Narcissistic Personality Disorder to be eliminated from new DSM?

[Dr. Richard Grossman]

Hi everyone,

From the NY Times:

A Fate That Narcissists Will Hate: Being Ignored
By CHARLES ZANOR
Published: November 29, 2010

http://www.nytimes.com/2010/11/30/health/views/30mind.html?_r=1

Comments?

Richard

[lighter]

The first thing that popped up, for me, was insurance companies paying off committee members to make it easier to squirm out of coverage.  

The second:  I don't care if they drop the N dx (it's confusing, and how many seek treatment anyway?)....
but, it would be nice to recognize identified patients, attempting to remain sane, while dealing with PD individuals.

I came to think of myself as "afflicted," but it could just as easily stand for "affected."

NSociopath Afflicted  (NSAFF)

Bi-Polar Disorder Afflicted (BIPOAFF)

Borderline Personality Afflicted  (BPDAFF) and so on.

Lighter

[Gaining Strength]

I don't have time to read the article yet but my initial reaction is - oh no - they are going to take away a classification that has been so helpful to my understanding what happened to me, just another denial of my experience and reality. That's what the news of your post hits me at first shot.  Not a good feeling.  But i will come back to it and read and process it on a different level a little later.  Thank you for sharing it.

[mudpuppy]

Not sure it's a bad thing as described.
For people like the N I'm most familiar with, who tidily meets each one of the traits of NPD, the present system is fine.
For others, most of whom seem to overlap disordered traits, sounds like it might be more useful. They'll still be diagnosed as personality disordered, but with a different maybe more focused description.

mud

[JustKathy]

I don't understand why they're removing it in the first place. My mother had all ten of the listed traits, and is was very validating for me to be able to reference that. It wasn't just validating on a personal level, but also gave me something to point to when telling others what was wrong with my mother.

Geez, it took me decades to finally get a diagnosis, and finally understand that my mother had an actual clinical disorder, and that it wasn't ME. And now that's been taken away. I feel like I'm 15 again, wandering around scared and confused, wondering why my mother mistreats me so badly.

So if there is no longer a clinical disorder known as NPD, what does that make my mother now? A sociopath? A bad lady? 

[nolongeraslave]

I agree with kathy. What damage is it going to do for the victims of narcissists? We don't need one more thing to tell us that we're the one that's crazy or that we're just imagining things.  The narcissistic entry in the DSM helps us explain how the narcissist affect us.   Growing up, it was SO hard to explain in words what narcissistic abuse was or what made my mom was gut-wrenching.....until I read about it in the DSM.

[Hopalong]

I too will miss its tidiness and will never forget the relief.

I remember when I was first told by an MD that I had had an "acute panic attack" and for the first time, something so terrifying had a name--and a shape--and that meant it had limits, and that there was something to do about it.

Names give power. When an abused child grows old enough and learns enough and first hears the term "abuse" -- for the first time, they can begin to grasp that there is right, and there is wrong. For many it's too late, but for many, it's a first step toward claiming their right to the pursuit of wholeness and holds out the option of rejecting their victim legacy.

I wonder if the analysts who've ditched the diagnosis have any sense of what healing there has been for the children/victims/survivors of those with severe NPD in having a name and a shape for what so distorted their worlds.

I wonder if that was even on their radar, the healing power of a contained summary of behaviors and traits equalling NPD. Or whether it was more a situation of arcane specialists' proprietary jargon creep, to satisfy some obscure professional jockeying for idea status...

Bitter? I sound bitter! Oh dear. But damn. A tomato's still a tomato, even if you start calling it a turnip.

Hops

[Ales2]

This is really sad. I just spent saturday arguing with my brother about whether my Mom is an N - he tends to think Borderline...so we agree she's completely crazy, just not how crazy and which kind! We'd need a clear definition to even have the discussion and deal with her in a constructive way.

I think this is a mistake, because when you can identify a disorder, it gives some relief and can help those who have to deal with Ns by giving them needed insight to alter their own behavior and set better boundaries. Take that away and its a little more nebulous...

Is there anyone we can write to and lobby to reconsider this?

[nolongeraslave]

Ales, I was just thinking that...to write to them somehow.

[BonesMS]

Hi everyone,

From the NY Times:

A Fate That Narcissists Will Hate: Being Ignored
By CHARLES ZANOR
Published: November 29, 2010

http://www.nytimes.com/2010/11/30/health/views/30mind.html?_r=1

Comments?

Richard

This is just as bad, if not worse, than Asperger's being lumped under the label of Autism with all of its con-commitment problems!!!!  WHAT IS THIS COMMITTEE THINKING?!?!?!?!?!?

Bones

[Guest]

I skip-read the article. I'm not sure if it's important that a name may change. It's still possible to list traits and behaviours and label them disordered, crazy, abnormal *harmful to others*.

I've often thought that the scale is from 'normal' to 'sociopath' with variations along the way.

Who was it said that all sociopaths (or was it psychopaths?) are Ns, but not necessarily the reverse? (Mud?) I think that's probably true enough for me to navigate my way around them, or know them when I have to deal with them. It's a matter of degree I guess.

After all, what stops a regular lacking-empathy N from illegal acts? Is it 'conscience', or is it plain fear. And if they're bright enough to work around the fear, and they have opportunity, they'll probably do what they can for their own gratification. I guess the difference between the N and sociopath is opportunity. That's flippant but that's how I feel. Tired.

[Gaining Strength]

I read it in print and what I noted absent was how the current diagnostic practise helps not only those who have the disorder but it also helps those who are terribly affected by the person with the disorder. 

[JustKathy]

but I kinda feel as though the term has become a catchall for anyone who is annoying

I definitely agree with this aspect of it. I actually started a thread on this last week, because I'm finding that the media's casual use of the word "narcissist" in reference to every spoiled reality star is trivializing a very serious disorder. I'd actually welcome it if the intent was to change NPD to something more pathological (as CB said), but unless I'm misreading the article, it sounds like they're removing it altogether, which ignores the disorder completely. If NPD has to exist under a different category or clinical term, that's fine (maybe even better), but it HAS to exist. For the sake of the victims, it has to be real.

[Izzy_*now*]

I'll still recognize one!

[sKePTiKal]

Oh my.

It seems that the committee is missing the connection between the definitions of specific disorder "types" - the causes that evoke the disorder - and the practical means of treating the disorders. There is a real cause-effect-treatment pattern that can be successfully distilled from the infinitely variable unique human suffering of individual people. It took a long time to create those "types"; define those disorders and it was based on many, many observations of what was common across distinct individuals.

Wouldn't it just have been easier to rate someone on a scale of severity (maybe bigger than 1-10) for NPD? And then note in the diagnosis other complicating, or co-existing issues? Doesn't that still allow for customized treatment? And still respect that the reason humans use "types" in the first place... is because of the commonality of features found across many, many people? Why have "types" become politically, socially incorrect (although this isn't consistently applied)?

As to the value of the diagnosis for us ACONs, et al - I have to say, that the old DSM criteria is very, very validating and becomes a sort of "home plate" for beginning to learn new ways to cope, grow and change ourselves. At least, in the beginning. I did become persuaded by my T, later on - that diagnosing my mom wasn't all that important to how I chose to heal, and deal with my own dysfunctional self. In fact, making that work "all about me" instead of her was a big leap forward... even though it still doesn't feel as if it's without Nrisk!!

Oh well. I guess in 20-30 years, there will be another committee that will decide that the DSM needs to be simplified into specific disorders... again... because the then-current system is too "cumbersome". I just wonder how often knowledge/skills are lost because of a group-urgency to redesign things....