NPD, BPD and other disorders -

[GHTD]

Should anything be done for people with narcissistic personality disorder, borderline personality disorder and other Cluster B disorders? I ask this because I notice a lot of lolcows could potentially be considered as having this (at least in my opinion), especially the ones that are unwilling to take any opinion and essentially declare war on anyone that doesn't share the same thoughts as them. I doubt any of them will get any treatment at all either, since the BPD/NPD diagnosis rate tends to be fairly low since these types seem to think nothing is wrong.

Should they just be left alone with nobody in their life? Become hermits and wait for the sweet verge of death, or what's your thought on this?

 

[The Last Stand]

I think with their narcissistic behavior, they'd learn the hard way that people don't want to associate with such self centered, toxic behavior.

Get help if they want to better themselves. I'm fine with that.

 

[TFT-A9]

1. Already mentioned - Cluster Bs resist even being treated because EVERYONE ELSE IS WRONG, THEY'RE FINE
2. Cluster Bs, even when they go to be treated, tend to figure out quickly what to say to a therapist/psych in order to avoid actually dealing with their issues and yield little fruit from it
3. Medication does little if anything for them

Conclusion - leave them to wither, you can't help someone who doesn't want it

 

[MrWhoDat]

If you didnt think there was anything wrong with you would you accept changing your entire life to live and behave how youre "meant to" when you dont understand why?
Its a massive leap of faith by these types of people, and theyre usually not prepared to change anything.

 

[Pukebucket]

1. Already mentioned - Cluster Bs resist even being treated because EVERYONE ELSE IS WRONG, THEY'RE FINE
2. Cluster Bs, even when they go to be treated, tend to figure out quickly what to say to a therapist/psych in order to avoid actually dealing with their issues and yield little fruit from it
3. Medication does little if anything for them

Conclusion - leave them to wither, you can't help someone who doesn't want it

I think it depends on the individual and how receptive they might be to specific kinds of treatment. Malignant narcissists and extreme anti-socials I'd argue are the least likely to accept treatment since that involves them having any sort of doubt whatsoever that their actions aren't right; they rely on an internal narrative and "intuition" based on that narrative, to the exclusion of anything that doesn't fit their purview. Some may acknowledge they have a problem, but how they think they're perceived is going to sway them heavily in one way or another. This is why most narcissists refuse to come to terms with the fact they have narcissism in the first place or, if they do, they refuse to get help for it. Because going to a psychiatrist is, to them, showing weakness.

Bipolar is a tough one because while they swing wildly between manic and depressive emotional states you can sometimes get through to them just long enough to get them on meds/in therapy, although whether they are able to continue that therapy is very contingent on how they respond to being "stable". For many people with BPD, being emotionally stable is a strange, new experience because they've lived most of their lives swinging between emotional extremes, and without constant assistance to ensure that they are able to get used to the experience it can be really easy for them to take minor progress as evidence that they've been "cured" due to finding themselves capable of making rational decisions without being clouded by extreme emotional swings.

Histrionic is similarly difficult but I'd argue it's easier than narcissism; while overly dramatic in nature, they often fixate on others as a need for validation and if they get it in their heads that going into therapy will give them attention then they'll typically do it, if only to have something to get validation for. There are some overlapping narc traits involved, but if they get the impression that the people they're close to want them to get help the odds are much more likely that they'll at least make a passive effort to get into the psychiatric system, if only for the sake of getting in on some mental health hypochondria fuel.

All this said, it really depends on the person. I don't think that most people are well-equipped to deal with people suffering from cluster B disorders because so many of them rely on emotional response over rational thinking, and I think there's a lot of people who try much too hard to play therapist for their friends or family or partners in the hopes that they'll get better with just some good herbal tea and self-help books. At best it's usually ineffective and, at worst, can result in people becoming enablers for the more malicious individuals who fall into the above category.

 

[Pickle Inspector]

The problem is even if they admit to having a mental health condition some of them refuse to take any responsibility for their actions, like they’ll say ‘That was a manic/depressive episode’ as it’s a get out of all responsibilities card.

 

[Rafal Gan Ganowicz]

Malignant narc survivor (just barely) here.
(M) NPD and BPD ( which is Borderline PD, NOT bipolar @Pukebucket ) people are the closest thing to classical theological perceptions of evil on earth. They need to be bound from doing harm. Whether this means disappearing them if you can get away with it, having them comitted (very difficult)or provoking them into doing something extravagant to have them jailed longterm (dangerous) , they need to be destroyed. There is no curing these people.

 

[Pukebucket]

The problem is even if they admit to having a mental health condition some of them refuse to take any responsibility for their actions, like they’ll say ‘That was a manic/depressive episode’ as it’s a get out of all responsibilities card.

I have somewhat mixed feelings on this. On the one hand you're absolutely right; people who act out abusively, even while in the midst of a manic or depressive episode, need to acknowledge that what they did was unacceptable and take steps towards changing their behavior for the sake of other people in their lives, otherwise what they did constitutes as abuse regardless of how they personally viewed it.

On the other hand, manic and depressive episodes are fucked because they can absolutely warp your perception of events and sense of identity, especially if you've experienced them throughout your entire life; it also doesn't help that as much as people suffering from mental health issues can be toxic, there are also people around them that can feed into that shit deliberately because enabling them allows them to be easily manipulated if an abuser can figure out what sets them off.

As a somewhat grim example, I knew a guy who dated a bipolar chick on and off, and he would deliberately gaslight and belittle her in small ways in order to set her off over the span of two weeks; then they'd have a huge argument during which he'd storm out and she'd buy weed, smoke it, pass out, and then he'd go back the next day in order to get make-up sex and any leftover pot she didn't use for free. He had it rigged like clockwork because he was able to predict her emotional cycles and responses and used her mental illness to fuck with her in a way that benefited him. He bragged about this openly to me and when I didn't share his point of view he tried to shrug it off as "you know how passionate some relationships can be", as if constant arguing and a deliberate manipulation was in some way beneficial to both of them.

When she started going into therapy and got medicated, she actually had the hindsight to realize what he did to her and how staying with him had cost her friends and family in the long run; but that was also a double-edged sword, because oftentimes hindsight like that makes someone take the responsibility and awareness of everything they did or didn't do prior onto themselves all at once in a way that can drive them back into harmful behaviors, because they may believe that they did, in fact, deserve to be treated like shit. Guilt over things you do while you aren't entirely in control of your mental state can really fuck someone up in the long run unless acknowledged in a gradual fashion, which is where you get a lot of denial and relapsing behavior.

This example wasn't remote, either; I grew up with a lot of Cluster Bs and I saw many variants on this behavior, including parental/child relationships being similarly "rigged" in order to feed unhealthy cycles to get specific responses.

This is why demanding someone hold themselves accountable the second they start taking meds is a bad idea, from a mental health perspective; it's not that the person in question is necessarily in denial about what they did (although some might be), but rather that it reinforces a lot of personal suspicions that they might not deserve the opportunity to become a better person, so why bother. This is why medication and therapy are both critical and needed to work in tandem; pills on their own barely do anything and a lot of the time it's more about the commitment. The action of taking medication, like the action of going to therapy, is something that can become an ingrained behavior and framework to start from on it's own, even if medicated reliance is not an ideal outcome for most other people on the planet.

Malignant narc survivor (just barely) here.
(M) NPD and BPD people are the closest thing to classical theological perceptions of evil on earth. They need to be bound from doing harm. Whether this means disappearing them if you can get away with it, having them comitted (very difficult)or provoking them into doing something extravagant to have them jailed longterm (dangerous) , they need to be destroyed. There is no curing these people.

Similar situation here, except the BPD/NPD who nearly killed me got pressured into regular therapy/medication and, after ten years of both, has not shown any sign of malignant behavior since due to having a social structure reinforced to make sure that treatment continues. I would never, ever recommend that anybody wait for a similar situation, either; I just got unbelievably lucky that someone recognized what was going on and was actually in a position to help.

There is absolutely no permanent, one-time "cure" for Cluster B disorders, but for those who are receptive enough there can at least be mitigation. I'm well aware that if the person in my life stopped taking their meds or going to therapy, we'd be back at square one, and they are aware that I am not going to stay a second time if that happens.

All this is to say that if you have any opportunity to escape a malignant narc, take it at the first opportunity. Don't expect them to change because, even if they do, odds are it will not be contingent on your presence. I got extremely fucking lucky. Most people don't.

 

[Salad Dodger]

One of my definitions of hell on earth is being in a relationship with someone who has borderline personality disorder.

A good friend was married to a woman who would have constant affairs. He was called home from work by his Mrs who was on the floor sobbing because the man she was cheating on him with had another side piece and she'd just found out. So here was this cheating slut begging her husband to comfort and hold her because she'd been cheated on.

The ones who accept their diagnosis try to use it as a get out of jail card. "I can't help it, it's my BPD!" Like it's a carte blanche to make everyone around them walk on eggshells while they manipulate and do whatever they can to keep you hostage to their bullshit.

Dr Marsha Linehan of Washington State University developed Dialectical Behavioral Training which is claimed to have empirical proof of making BPD manageable. The problem is it seems a lot of women with it are dependant on drama, they thrive on interpersonal chaos. One OMGDRAMA! is too many and a thousand is never enough.

 

[soft kitty]

There isn't much you can do, except advise them to seek therapy. You can't force them to get help; unless they start becoming a danger.

 

[Clown Baby]

If you didnt think there was anything wrong with you would you accept changing your entire life to live and behave how youre "meant to" when you dont understand why?
Its a massive leap of faith by these types of people, and theyre usually not prepared to change anything.

This. "Healing" for someone with a cluster-b disorder means admitting that every single instinct for the way they behave socially is wrong and must be corrected. It's too hard for most of them, and in a lot of instances they have been a black sheep for so long that their families and friends don't support them when they're actively working to get better.

Marsha Linehan of Washington State University developed Dialectical Behavioral Training which is claimed to have empirical proof of making BPD manageable. The problem is it seems a lot of women with it are dependant on drama, they thrive on interpersonal chaos. One OMGDRAMA! is too many and a thousand is never enough.

DBT can make BPD manageable, if the person uses it as intended. The problem is that people with BPD have emotions that hit them like a bag full of bricks, and in order for DBT to help them they must choose every time their emotions are out of control to use a skill they learned to deal with it, all while resisting the baseline instinct to have a meltdown. It's like having a horrible itch multiple times a day and instead of scratching it choosing every single time to rub a balm on the itch that doesn't soothe the same way, but ultimately is more healthy.

It's not just that they "love drama," it's that a tiny slight directed at them, one that would roll off the back of a normal person, causes them deep personal injury and they immediately want to strike back/scream about it on sm/cut off a long term relationship over one interaction. Most of them can't handle stopping to think about it logically and coming up with a healthier response because no matter what their biological age they haven't progressed past 16 when it comes to emotional maturity.