Article on Narcissistic Personality Disorder in Financial Times

[Dr. Richard Grossman]

Hi everybody,

FYI:

When narcissism becomes pathological

By Adrian Tempany

Published: September 4 2010 00:23 | Last updated: September 4 2010 00:23

http://www.ft.com/cms/s/2/5ff67be2-b636-11df-a784-00144feabdc0.html

Thoughts?  Comments?

Richard

PS I disagree with the statement that there's no genetic predisposition to the disorder:  http://www.voicelessness.com/narcissism_genetics.html 

[mudpuppy]

This quote I found peculiar:

“It’s not clear-cut that society as a whole is more individualistic than, say, 20 years ago,” says Dr Martyn Pickersgill, a sociologist at the University of Edinburgh. “You can see all these new mechanisms of community, from Facebook to more overt activism. In mental healthcare you have a number of grass-roots groups. This is a reaction against individualism.”

If the claim is that individualism causes NPD I think it's incorrect.
If the claim is that an individualistic society makes those with NPD uncomfortable then I can sign on.
Secure people can function quite well in an individualistic society because they are free to make whatever associations they please.
NPD folks cannot function alone and very seldom do. More often the weird loners are schizoids or schizo affective or out and out sociopaths. Virtually all of the NPDs I'm aware of have gone out of their way to have a social circle around them; to dominate, to use, to manipulate, to be the center of. They are of course alone within that network, because I don't think it's possible to be without empathy and real friends and not be alone. But being alone within a group is not the same as being an individual.
Seems to me the weaker the individualism in a society the more likely tribalism and conformity will predominate and there will be less social mobility between groups. And those more rigid social structures can be precisely the means by which NPD can flourish.

mud

[sunblue]

Hmmmm....very interesting article, although I too, am not in agreement totally with the assessment.  I've read Sam Vaknin's work extensively and while his theories are on the right track, one must be always cognizant of his own rather deep-seated narcissism and the supply which is constantly seeks.

However, there were a couple of other points that seemed not on target for me.

*I'd be concerned that the new version of the DSM would stipulate a diagnosis of NPD only in terms of being co-morbid with another disorder.  Once again, I think that diminishes the role that NPD would play in the patient's life.  For some reason, the mental health community seems to be fighting hard to not value NPD as a disorder in and of itself.  The inference seems to be that NPD is only serious enough, only of value enough as a diagnosis if it accompanies another disorder. Perhaps this is because NPD is so difficuclt to treat and/or to diagnose properly.  But I think the move would be a significant step backwards.  What is needed is a better way to fully diagnose it and treat it, not to supplant it in preference to other disorders.

*Second, while there are no numbers to justify the theory either way, I believe it's not so much that there are more cases of NPD today because of changes in our society but because true NPD was incorrectly diagnosed or not diagnosed at all.  Even today, so few mental health professionals seem to take it seriously as a diagnosis.  I have seen a number of T-docs as a victim of NPD but not a one has taken NPD seriously.

*Third, I do think that in some cases there is a predisposiition to NPD which is genetic.  I also believe it is likely someone becomes NPD due to a parent who may have been NPD.  And, no, I don't think men are more likely to be NPD than women.  I've experienced both.

I would hope that articles like this will serve, at least, to awaken the medical community as well as the genral public to the painful consequences of NPD, both to victims of those with it and those who are diangosed with the disorder.  What is desperately needed are better diagnonstic mechanisms and ways to treat it.

Thanks for the link.

[sKePTiKal]

And so we're back to definition of terms, I think. (As in the article about classifying grief as depression in the DSM).

I don't know that even our group here has a concise definition of NPD; the list of traits at the end of the article do help. Our understanding of NPD is like the understanding of the definition of pornography: we know it when we see it. Yet, the range of severity or inherent-ness of symptoms in people we could identify as NPD is immense. And I agree, that often (but not as a prerequisite) NPD is co-morbid with other definable disorders. Like mud, I don't think "individualism" has a thing to do with it... and the example of Facebook, Twitter, etc would seem to more support people flirting with an N-attitude (Look at me! I'm having spaghetti for dinner!) than the opposite. Yes, social networking does lend itself to a form of community - so does VESMB. It's just a tool that can be used to reach an end; it doesn't predict what that end is, however.

I have a strange idea and maybe it won't make a lick o' sense. But, I wonder if the only way to effectively treat NPD is to treat the people who are vulnerable to being taken in by it?? The idea comes to me, via the AHA moment that seems so common once we've seen that the "great Oz" is just a sad little man behind the curtain. Once "exposed" like this, very quickly the great Oz loses the power of illusion over others.

Once we understand that a.) there are people that we are supposed to be able to trust - but can't and that b.) people can and do present themselves falsely and deny all evidence that exposes the lie - then we are finally able to stop blaming ourselves and feeling "at fault" in the relationship; we are able to begin to actually protect ourselves with healthy methods... and not simply try to appease the N for the bestowal of illusory "grace" on our needs.

It's also confusing when there are "healthy N" traits and no real idea where healthy starts to take a turn for the worse. I just about choked & dropped Cozolino's book on neuro-psych in the chapter where he describes someone who could easily be one of us on the board. He stuck the narcissist label onto someone in a case history, who developed obsessive caretaking traits... to maintain a role of importance in his relationship with neglectful and N parents. And of course, he repeated this throughout his life's relationships, until he finally "saw" what he was doing. I could easily have been described a "pathological caretaker"; parentification is a survival strategy; but does that make me N?

I re-read that several times, to make sure I wasn't misunderstanding him. I was sorta outraged that he seemed to be "blaming the victim" by classifying the client as N, in that case. And I've been pondering this for a couple of months... trying to see where I wasn't "getting it". And I believe that it's this fuzzy gray area of healthyN/NPD traits that's losing me. Growing up with N... I believe we try so hard to "not be like that" and believe that "all N is bad" (based on firsthand experience)... that we go through our own ego-struggles with where that line of healthy/unhealthy N is... often rejecting what is considered healthy N and even denying our own attempts for ego-survival - for fear of becoming the monster we've been afraid of so long. (And I know that's kinda hard to follow - sorry! It's just as confusing to be in that kind of loop.)

So, I wonder if we need to toss out Freud's "narcissist" definition and coin two new terms to distinguish between what is healthy ego defense or survival - healthy N - and the other kind? I think we could all agree that there is big difference between someone who indulges their ego with status symbol kinds of things or insists on being the height of fashion - and the type of truly sick person who can only feel good at the expense of others' well-being.