Rejection and Abandonment in Cluster B Personality Disorders and Their Intimate Partners

Real or perceived rejection leads patients with cluster B personality disorders to react with hypervigilance. The narcissist's grandiosity is challenged (narcissistic injury) and it often results in narcissistic rage.
The primary psychopath sees rejection as a frustrating obstacle to be overcome and vindictively obliterated. The secondary psychopath see it all in the framework of a power play to be won. The borderline patient catastrophises and considers every rejection, however minor or justified, as abandonment: she split her partner and escalates her extreme behaviors in a hurtful and dysempathic cascade. The histrionic takes every rejection as a blow to her self-esteem and uses seduction, flirtation, and attention-seeking displays of emotionality to restore it. All these patients somatize.

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