What are NPD, BPD & Codependency?

What are NPD, BPD & Codependency?

The source for identifying these traits is The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (“DSM-5”). This is a reference book on mental health and brain-related conditions and disorders written and published by The American Psychiatric Association (“APA”). This publication and the lists of traits are readily available on the internet and at any library.

Disorders are on a spectrum. Just because someone exhibits some of the traits of NPD or BPD, it does not mean that they have the disorders. At times, we can all exhibit some of the traits to a certain degree, so be careful in judging others or yourself but also be willing to take a good hard look. From what I understand, the greatest challenge for people who suffer from both of the personality disorders is that they rarely seek counseling so seldom find the tools to change. The best news for those who live with codependency is that they are more open to counseling, which is a great tool in recognizing behaviors, building healthier relationships and making a new life for themselves. To help identify what these look like, review the following traits of each:

Narcissistic Personality Disorder (“NPD”)*

1.       Grandiose:

• Self-important

• Exaggerate / overestimate abilities and achievements

2.      Frequent Fantasies of Having / Deserving Great:

• Success

• Power

• Intelligence

• Beauty

• Love

3.      Belief in Superiority:

• See themselves as unique, “more special” than others

• Keen to associate with others who are “worthy”

4.      Need for Admiration:

• Center of attention

• Fragile self-esteem

• Fish for compliments

• Preoccupation with other’s opinions of them

• Slighted, or even enraged, when ignored

5.      Entitled:

• Expect VIP treatment (to an unreasonable degree)

• Enraged when not catered to

6.      Exploitive:

• Consciously or unconsciously use others for selfish gain

• Form relationships to boost their own ends

• Use vulnerabilities of others, even loved ones, against them

7.      Lack Empathy:

• Unable / unwilling to identify with the needs or desires of others

• Capable of mimicking empathy as an exploitive tool

8.      Envious:

• Envy other’s achievements

• Belittle or diminish the success of others

• Assume others are envious of them

9.      Arrogant:

• Patronizing, haughty, snobbish, disdainful

• Condescending, particularly to subordinates / service personnel

 Borderline Personality Disorder (“BPD”)*

According to the DSM-5, a person must exhibit at least five of the following nine criteria to be diagnosed with BPD. These traits must have been present for at least one year, be unchanging, inappropriate, and associated with a significant negative impact on interpersonal relationships or school/work performance.

1.       Fear of Abandonment:

• Discomfort or irrational fear of being left alone

• If feeling neglected will react with intense fear or anger

• May push others away to feel a sense of control

2.      Unstable, Intense Relationships:

• Rapid, dramatic shifts in interpersonal relationships; sudden idealization to devaluing and vice versa

• Chaotic family lives and marriages

3.      Unstable Sense of Self:

• Distorted self-image

• External locus of control

• Intense shame, see themselves as “bad”

• Dramatic / sudden changes in careers, goals, relationships

• Self-sabotage, suddenly quitting good jobs and healthy relationships

4.      Rapid Mood Changes:

• Sudden and irrational shifts in mood lasting hours or days

• Intense uncontrollable anger, fear, anxiety, hatred, sadness and love

5.      Impulsive and Risky Behavior:

• Reckless driving

• Fighting

• Spending sprees

• Gambling

• Substance abuse, binge eating

• Unsafe sexual activity

6.      Repeated Self-Harm, Suicidal Behavior:

• Cutting, burning, suicidal ideation (or threatening to do so)

• Triggered by rejection, fear of abandonment, disappointment by loved one

7.      Persistent Feelings of Emptiness:

• Bored

• Unfulfilled / empty

• Feelings of worthlessness

• Self-loathing

8.      Anger Management Issues:

• Intense / sudden rage

• Physical fighting / abuse

• Biting, hurtful sarcasm

• Bitterness, angry tirades often followed by bouts of shame

9.      Temporary Paranoid Thoughts:

• Paranoia, sometimes hallucinations triggered by extreme stress / fear of abandonment

• Dissociative episodes, generally short-lived

Codependency:

The DSM-5 does not recognize codependency as a distinct personality disorder. It is a psychological trait that describes people who feel extremely dependent and responsible for others’ feelings and actions. Codependency often develops when a child grows up in a dysfunctional family environment and then continues to manifest in dysfunctional adult relationships, lacking boundaries and an appropriate sense of self. Some common signs of codependency are:

1. Deep-seated need for approval from others

2.  Overwhelming fear of rejection or abandonment

3. Self-worth dependent on other’s opinions more than their own

4. Taking on more work than they can realistically handle, both to earn praise or lighten a loved one’s burden

5. Tendency to apologize or take on blame in order to keep the peace

6. Pattern of avoiding conflict by appeasing or withdrawing

7. Tendency to minimize or ignore their own needs and desires

8. Martyrdom, chronic feelings of being taken advantage of, unfulfilled, resentful

9. Excessive concern about a loved one’s habits or behaviors

10. Need to “fix” or rescue others. Making decisions for others or trying to “manage” loved ones.

11. Giving advice, even unsolicited, expecting that everyone should follow this advice

12. Absorbing moods of those around them

13. Guilt, shame or anxiety when doing something for themselves in lieu of others

14. Idealizing partners or other loved ones, often to the point of maintaining relationships that leave them unfulfilled

15. One-sided relationships. Enabling or excusing bad behavior or poor choices of loved ones. Continuing relationships even after the other person has repeatedly hurt them (physically, emotionally, financially, etc.)

 *Source: Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Text Revision. 2022 APA Publishing