Borderline Personality Disorder(BPD) and psychopathy both belong to the same cluster of personality disorders, but differ greatly from each other. The disorders have different characteristics, diagnoses, treatments, and prognoses. This does not take away the fact that the disorders overlap in symptoms and are often used interchangeably.
Because of Hollywood and mass media, a lot of the representation of mental illness is very far from accurate. Because movies, books, and TV series want to reach the “wow factor” in their audience, anything that might fascinate, disgust, and scare the viewers is good enough. Since relatively little is known when it comes to the mental health realm, the mystery, and stigma surrounding it provoke fascination in people. Something becomes extremely intriguing when you cannot put your finger on it.
BPD and psychopathy
Both borderline personality disorder and psychopathy are difficult mental disorders, and the names are often used interchangeably. This is because, in the mass media, borderliners and people who suffer from psychopathy may be portrayed as heartless criminals, crazy maniacs, and overall horrible human beings. BPD and psychopathy are two of the most controversial mental disorders because of how they affect the patient and the people surrounding them. It does not help that around 35% of all serial killers will turn out to be psychopaths and that borderliners are often thought to be psychopathic.
What is psychopathy?
In psychopathy or antisocial personality disorder, the sufferers lack empathy towards others. They are detached, which makes it possible for them to be very manipulative. Psychopaths often develop from unemotional and detached youth. Psychopathy is not an illness, but a personality trait. It is a disorder of the personality.
Because psychopaths can be so detached from what and who surrounds them, they can act in ways considered pleasant. But beneath that charm, emptiness, and lack of conscience subsides. Their ability to manipulate, their charm, and their lack of empathy make it so that psychopaths are often inclined to criminality (but of course not always). Psychopaths are about 25% more likely to end up in prison than non-psychopathic people. As mysterious as psychopathy sounds, it is far from uncommon: it is twice as common as schizophrenia, bipolar, and anorexia, and it is almost as common as OCD and panic disorder.
Psychopaths can easily hide their symptoms due to their manipulative abilities, which makes the disorder difficult to detect. Some characteristics of psychopaths are:
Superficial charm
Callousness
Often bored
A grandiose idea of self
Pathological lying
Lack of realistic, long-term goals
Lack of empathy and remorse
Juvenile delinquency
Promiscuous sexual behavior
Traits of psychopathy can be spotted as early as before the age of 10, but this does not mean the child will surely turn into a psychopath in adulthood.
The causes of psychopathy are relatively unknown
It is believed that psychopathy is influenced by genetics and the person’s environment, especially while growing up. Additionally, brain anatomy might play a role in the development of psychopathic traits; atypical functioning in the amygdala (the emotional control center of the brain) has been observed in people with psychopathic traits.
Treatment for psychopathy is not simple
This is because psychopathy isn't a disease, but it is a personality trait. Empathy cannot be administered through a pill, and no amount of therapy will make a psychopath feel any type of remorse. However, different approaches allow psychopaths to fit better in our society and make them less prone to criminality. Some of these approaches are psychotherapy, behavioral skills training, and recognition of the important leading roles in one’s life such as family, school, peers, and the community. Additionally, medication might also be required. The sooner the traits are recognized in youth, the more probable it is to avoid criminal behavior through multimodal therapy.
BPD and psychopathy similarities
Psychopathy and borderline personality disorder are two separate disorders with a noteworthy overlap in symptoms. In the DSM-5, psychopathy and BPD are both classified as Cluster B personality disorders. Overly emotional, dramatic, and unpredictable thinking and behavior are typical characteristics of the disorders in cluster B. These similarities might be the reason why people tend to use BPD and psychopathy interchangeably.
Another similarity the two disorders might share is how they develop: being exposed to emotional, physical, and emotional abuse, neglect, and early exposure to trauma is shown to play a relevant role in the development of both disorders. Additionally, in both disorders, biological factors might play a role.
BPD and psychopathy differences
Even though both disorders belong to the Cluster B Personality Disorders that affect emotions and interpersonal relationships, they are very different. The biggest difference between the two illnesses regards empathy: people with antisocial personality disorder lack empathy and remorse. Easily put, they do not care about the majority of things. This does not count for BPD.
People suffering from borderline personality disorder have an immense fear of abandonment. They cling to people in relationships, and often either idolize or devaluate the people close to them. Borderliners often use the sentence “I can't live without them” when referring to their partners. They go from loving intensely to hating the same person they cannot live without. This emotional turmoil leads to anger outbursts, inability to properly control emotions, and self-sabotaging in an attempt to self-soothe.
All of these characteristics are not present in psychopaths. People with antisocial personality disorder appear to be cool and collected. Sure, they are not able to feel other people’s emotions, but they know how to play around them. A psychopath will do whatever it takes to get his way, regardless of the consequences it has on other people.
It is possible to have BPD with some psychopathic traits, but the two personality disorders are very different.
Comorbid BPD and psychopathy