Three Voices: Histrionic, Psychopathic, Borderline

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Borderline Personality Disorder (BPD) is often diagnosed together (comorbid) with other personality disorders: histrionic, narcissistic, and antisocial (psychopathy). The majority of persons diagnosed with these comorbidities of personality disorders are women.

Borderline Personality Disorder is a post-traumatic state which is repeatedly triggered by neglect, abandonment, withholding of sex and intimacy, verbal and psychological abuse and by life’s circumstances, dangers and chaos.

When Borderline PD is comorbid with Histrionic PD, such women react by seeking comfort, acceptance, validation, sex, and intimacy from other men.

But the comorbidity creates conflicting inner voices:

Histrionic: Men will make you feel better, restore your self-esteem.

Antisocial: Don't feel guilty about cheating and being a "whore". It is fun, you deserve it, it is not your fault, no one gets hurt if you keep it a secret - so go for it.

Borderline: Your Sexuality is bad, mad, and dangerous. Don't take it too far or it will end calamitously.

When such a woman experiences a narcissistic crisis or injury – when she is hurt, humiliated, or frustrated and when her femininity is doubted or challenged - her histrionic side forces her to reach out to men to make her feel better by ameliorating her frustration. Flings with men restore her self-esteem and self-confidence and regulate her labile sense of self-worth. She contacts men with the intention of having intimacy and sex with them.

Her antisocial (psychopathic) voice legitimizes her histrionic behavior: "Don't feel guilty about cheating and being a 'whore'. It is fun, you deserve it, it is not your fault, no one gets hurt if you keep it a secret - so go for it."

Her borderline aspect feels stressed and panics. When she is faced with a man's expectation to have sex and with her own sexual desire, she freaks out. Sex is perceived as traumatic: it is associated with pain and hurt, a kind of punishment. The following negative thoughts prevail:

(a) Sex is "dirty";

(b) Men are evil, dangerous, one-track minded (they want only sex and then they will discard you);

(c) Sex inevitably results in pain and hurt;

(d) You should feel guilty about cheating;

(e) You should feel ashamed for being so "whorish".

So, when faced with the prospect of sex, borderline patients panic because of these negative thoughts. The panic leads to depersonalization ("splitting" from oneself in a paralyzing trance, going “auto-pilot”, or lapsing into a dream-like state).

If such a woman crosses the line and has full-fledged sex, she experiences dissociation: she forgets sexual acts that conflict with her values and boundaries, especially if she finds them enjoyable.

(From the book "Malignant SelfloveNarcissism Revisited" by Sam Vaknin Click on this link to purchase the print book, or 16 ebooks, or 3 DVDs with 16 hours of video lectures on narcissists, psychopaths, and abuse in relationships)