoms of BPD and may cause additional complex trauma.
How Does BPD differ from NPD?
Many people wonder how Borderline Personality Disorder differs from Narcissistic Personality Disorder, or how Borderline Personality Disorder differs from the usual symptoms of trauma. While there are a few overlapping symptoms between these conditions, there are many marked differences between Borderline Personality Disorder with no other comorbid conditions (as well as borderline traits on their own) and Narcissistic Personality Disorder (or narcissistic traits on their own) that are worth highlighting. There are also some important distinctions between Borderline Personality Disorder and more temporary symptoms of trauma or complex trauma.
Borderline personality disorder (BPD) is a mental health condition with a long-term, sustained pattern of behavior characterized by emotional intensity and affective dysregulation, a pattern of unstable relationships, impulsivity, frantic attempts to avoid abandonment and reoccurring self-harm. Symptoms and traits of BPD usually begin in adolescence, but BPD can only be diagnosed in adults.
Narcissistic personality disorder (NPD) is a personality disorder characterized by a chronic lack of empathy, exploitation of others, an excessive sense of entitlement, pathological envy, a haughty or condescending attitude, vanity or self-absorption, and a need for admiration. While NPD likely also involves an interaction between biological and environmental factors, some research, including longitudinal studies, suggest that parental overvaluation in childhood may cause narcissistic traits.
One of the biggest differences between Narcissistic Personality Disorder and Borderline Personality Disorder is in the capacity for emotional empathy…