A family member has been diagnosed with Narcissistic, Bipolar and Borderline Personality Disorders from two letters he wrote to a young girl 46 years younger than he with whom he was having an affair although he was married with 4 children. This was one of many affairs, the others being casual so to his mind did not count but he "fell in love" with this girl and relentlessly pursued her even though she had a restraining order against him after her parents found out about the affair. Is it possible to make a diagnosis from letters. I have read the letters and even to my mind they appear not to have been written by a sound mind. What is the difference between a psychopath and a narcissist?
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Hello, I have been practicing psychotherapy for over 20 years and am happy to respond to your question. It is not possible to make an accurate differential diagnosis of someone without seeing them in person for a thorough mental health evaluation. But from the information you have provided, this man certainly has serious mental health issues. I am assuming that you showed the two letters to the psychologist you refer to and I imagine after reading them, he/she made an initial hypothesis of possible diagnosis, but not final diagnosis. If your family member could be seen in person for several sessions, the psychologist would determine which one of the three, NPD, Bi-Polar or BPD is the appropriate diagnosis. As to your last question, someone with Narcissistic Personality Disorder is totally self-centered, manipulative and has no empathy for others, but he will not harm others, commit murder. Someone with NPD usually abides by the laws and rules of society. A psychopath has no moral compass and is capable of murder, mass murder. For example the Boston bombers etc., are psychopaths. I hope this is helpful. Chat back if you have any questions. Take care, Eleanor