Is Narcissistic Personality Disorder or Borderline Personality Disorder Harder to Treat?

In my opinion, both disorders can be damaging. Often, a person with Borderline Personality Disorder (BPD) displays traits of Narcissistic Personality Disorder (NPD), leading to a more severe condition. Despite some similar traits, there are significant differences, and an untreated BPD can be a recipe for disaster, especially when lacking proper treatment.

Brain Differences and Treatments

Neither BPD nor NPD are curable, and it is important to recognize the significant brain differences between those with these disorders and healthy individuals. BPD is highly treatable with Dialectical Behavior Therapy (DBT), which helps individuals manage the symptoms of their disorder. Unfortunately, there is no current treatment for NPD.

Client Motivation and Treatment Complexity

While I tend to say NPD is harder to treat, this is a general statement and should not be applied to every individual. A key element in therapy is client motivation, and my experience suggests that NPD tends to be a less motivating stimulus for change compared to BPD. People with NPD are typically more stable, while those with BPD experience extreme emotional volatility, making their condition more distressing and introducing more critical moments for change.

In many cases, NPD presents a facade of inflated self-worth, whereas BPD individuals are often acutely aware of their fragility and anxiety. This self-awareness can be a powerful incentive for change, while NPD individuals must leave a position of relative comfort to engage with extreme anxiety and self-doubt. Consequently, individuals with BPD are more likely to seek and stay in therapy, with less external pressure or coercion.

Sustaining Change and Coping Strategies

Sustaining change can be challenging for both BPD and, generally, humans. Initiating change is typically more difficult in the context of NPD. Nonetheless, some individuals with BPD may never seek or receive treatment, while people with NPD might work tirelessly to manage their condition.

Conclusion

The disorders themselves make it more likely that someone with BPD will seek and stay in therapy, especially with less external pressure. However, it is essential to recognize that every client and every course of treatment is different. Both conditions can be managed effectively with the right support and motivation.

Related Keywords

Narcissistic Personality Disorder Borderline Personality Disorder Treatment Difficulty