Voicelessness and Emotional Survival Message Board
Voicelessness and Emotional Survival => Voicelessness and Emotional Survival Message Board => Topic started by: Dr. Richard Grossman on November 30, 2010, 08:41:45 AM
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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
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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
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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.
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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
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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? :(
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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.
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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
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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?
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Ales, I was just thinking that...to write to them somehow.
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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
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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.
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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.
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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.
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I'll still recognize one!
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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....
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I think it might be appropriate to replace the term Narcissist with the term Interpersonal Psychopath/Sociopath in the DMV.
That would make it easier for the public to understand what N's are, IMO.
Lighter
[from Diagnostic and Statistical Manual of Mental Disorders, 4th edition, 1994, commonly referred to as DSM-IV, of the American Psychiatric Association. European countries use the diagnostic criteria of the World Health Organization.]
A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy.[jma: NPD first appeared in DSM-III in 1980; before that time there had been no formal diagnostic description. Additionally, there is considerable overlap between personality disorders and clinicians tend to diagnose mixes of two or more. Grandiosity is a special case, but lack of empathy and exploitative interpersonal relations are not unique to NPD, nor is the need to be seen as special or unique. The differential diagnosis of NPD is made on the absence of specific gross behaviors. Borderline Personality Disorder has several conspicuous similarities to NPD, but BPD is characterized by self-injury and threatened or attempted suicide, whereas narcissists are rarely self-harming in this way. BPD may include psychotic breaks, and these are uncharacteristic of NPD but not unknown. The need for constant attention is also found in Histrionic Personality Disorder, but HPD and BPD are both strongly oriented towards relationships, whereas NPD is characterized by aloofness and avoidance of intimacy. Grandiosity is unique to NPD among personality disorders, but it is found in other psychiatric illnesses. Psychopaths display pathological narcissism, including grandiosity, but psychopathy is differentiated from NPD by psychopaths' willingness to use physical violence to get what they want, whereas narcissists rarely commit crimes; the narcissists I've known personally are, in fact, averse to physical contact with others, though they will occasionally strike out in an impulse of rage. It has been found that court-ordered psychotherapy for psychopaths actually increases their recidivism rate; apparently treatment teaches psychopaths new ways to exploit other people. Bipolar illness also contains strong elements of grandiosity. See more on grandiosity and empathy and its lack below.]The disorder begins by early adulthood and is indicated by at least five of the following:
Translation: Narcissistic Personality Disorder (NPD) is a pattern of self-centered or egotistical behavior that shows up in thinking and behavior in a lot of different situations and activities. People with NPD won't (or can't) change their behavior even when it causes problems at work or when other people complain about the way they act, or when their behavior causes a lot of emotional distress to others (or themselves? none of my narcissists ever admit to being distressed by their own behavior -- they always blame other people for any problems). This pattern of self-centered or egotistical behavior is not caused by current drug or alcohol use, head injury, acute psychotic episodes, or any other illness, but has been going on steadily at least since adolescence or early adulthood.
NPD interferes with people's functioning in their occupations and in their relationships:
Mild impairment when self-centered or egotistical behavior results in occasional minor problems, but the person is generally doing pretty well.
Moderate impairment when self-centered or egotistical behavior results in: (a) missing days from work, household duties, or school, (b) significant performance problems as a wage-earner, homemaker, or student, (c) frequently avoiding or alienating friends, (d) significant risk of harming self or others (frequent suicidal preoccupation; often neglecting family, or frequently abusing others or committing criminal acts).
Severe impairment when self-centered or egotistical behavior results in: (a) staying in bed all day, (b) totally alienating all friends and family, (c) severe risk of harming self or others (failing to maintain personal hygiene; persistent danger of suicide, abuse, or crime).
1. An exaggerated sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
Translation: Grandiosity is the hallmark of narcissism. So what is grandiose?
The simplest everyday way that narcissists show their exaggerated sense of self-importance is by talking about family, work, life in general as if there is nobody else in the picture. Whatever they may be doing, in their own view, they are the star, and they give the impression that they are bearing heroic responsibility for their family or department or company, that they have to take care of everything because their spouses or co-workers are undependable, uncooperative, or otherwise unfit. They ignore or denigrate the abilities and contributions of others and complain that they receive no help at all; they may inspire your sympathy or admiration for their stoicism in the face of hardship or unstinting self-sacrifice for the good of (undeserving) others. But this everyday grandiosity is an aspect of narcissism that you may never catch on to unless you visit the narcissist's home or workplace and see for yourself that others are involved and are pulling their share of the load and, more often than not, are also pulling the narcissist's share as well. An example is the older woman who told me with a sigh that she knew she hadn't been a perfect mother but she just never had any help at all -- and she said this despite knowing that I knew that she had worn out and discarded two devoted husbands and had lived in her parents' pocket (and pocketbook) as long as they lived, quickly blowing her substantial inheritance on flaky business schemes. Another example is claiming unusual benefits or spectacular results from ordinary effort and investment, giving the impression that somehow the narcissist's time and money are worth more than other people's. [Here is an article about recognizing and coping with narcissism in the workplace; it is rather heavy on management jargon and psychobabble, but worth reading. "The Impact of Narcissism on Leadership and Sustainability" by Bruce Gregory, Ph.D. "When the narcissistic defense is operating in an interpersonal or group setting, the grandiose part does not show its face in public. In public it presents a front of patience, congeniality, and confident reasonableness."]
In popular usage, the terms narcissism, narcissist, and narcissistic denote absurd vanity and are applied to people whose ambitions and aspirations are much grander than their evident talents. Sometimes these terms are applied to people who are simply full of themselves -- even when their real achievements are spectacular. Outstanding performers are not always modest, but they aren't grandiose if their self-assessments are realistic; e.g., Muhammad Ali, then Cassius Clay, was notorious for boasting "I am the greatest!" and also pointing out that he was the prettiest, but he was the greatest and the prettiest for a number of years, so his self-assessments weren't grandiose. Some narcissists are flamboyantly boastful and self-aggrandizing, but many are inconspicuous in public, saving their conceit and autocratic opinions for their nearest and dearest. Common conspicuous grandiose behaviors include expecting special treatment or admiration on the basis of claiming (a) to know important, powerful or famous people or (b) to be extraordinarily intelligent or talented. As a real-life example, I used to have a neighbor who told his wife that he was the youngest person since Sir Isaac Newton to take a doctorate at Oxford. The neighbor gave no evidence of a world-class education, so I looked up Newton and found out that Newton had completed his baccalaureate at the age of twenty-two (like most people) and spent his entire academic career at Cambridge. The grandiose claims of narcissists are superficially plausible fabrications, readily punctured by a little critical consideration. The test is performance: do they deliver the goods? (There's also the special situation of a genius who's also strongly narcissistic, as perhaps Frank Lloyd Wright. Just remind yourself that the odds are that you'll meet at least 1000 narcissists for every genius you come across.) [More on grandiosity.]
2. Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love
Translation: Narcissists cultivate solipsistic or "autistic" fantasies, which is to say that they live in their own little worlds (and react with affront when reality dares to intrude).
3. Believes he is "special" and can only be understood by, or should associate with, other special or high-status people (or institutions)
Translation: Narcissists think that everyone who is not special and superior is worthless. By definition, normal, ordinary, and average aren't special and superior, and so, to narcissists, they are worthless.
4. Requires excessive admiration
Translation: Excessive in two ways: they want praise, compliments, deference, and expressions of envy all the time, and they want to be told that everything they do is better than what others can do. Sincerity is not an issue here; all that matter are frequency and volume.
5. Has a sense of entitlement
Translation: They expect automatic compliance with their wishes or especially favorable treatment, such as thinking that they should always be able to go first and that other people should stop whatever they're doing to do what the narcissists want, and may react with hurt or rage when these expectations are frustrated.
6. Selfishly takes advantage of others to achieve his own ends
Translation: Narcissists use other people to get what they want without caring about the cost to the other people.
7. Lacks empathy
Translation: They are unwilling to recognize or sympathize with other people's feelings and needs. They "tune out" when other people want to talk about their own problems.
In clinical terms, empathy is the ability to recognize and interpret other people's emotions. Lack of empathy may take two different directions: (a) accurate interpretation of others' emotions with no concern for others' distress, which is characteristic of psychopaths; and (b) the inability to recognize and accurately interpret other people's emotions, which is the NPD style. This second form of defective empathy may (rarely) go so far as alexithymia, or no words for emotions, and is found with psychosomatic illnesses, i.e., medical conditions in which emotion is experienced somatically rather than psychically. People with personality disorders don't have the normal body-ego identification and regard their bodies only instrumentally, i.e., as tools to use to get what they want, or, in bad states, as torture chambers that inflict on them meaningless suffering. Self-described narcissists who've written to me say that they are aware that their feelings are different from other people's, mostly that they feel less, both in strength and variety (and which the narcissists interpret as evidence of their own superiority); some narcissists report "numbness" and the inability to perceive meaning in other people's emotions.
8. Is often envious of others or believes that others are envious of him
Translation: No translation needed.
9. Shows arrogant, haughty, patronizing, or contemptuous behaviors or attitudes
Translation: They treat other people like dirt.
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Agreed, thanks for that Lighter. I haven't read a list of traits for a long time and a reminder is interesting. I was particularly struck by the expression "Narcissists cultivate solipsistic or "autistic" fantasies" - it explains something I couldn't describe before.
CB I agree about the self-harm too: they simply won't do it. Might threaten it I guess?
The two different directions of lack of empathy made me think ((a) accurate interpretation of others' emotions with no concern for others' distress, which is characteristic of psychopaths; and (b) the inability to recognize and accurately interpret other people's emotions, which is the NPD style.) Can one person appear to exhibit both? If there's an emotioin they do have - fear? shame? - they may react as (a) whereas they may have no idea what is going on with, say, me sympathising with someone else and show (b). But this is on the basis that (a) is really understanding emotions and I wonder. I suppose it's like a computer interpreting. Maybe I've been in contact with people more towards the psychopath end of the scale that I imagine. Sometimes i think so for sure. An NPD + Psycho. Interesting if nothing else.
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2. Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love
Translation: Narcissists cultivate solipsistic or "autistic" fantasies, which is to say that they live in their own little worlds (and react with affront when reality dares to intrude).
Thanks Lighter! This is the feature that most drives me into a self-destructive coniption-fit of frustration and exasperation. But, the fastasy or delusion isn't only limited to starring in a "happily ever after" narrative. The way I've gotten to know it, is where the story-line is how much was sacrificed and what a martyr who "out of the goodness of her heart".... yada, yada, yada. Completely denying the existence of other choices - and the direct negative results of the self-imposed martyrdom. Including what the same choice looked & felt like from MY experience!! There is a distinct inABILITY to understand that I might see it/feel it differently or to understand why. As if I - me - who I really am as a person - doesn't exist in their reality; I only exist as the character that they have created for me.... and difficulty arises, if I speak or act "out of character".
It's different from the "we all have our reality" phenomenon, in that there is an acknowledgement that one is choosing to see things a specific way and accepting that others might have a completely different viewpoint. What distinguishes the N, is that he/she will persist persuading and expecting other people to accept their own "reality" as being the only "real" one... and everyone else who sees something else, is just out to hurt, harass, embarrass or discredit them (or alternately stupid, foolish or crazy) - because they had a different experience of the same situation or series of events!
And lord, don't hold their feet to the fire with "proof" that they're wrong, either!! It's as if they are able to dissociate their brains on command... and they literally don't hear you or see what you're showing them. They are ONLY able to exist in that "autistic fantasy" - and have extreme difficulty dealing with normal, real situations of everyday life. Maybe this is why there's always a co-N, or often enough to see the pattern. They need someone to interact with the real world. For them. Because they can't - their self-narrative won't allow it.... unless they are "making everyone jump" according to their whim and delusional reality.
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Amber, yes. Altho I can get frustrated, now I tend not to so much. Frustration comes from wanting it to change? If I think long and hard enough,I guess what I end up feeling is sick. Sick of 'them', cold with it. There are too many. Etc.
Yeah, we don't exist as real people, but then nobody does to them. I really don't care any more about that, how I appear or don't, to some screwed up N-scale psycho half-human (I agree with Sam: they are *not* fully human). So they might think I'm crazy/stupid/harmful? Who cares. Really.
Your last para: oh yep. This is why they need co-Ns; this is why we have laws and prisons.
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ah! thanks Guest; I hadn't seen "frustration" in the same light as "hope"... like hoping my mom would change = being frustrated that my brother (who is GC) wants to beat me up with his anger and makes everyone around him crazy by not being engaged in what is going on around him... and then needs to blame someone, which can't be himself... then looks for someone to beat up with anger... he is constantly sabotaging or throwing a monkey wrench into what should be straightforward, simple processes... with totally absurd justifications for it. Delusional "reasons".
yeah; I guess I should just take a number on the frustration thing. It's not something special he reserves for me; it's not personal; it's just his schtick. Back slowly away from the foaming at the mouth N..... distract him... then, spring the trap. Now I know where this kind of thinking comes from! I've had a lot of practice.
:D
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oh..............yeah.
I think I just convinced myself that the success of healing for those of us who've been "limited" through relationships with these people, who for sake of clarity & understanding need to have a name and a set of definable characteristics.....
in other words, I think it's important to keep NPD in the DSM.
How much more difficult would it be for one of us to heal, if we couldn't simply refer to a known set of traits of NPD - and therefore the known kinds of "fall out" on others which do seem to have identifiable patterns?
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CB, whoah, my goodness, yes, put the father in the psych ward or somewhere just as secure. Agreed, labels aren't everything by any means.
Amber, at least the DSM folks don't control the intertubes eh? Doesn't matter what they call it or don't call it. This website and others will be found by people who want answers etc.
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I have the sneaking suspicion that this committee has narcissistic people inside.
It is like saying that all our suffering does not exist.
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I understand that you can be very self centered and not be a narcissist. I also understand that (narcissist) is being applied very freely to people who don't fit (narcissist) but have some of the traits (and by non professionals).
But to know a (true narcissist) you have to live with them 24/7 and don't need to be a professional. Of course at one time we may not have been able to (label)
NPD but we sure did know (NPD).
So we went runining.....HELP ME...some of us middle aged to the professionals (with many years of either living/raised by 24/7) of not A Person (young) narcissistic (w) traits manipulation and so on that can still (grow out of or grow up) and haven't yet? Well we really can't say they are narcissist (because that don't exsist) but they sure are narcissistic with manipulations for the last 65 years....HELLO!!!!!!!!
Oh come on now!
I can say when I was with ex-h (in our 20's) and the mental health professionas to diagnosis (narcissistic with manipulation traits) probably would have been appropriate.
And there were many more traits then just that. But I can see how they do not want to label (at young ages) and hope with T or just one Growing Up ...can happen.
And I can see (at the age of 54) that it is appropriate to diagnosis NPD.
It's 28 years later....and only 1 1/2 -2 don't remember .....My ex-approached our S (for contact) with (new to be) Personality Disorder/narcissistic (w) every trait there is to have....but in the year 2013 (i think it said) no longer a narcissist?
To the commitee:::
Fome Me::
HA,HA, HA, HA, HA, HA, HA, HA, HA!!!!!!!!!!!!!!!!!!!
Shwoooosh!!!! Felt like that old time ....Gas Lighted ...feeling!
I AIN'T BUYING IT!
I understand you don't want to Jump on....YEAH they are NARCISSIT
but what about ....28 years later (like my kids a father) with no hope/no healing AND no Professional in the Mental Health Field (being able to help him) for when he did go he didn't stay.
And I think someday (there will be a break through) but not today.
So the DSM of NPD. (healed me) help me understand, let go, heal, be compassionate and forgive. It also helped me teach my children about thier father's disorder and to have no hatred, compassion and forgiveness.
So as of today:: It's still NPD and so many effected by people whom suffered from this diorder have been helped (understanding) the disorder.
The damage that will be done (will be to the people effected by it) more then the narcisisist.
Like I sad...I can see being very carefull to not diagnosis a young person...Agreed.
But 28 years later? I think your safe!
NPD.
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But 28 years later? I think your safe!
Exactly. To remove it now sends a message that the disorder no longer exists, that these people who have tortured us are what? Cured? Might as well call them cured if they don't have NPD anymore.
I have no problem with the DSM removing NPD IF they intend on replacing it with another term. With the word narcissist being thrown around casually by talk show hosts and tabloids, I'd actually prefer a new name for the disorder. But to have nothing at all is bad, really bad. We, as victims, have suffered SO much. We deserve some validation. Call it Whackadoodle Syndrome, I don't care, but call it SOMETHING. Don't try to tell us that it no longer exists.
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From the NYT article:
He also blamed a so-called dimensional approach, which is a method of diagnosing personality disorders that is new to the DSM. It consists of making an overall, general diagnosis of personality disorder for a given patient, and then selecting particular traits from a long list in order to best describe that specific patient.
This is in contrast to the prototype approach that has been used for the past 30 years: the narcissistic syndrome is defined by a cluster of related traits, and the clinician matches patients to that profile.
Now one can quarrel with the new approach, but to say that someone who has NPD will now be declared normal and not disordered is not accurate. Nor does it seem to be a method of denying what they do to their victims or the seriousness of their illness.
mud
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I'm not saying that Ns will be declared normal in the literal sense. That's my own interpretation - if NM no longer has NPD, then what DOES she have? If thy are not going to replace NPD with another clinical term, it essentially means that the mother who I have believed for decades to have NPD, no longer has it. It leaves me dangling in a confused state and places me back at square one, when I didn't know what was wrong with her.
With this change, I need, for my own validation, a new clinical term that I can apply to my NM. According to the quote that Mud posted, she still has a personality disorder, but I would need to start the identifying process all over again, sit down with a psychiatrist, go through her particular traits, and identify some new term. So it sounds like ten of us on this board could see a professional, go through this process, and each come out with a slightly different diagnosis. That's just messed up. One thing I've found in reading this board over the years, is that all Ns have eerily similar traits, right down to using the same vocabulary words. Seems to me that they SHOULD fall into one clear category, not be analyzed on an individual basis.
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Oh no! I think this would be a very, very bad move! It's one thing to redefine NPD,clarify it...but not to eliminate it. It's been hard enough for anyone like us, vicitims of Ns, to be taken seriously by the medical community. If it's eliminated from the DSM, it's just as if the damage and pain we endure means nothing...that it's not real and doesn't matter.
Espeically since it seems NPD behavior is on the rise, why now eliminate it from the DSM? At least when it's in the DSM, you have a chance that it can be treated...if not for the N, at least for the family who gets hurt by them. It's not the N who will feel ignored by this move, it's those of us who have struggled with the effects of it all our lives. After all, Ns rarely feel pain of their illness since they don't think they're ill. they would never get treated on their own anyway.
This is heartbreaking to me.
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What are your thoughts, Doc G?
tx,
Hops
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I wouldn't mind seeing NPD replaced with something outsiders can more easily understand.
If I say, Psychopath with heavy Narcissistic features...... nobody knows or cares what the second part means.
If I say Narcissist, everybody has a preconceived notion of what that means TO THEM, usually something silly.
It's too confusing, IME to say Narcissist.
I'm still voting for Interpersonal Psychopath Disorder.
IPD.
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Here's one guys take on it. Collusion with the pharm companies? Hmmm. Wouldnt surprise me.
http://www.psychologytoday.com/blog/do-the-right-thing/201012/the-end-narcissistic-personality-disorder-say-it-aint-so
CB
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Collusion with the pharm companies wouldn't surprise me at all, as Ns never seek treatment, and even if they did, there's is no medication that can help them. However, my doctors have tried every antidepressant on the shelf as a way of treating ME. Victims of Ns who suffer from anxiety and depression will continue to suffer regardless of whether or not NPD remains in the DSM, so the pharm companies will continue to profit from the victims. You won't see clinical depression or GAD coming out of the DSM anytime soon.
If I say Narcissist, everybody has a preconceived notion of what that means TO THEM, usually something silly.
I get that reaction too. "Oh, your mother is like Kim Kardashian?" The press has made a mockery of a very serious disorder.
My T told me that my mother also has sociopathic tendencies, so I may start to use the word sociopath instead. I like your idea of "Interpersonal Psychopath Disorder." That term sounds very fitting. It sounds like they don't plan on finding a term to replace NPD, though. The original article suggests that psychiatrists will be taking an individualized approach, so we all may get different responses. Regardless, NPD has been in the DSM for 30 years, countless books have been written on the subject. It's not going to just go away and stopped being discussed, not by victims OR professionals.
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I would like to know if they are to change it to (personality disorder) with narcissistic traits .. (would that confuse victims) and they would still think there is (chance for change) and keep Hope!
What are the other disorder's they are going to drop? There were 5 but most upset over NPD. Why is that?
Love
Deb
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I'm wondering the same thing Deb. I haven't seen any mention of the other disorders that were dropped. Wonder what they are, and why no one is upset about those ones being omitted.
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...other disorders to be dropped, see: http://psychcentral.com/blog/archives/2010/11/30/personality-disorders-shakeup-in-dsm-5/
..Paranoid, Schizoid, Histrionic and Dependent Personality Disorders are to go. So.....what will sufferers of Dependent Personality Disorder do? (Sorry, that *is* a bad joke.)
Seriously, we have a long long way to go in talking about other people's minds, however we might label them.
Isn't Asperger's going to be dropped too?
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Aspberger's - as I understand things - will be rolled back into the autistic spectrum; a subcategory.
I keep thinking about this, obsessive that I am! And it still bothers me and I'm still not sure that if I was asked to vote yea/nay on this, if I could boil it down to something that simple.
A couple of the things:
4 out of the 5 disorders - the "qualifying list of symptoms/criteria" to be diagnosed with the disorder - all are emotionally abusive and can seriously impact people in relationship with them; particularly children who really can't "go NC" without serious repercussions. What are they thinking removing descriptions of specific kinds of abusers??
As far as my limited knowledge of it goes, the DSM doesn't identify any diagnostic/therapeutic set of criteria for ACONs, ACOAs, etc. and yet I know from my experience - and the stories of many of us here (and elsewhere) - that there are certain characteristics we have in common - in large enough numbers to define it as a subset. And more importantly, many of us have needed therapy to start the healing process - expert reparenting, help with depression & anxiety etc that is a direct result of the disorders - specifically, the recognized patterns of effect on others (abuse) - which are being removed, generate. And wouldn't it be easier for both therapist and patient, if these patterns had an "official" set of diagnostic criteria?
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I have a hard time understanding - accepting - that a diagnostic tool such as the DSM, would be subject to a revision, which seems to have no more basis than to "not stereotype" or "profile" people - i.e, applying political correctness where it can do real harm. Not all profiling or typing is BAD... there are valid, useful and lifesaving reasons for it, when used appropriately. If it's not broken; don't try to "fix" it.
There are lists of symptoms which are used to diagnose a cold, sinus infection or flu; there are overlaps on those lists as well as significant differences. The lists aren't intended to be a replacement for observation or investigative testing; but they are generally correct a high enough percentage of the time that even ERs and Trauma teams use the same kind of checklists to save time - and lives. Checklists are important ways of organizing information... and the DSM is just one big checklist.
I mean - in human terms - how can we teach people to recognize an abuser without a defined list of characteristics? And what unintended consequences does this begin to create... are the folks supporting the "dimensional" approach to diagnosis really intending to validate and accept people who are untreatably abusive? (and we know they exist) You can't - in reality - pretend these people do not exist, by simply removing the definition of what those people are/aren't.
You can't teach a kid what a bully is, without a defined set of characteristics. So how would they ever know they were being bullied? How do you ever teach the bully, that what they are doing is wrong - and why? Simple punishment doesn't correct the behavior.
I think this move to remove these categories, simply blurs the lines even more and unavoidably provides an unwarranted acceptance of certain behaviors under a dispersed collection of personality attributes. That could prove to be - in 3-D reality - quite dangerous - even life threatening - to people in relationship with those kinds of non-typed "patients".
Sorry this is so long and kinda rehashes things yet again. I had to put down the pieces that I can't get to "fit together" and make sense.
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Hi Hops (and everyone),
This is such a great discussion with so many terrific points made, I didn’t want to butt in…But here are some of the important questions being raised:
What is the purpose of the DSM as far as personality disorders are concerned particularly the ones such as NPD that are very difficult if not impossible to treat? Are they useful to clinicians—or just insurance companies? Should it matter, DSM-wise, if the personality disorders are useful to those who have been afflicted by parents, spouses/significant others, siblings, friends, etc. who have the disorder—if the purpose of the DSM is simply for professional use?
And concerning narcissism in particular:
Isn’t the trait a continuous variable with human beings having very little (many of the the chronically depressed) to some (healthy narcissism) to a lot (such that it dominates interactions with other people)? And if it is, where is the diagnostic cutoff point? And furthermore, given the continuous nature of the trait, and given that most people have some, anyone can call anyone else narcissistic and be correct. (Anyone want to read or re-read Dawkins’ The Selfish Gene?!!!)
Furthermore, some people with high levels of narcissism exhibit other personality disorder traits. Such that diagnoses are at some times almost random: “Borderline Personality Disorder with Narcissistic and Paranoid features” or is it “Narcissistic Personality Disorder with Borderline and Paranoid features”?
Furthermore, different people have different narcissism meters. I am extremely sensitive to it—and have always been (the reason I started this site). But other people I know, including clinicians, don’t see it, hear it, feel it around them. Instead, they see other aspects of people’s personalities—perhaps those aspects that particularly bother them. Having trained in the Harvard Medical School and psychoanalytic community, I felt that narcissism abounded. But others didn’t see it, feel it, question it—or it simply did not matter that much. And I always thought to myself: what if the clinicians are diagnosable? Then the world is truly mad! (One of the 10 minute plays I submitted to the Boston Theater Marathon this year is on this theme.)
I’ll stop here, and perhaps offer some of my own personal answers to these questions later on…
Richard
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Dr G
I often think to myself: the clinicians are diagnosable. I mean it. Not that I know, or know of, many (thank goodness). But then so are many people in positions of 'authority': by the nature of the job, nutters are attracted to positions of power.
We don't like black and white thinking but heck, sometimes the world divides easily for me between Givers and Takers. It's an easy distinction for me, but then I don't overly crave fame or power etc. But then we're all 'takers' in a competitive survival of the genes way. Or are we?
If the DSM is used in law (as it is, by professional expert opinion?) then I guess it matters to the victims...or maybe not. The most important thing is behaviour, not the diagnosis label, I would think. Oh and justice too!
Humans are necessarily nuts though. If we weren't, we wouldn't survive.
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I'm looking forward to your thoughts about the questions you posed, Dr. G!
I'm still flip-flopping around about how I feel and what I think about all this... so I'm not sure I'm even making sense to myself. Every time I think I've nailed it down... I remember something that was pivotal in my own experience or something someone else struggled with that required being able to hold up a "bad guy" - to be able to work through it and get past that level of understanding about ourselves.
Having the NPD spectrum of characteristics officially recognized in the DSM, enabled a lot of us to realize that we weren't the bad guys like we thought we were and freed us to proceed to the next level after "explanation and processing/understanding of what happened to us" to healing and seeing the possibility that one can eventually let go the concept of "bad guy and victim".
What changes in the therapeutic relationship if the "bad guy" is no longer so easily identifiable or definable?
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And furthermore, given the continuous nature of the trait, and given that most people have some, anyone can call anyone else narcissistic and be correct.
We all have some level of money, from two mites to wheelbarrows full of it. That doesn't stop us from noting correctly, that Carlos Slim is rich, but it also doesn't mean we have any conception of what it's like to have his wealth.
And I always thought to myself: what if the clinicians are diagnosable?
Present company excepted, the few I've known have been.
Furthermore, some people with high levels of narcissism exhibit other personality disorder traits.
That would appear to be the primary good of the proposed new approach; assessing these people more accurately. It probably is not a good thing for those people, and their victims, whose traits fit neatly into one of the current classifications.
Anyone want to read or re-read Dawkins’ The Selfish Gene?!!!
Not really. Apparently many evolutionary biologists who merely seek knowledge rather than celebrity or a soapbox have little use for many of Dawkin's ideas or his polemics.
So.....what will sufferers of Dependent Personality Disorder do? (Sorry, that *is* a bad joke.)
I thought it was a pretty good one.
mud
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Maybe I'm just extremely sensitive to this issue but for me there is no gray on this issue: in my view, NPD needs to be in the DSM. It is only in the defining and labeling (even when those are working definitions and imperfect labels) of behaviors that results in the study, funding and treatment of disorders that emanate from a series of behaviors (in this case, those of the Narcissist.) And my perspective is that one can say that ANY set of behaviors or type of mental illness can be viewed on a continuum---from depression to schizophrenia to bipolar disorder to narcissism. By no longer including it in the DSM, the medical community is shouting out the message that Narcissism, as a set of behaviors, should not be taken seriousl---not in the Narcissist or those who victims of Narcissists. Indeed, by excluding it, those of us who have sought or seek treatment for other conditions resulting from lviing a life in the Narcissist's world are being marginaliized. I, for one, was extremely relieved and comforted when one psychologize I sought out pulled out his worn DSM and read off the characteristics of NPD. Finally, there was documentation---and a medical one at that---that explained that what I was experiencing was real...and that there was an explanation for why the toxic people in my life behaved in the way they did.
Diagnosing and treating mental illness is far from an exact science. But just because some behaviors or disorders are more difficult than others to identify, diagnose and treat doesn't mean they are not valid, honest-to-goodness illnesses that should be studied, understood and treated. Let's face it. If a set of behaviors does not have a bona fide definition tied to it that is accepted by the general medical community, it will be dismissed, ignored and marginalized. In the case of Narcissism, when that occurs, its victims will be further hurt and the Narcissists themselves will have little to no chance of improving their condition.
If anything, Naricissism, at the far end of the continuum, seems to be rampant today. It needs to be included in the DSM and more widely understand by both clinicians and the general public. Treating it, diangnosing it and defining it may be a work in progress but it is one that must be pursued if we are interested in avoiding thelifelong damage Narcissism causes. Clinicians aren't perfect and this disorder isn't one size fits all. But to turn their back on this widespread and oh so damaging disorder would be detrimental to those suffering from it or because of it. My advice to the clinical community? Try harder. Dig deeper. Work to better understand it and move the needle forward. Now's not the time to give up. The repercussions are just too all encompassing and damaging. We can all attest to that on this board.
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Mud - I've been thinking about what the defining characteristic might be on that N-continuum... and where to set it with an eye toward having a datapoint to use, to assess with some higher probability of correctness, the diagnosis of N.
What is one defining trait of NPD, that separates the disordered folk from those at the less engaged end of the spectrum (those that are simply Nish)? If we could say what this one (or more) thing is - and where it "crosses the line" from healthy to unhealthy - then we'd have that datapoint, which in fairness would only be a starting reference point. There would have to be a lot more "evidence" gathered... but it would suffice for a definition in the DSM, to "know one when you meet one". A definition need not prohibit the dimensional approach to treatment and to my way of thinking, works to support a basic working definition of NPD (vs "just" N) with much more detail.
I keep coming back to the idea of boundaries and control over others. An NPD at the fully engaged end of the spectrum may acknowledge that boundaries exist for them - but not see any reason whatsoever to respect other people's boundaries - because the NPDs goal in life is control over others, in support of the N's delusion of being more perfect, smarter/all knowing or more powerful than others. I think all the other things derive off of this - lack of empathy, sadism, etc. Someone with N-tendencies may still (when it suits them) actually respect some boundaries, in some situations. It's that delusion that one can control others, and that this is a good thing, that stands out for me as the difference between NPD and N.
I think this is recognizable enough - like your Carlos Slim example - to "know" when someone's NPD or when they merely have N tendencies... when they're comfortably well off versus wealthy.
MAYBE... It feels like I'm still missing a vital, probably obvious piece of the picture. But it simply doesn't make a lot of sense to me to remove a category/disorder... simply because people disagree on where to draw a line separating healthy/unhealthy. It's like the deal with categorizing grief as depression! Of course one's depressed when there's a loss in one's life... but there is a common sense distinction between "ordinary - natural" depression and the more serious levels of it, that persist and invade all areas of one's life. It's common sense - because it's simply obvious.
I don't know if my idea for a definition "works"... what does everyone else think? Remember the idea is to separate N from NPD... to "say" what the difference is.
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Hi PR,
Doubt there is one defining characteristic of someone with NPD.
The grandiosity is one that seems pretty exclusive to them and psychopaths but it's also pretty hard to measure or even demonstrate to an outsider in and of itself.
The incessant lying and control freakishness are not exclusive to NPD and are sometimes shared by people narcissistic but without full blown NPD.
The one thing that might meet your criteria is the lack of empathy, but again that is pretty hard to measure or demonstrate to any third party. However someone with N traits but who also has empathy is certainly different in kind not just degree from the soulless, heartless thing that is an NPDer, who seems to me have crossed some type of bridge to another world of self absorption and indifference to others. To me the lack of empathy is synonymous with or a symptom of the utter lack of a conscience with these people. The lack of a conscience seems pretty similar in practice to the Anti Social PD and psychopathy, the only difference seemingly being the NPD's aversion to committing overtly violent acts. Instead they prefer control through primarily emotional and psychological abuse rather than the physical type although usually the ASPD and certainly the psycho are quite good at the psychological side of things as well.
I've never been entirely sure where NPD ends and psychopathy begins and am not convinced there is a real difference, unless one defines it precisely as this line of physical violence. And I'm convinced that people with NPD only forego violence as a means of self preservation and would not have the slightest qualms about regularly knocking heads together if they thought they could get away with it, as can be seen in those who practice child abuse but no other violence, which is much easier to get away with and hide and carries much less risk of the victim's retaliation than violence toward an adult. Perhaps we could define NPD as psychopathy with a broad yellow streak? Or maybe psychopaths are NPDers who have learned to shed their inhibitions brought about by their overriding concerns of self preservation.
mud
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Mud I'm finding I agree with most of what you say above.
Re " lack of empathy, but again that is pretty hard to measure or demonstrate to any third party." - but perhaps with MRI proof of differences in brains, especially regarding empathy and fear responses (of psychopaths in particular), we might be getting towards a way of measuring?
"people with NPD only forego violence as a means of self preservation " - is it possible that psychopaths don't care about self-preservation but feel similar to NPDs about violence, that is: they see no difference between themselves and 'others' so...if they're going to be violent (NPDs) they imagine that *they* will feel the violence?? Possible? And psychos just don't care how they might feel? Hmmm.
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CB: I agree with you, that even without a name or DSM classification of just how my momster is disordered, that any T would be able to see the results of that kind of primary relationship on me. I think where I was going with all that was summed up succinctly by Hops - about the power of a "name". I am afraid that without a name for these people, that in the collective conscious, the model/pattern/concept will cease to exist... yet the momsters & popsters & abuse will continue their destruction, unacknowledged by society. Starting with the psychological community.
Thanks mud, for your thoughts! I admit that I'm going through what might be a futile "thought exercise". Where are the tools to quantify the criteria (and can we identify enough criteria that is consistent across many kinds of Ns?) of what an N is? Maybe Guest's suggestion of MRIs in identifying faulty neuro-wiring... but I'm not sure it's evolved to that point yet.
Your comment about yellow streaks, does give me another idea, tho. It tied in with the criteria of control over others - and that is, that I think NPDs are literally scared to death to feel anything, so instead they manipulate others into emotional states... through what I'll just call psychological warfare, for now... so that they can at least "see" what the emotions might look - might feel like. It's almost as if, in their quest to preserve their inner delusion of perfection... they dare not sully themselves with an emotion. It's too viscerally human. So they create the conflicts, wield anger or control like a club, trespass boundaries... all to externalize emotion so that they can then laugh at it, put it down, or put it under a microscope & study it... because it's completely foreign to them. They don't care that this is mean; it's how they continue existing. Like a form of self-preservation. They have to act on something outside themselves to "be" - to exist - to feel "real".
But, perhaps, that's only one form of NPD; maybe that's not even NPD... I truly don't know. But like a lot of people, I would consult the DSM to find out where that description "fits" best. The DSM isn't simply an encyclopedia of symptoms for mental health professionals, anymore. It's become accepted as the authoritative dictionary of disorders and is how people have been able to mainstream ideas into popular culture about BiPolar, Depression, etc. Perhaps, that's not what it was intended to be... and there are certainly dangers inherent in the attempts to classify someone's behavior and "stick a label on them" by the general public. A quick tour through all the support boards on the 'net returns a lot of comments about the DSM this... the DSM that...
So the cat's out of the bag already... In a way, awareness of and attempts to understand mental health issues is a really good thing - overall and long term. I just don't see that popular culture can sustain a conversation or discussion long enough to deal with the subtleties or complexities... to do more than label - correctly or incorrectly. And the DSM is the tool that enables them to do this. So, taking away that "name" for this particular kind of disorder is, I'm afraid, going to lessen awareness of NPD and only add to overall confusion about where healthy N stops and turns into abusive NPD.
I'm not sure it should, but it does matter to me.
I've talked myself inside out & in circles, on this and I can't wait to read what Dr. G has to offer on this topic!
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I am afraid that without a name for these people, that in the collective conscious, the model/pattern/concept will cease to exist... yet the momsters & popsters & abuse will continue their destruction, unacknowledged by society. Starting with the psychological community.
That's my fear as well. Though, I'd be willing to bet that the term NPD continues to live on long after it has been removed from the DSM. It was there for 30 years, and many victims were given this diagnosis by psych professionals. There have been countless books written on the subject. Is all of that suddenly going to go away? Even though it will no longer be in the DSM, and we WILL lose a certain amount of validation, I just can't see the term vanishing.
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And I'm convinced that people with NPD only forego violence as a means of self preservation and would not have the slightest qualms about regularly knocking heads together if they thought they could get away with it
I absolutely agree with this. My NM has never displayed any violent tendencies, however, she is obsessed with crime shows and real-life stories of serial killers. She volunteers at the local police station, and started bragging one day that she had been there long enough to gain access to the morgue, and that they would let her view autopsies. Some of this falls under delusions of grandeur, having the badge, telling people she has authority, that she's "just like a CSI." But I've always found her preoccupation with crime, specifically murder, to be be quite troublesome. I'm quite sure that she has the fantasies, but lacks the ability, opportunity, what have you, to ever act on it.
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It's almost as if, in their quest to preserve their inner delusion of perfection...
Yeah, but I don't think they have any inner delusions of perfection.
I think they perceive themselves as irretrievably flawed and inferior to everyone else. So inferior that if anyone knew how truly scared and screwed up they are they think they'd die.
I think they attempt to create a delusion of perfection in how OTHERS see them, or at least a method by whch they can control how others react to them. IOW if they bully everyone within their orbit into acting as though they're the cat's PJs their delicate little psyches are sufficiently protected enough so that they can survive.
I think their internal perceptions are so flawed that they percieve themselves to be more defective than they really are, mistaking universal human frailities as their uniquely terrifying cross to bear. And the one overriding flaw that they can't or won't deal with, their lack of empathy is the one that allows them to turn what would ordinarily be just some unpleasant traits into the puppet show from hell they try to create around themselves, in order to insulate themselves, at any cost to others, from what they think reality will do to them.
mud
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I wish there was a simple *like* button on this board.
Mud, am I over-reading or are you quite annoyed in the last sentence above? It reads to me like a rallying closing statement. I like it.
Unless they're exceptionally 'clever' (like Sam), I doubt they even know that they have a lack of empathy....how would they realise it? Isn't that idea a paradox in itself?
I think they're fear-based. Not normal fear; I guess it's shame fear. Sad nutters.
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I agree with your last post, Mud.
When my Nsociopath could have said a few apologetic words to redeem himself, he instead chose bullying.
He fairly swelled in his ability to bully, and terrorize...... giddy with it at times, bored at others.
When bullying failed..... he moved to people in our orbit, calling it..... "Broadening his campaign."
I believe he felt unworthy of love...... utterly.
He wanted to conquer it, take it, leverage it and hold it hostage, so it couldn't go anywhere.
Lighter
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Mud, am I over-reading or are you quite annoyed in the last sentence above?
Probably didn't realize it when I wrote but I guess I was, a bit. Doesn't matter how clinical you try to sound, what has been done to you is always lurking in the back of your mind.
When bullying failed..... he moved to people in our orbit, calling it..... "Broadening his campaign."
Heh. Heard things just like that myself. To these idiots, to paraphrase Clausewitz, life is the continuation of war by other means.
mud
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To these idiots, to paraphrase Clausewitz, life is the continuation of war by other means.
mud
That's true, isn't it?
It must really suck to be them.
Lighter
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True Mud,
that's probably *one* of the reasons I write much less than I used to. Plus it bores me to think about writing more than a few lines. And if I think about it now, for a moment, if I were to write more, it would be in outrage at what has been done to others, not just me. I got off lightly. My justified anger is very cold about the whole stinking mess that I saw spread. And that is enough writing about that. As for the rest, it doesn't matter any more.
Lighter: exactly.
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Plus it bores me to think about writing more than a few lines.
That's a much underdiscussed aspect of these clowns. Despite all the drama surrounding them and their outrageous antics, or perhaps because of them, they are universally the most tedious, boring people on the planet.
Presumably that's because they are utterly uninterested in anything actually important in life.
mud
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PR--This really rang true to me:
So they create the conflicts, wield anger or control like a club, trespass boundaries... all to externalize emotion so that they can then laugh at it, put it down, or put it under a microscope & study it... because it's completely foreign to them. They don't care that this is mean; it's how they continue existing. Like a form of self-preservation. They have to act on something outside themselves to "be" - to exist - to feel "real".
Mud, it's always struck me too--how deeply bored I feel around most narcissists.
There's a lively tune at first, while I learn their presentation and sometimes suffer
the consequences of my appetite for drama ("you're THAT amazing? Tell me more!"),
but after a while, I realize there's a LOT of repetition going on and feel like it's time
to "move along, nothing to learn here..." 'Course, took me 'til age 60 to learn that.
When I'm seized with a long flare of my own Nspots blocking my better-brain--I am sure I get boring too.
Hops
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Nothing can take away from me the knowledge I’ve gained over the past few years. I personally described my NM as one suffering from “Malignant Narcissism” as she has become very paranoid and antisocial as the years have gone by; she is even now showing a lot of schizophrenia symptoms. One of my brothers was a Paranoid Schizophrenic.
http://en.wikipedia.org/wiki/Malignant_narcissism
It is true the media has over used the word narcissist as to describe many people of varying degrees of self-absorption. There is even a musical band called “Malignant Narcissism”.
Some new term IS NEEDED to separate what the general population has come to THINK of as narcissistic, and what we KNOW as narcissistic.
But none of this can take away the validation that I have already received, and the knowing that other people understand some of what I have been through. As for the rest of the people I come across “out there’, they can just know that my mother was seriously mentally ill, abusive and not capable of love.
I simply have to believe that they will come up with some new term to describe what we all know exists. And this new term will describe these ‘far end of the spectrum’ monsters.
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I think their internal perceptions are so flawed that they percieve themselves to be more defective than they really are, mistaking universal human frailities as their uniquely terrifying cross to bear.
And the one overriding flaw that they can't or won't deal with, their lack of empathy is the one that allows them to turn what would ordinarily be just some unpleasant traits into the puppet show from hell they try to create around themselves, in order to insulate themselves, at any cost to others, from what they think reality will do to them.
Mud, the first sentence could be applied to some of us, also (like myself). But instead of demonstrating lack of empathy toward others... I turned that laser-gun of self-perception distortion on myself... and perhaps had some help in doing so, you know? (projection)
Do you think perhaps, that the puppetry becomes a self-validation in NPD? In that - by exercising "power" (or the illusion of it) over others, some of that fear of being revealed as "less than human" is calmed? That the "payoff" for the constant campaign of control, meanness, etc is simply a way to reassure themselves that what they're afraid of - is manageable? That this is how they've coped with a need for a feeling of "safety"?
That still leaves open the question of whether or not, Ns or NPDs are capable of changing. As much research as we've collectively done here, I don't recall much in the way of stories of successful treatment. Perhaps - and I'm going way out on a limb here making a lot of assumptions - perhaps the suggestion to remove NPD from the DSM is a way to acknowledge the fact that these people are not treatable?
My Dad - the classic N - could fire all his employees on a whim (and did). But he also went out of his way to help others, too. He was capable of apologizing and admitting he was wrong. He was able to change himself and his behavior over time (until his stroke). My mom on the other hand - is exactly the same as she was when I was growing up... is quite content in that... and it's the rest of the world that's stupid, wrong, and rediculous - not her. And she's quite incapable of self-awareness - of understanding how what she says and does affects others.
The one thing I would add to the consistent traits list, along with lack of empathy is that lack of self-awareness, too. Specifically, the lack of self awareness of how they are really seen by and awareness of impact they have on others... followed by the lack of empathy. I've seen this in both N-ex-husbands; my mom; my old Nboss.
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Hi everybody,
I appreciated all of your comments. Here is my view:
To put it simply, there are over 100,000 posts here supporting the continued inclusion of Narcissistic Personality Disorder in the DSM. Whatever the primary purpose of the DSM is, an extremely important secondary purpose is to confirm the existence of a mental disorder everyone here knows is real. The people here have not simply dealt with people having “narcissistic traits”. They have had to deal with people whose every interaction was dominated by narcissism—and whose personalities are well described in the current DSM. Of course not everybody with personality disorders neatly fit the current schema. But there are certainly enough people that fit the current diagnostic description to a tee—and many do not fit anything else. Narcissism is part of our culture and our species, and like with all personality disorders, there will always be people who are on the edge, or near diagnosable. But this doesn’t matter to me: Narcissistic Personality Disorder in its truest form is a different beast—you sense it, feel it, and know it when you see it. For a clinician, the diagnosis is not difficult. And the damage done by people with NPD to those closest to them is often deep and long lasting. Removing the diagnosis from the new DSM would not only be a theoretical mistake, it would leave those who have suffered as a result of their relationship to people with this very real disorder a far more complicated and difficult path to understanding and healing.
Richard
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Do you think perhaps, that the puppetry becomes a self-validation in NPD? In that - by exercising "power" (or the illusion of it) over others, some of that fear of being revealed as "less than human" is calmed? That the "payoff" for the constant campaign of control, meanness, etc is simply a way to reassure themselves that what they're afraid of - is manageable? That this is how they've coped with a need for a feeling of "safety"?
From what I've seen virtually all Ns construct a cult like coccoon around themselves. Usually family members as they are the most easily psychologically manipulated but also any acquaintances who are malleable and weak enough to be drawn in. I think the entire point of it is, as you say, to validate themselves as worthy of respect and leadership and to insulate themselves from the real world which they perceive as utterly invalidating to their carefully constructed facade of competence that they try to project.
mud
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Whatever the primary purpose of the DSM is, an extremely important secondary purpose is to confirm the existence of a mental disorder everyone here knows is real.
Hear, Hear and Hallelujah and Amen...
The DSM doesn't have to fit in a specified number of pages, does it? What's the rush to throw out established diagnoses and call one thing another (grief being classifed as depression - in an earlier change)? I don't think human evolution is leaving the DSM "behind".
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Imagine... I open up the current issue of Wired magazine, that I read for the creativity & science & tech in it... and there is an article titled "The Book of Woe", which is part interview of Dr. Allen Frances... part expose on the process of deciding what is/isn't in the DSM-5... and part explanation of the inner workings of the "establishment" of the American Psychiatric Association. It's written by a therapist - Gary Greenberg. He's posted more about this on his website (garygreenbergonline.com). I have no idea what his credentials are... but the article seemed to be written mostly objectively.
Apparently, disagreement and dissent over the proposed changes is growing. And there is more to the discussion than what we addressed. More at stake, too, I think.
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Thanks for posting that Amber. I bookmarked his blog. He has some interesting thoughts.
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Ditto. Amber, thanks. Having read, I tend also to think "rank incompetence" - which he does not? - because really, I tend to think that in general, because conspiracy takes far more effort and more intelliigence than such groups of people exhibit...but I could just be blissfully ignorant. Again!
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I can't tell if he's thinking there's a conspiracy or not. I know in the article he questioned perhaps a blindness of arrogance... which could appear to some as a conspiracy. I think the universe is way too random for there to be as much organized conspiracy as some (even myself some days) fear.
I am glad that a discussion is beginning to happen, through the concerns voiced by the "dissenting" group. I am glad that some people said "HEY.... wait a minute..." in a way that couldn't be hidden behind closed committee doors. I am glad that assumptions and premises and processes are being questioned and double-checked...
... because the importance and function and authority of the DSM is such, that it directly affects what the professional community considers "normal" and "abnormal"... thereby affecting many, many individual people. To me, that's way more important than even the issue of using drugs to "cure" emotional or psychological issues and the possibility that there are unethical connections between the pharma/psychiatric communities. And that's an issue I do care about. (Greenberg's article on the placebo effect & depression is most interesting!)
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Hi everybody,
Here's a Boston Globe article, "Who, Me, a Narcissist? by Karen Weintraub, on the issue of whether Narcissistic Personality Disorder should be eliminated from the new DSM:
http://www.boston.com/lifestyle/health/articles/2011/01/24/many_experts_are_considering_a_redefinition_of_narcissism/?p1=News_links
Also, there's a section on "Narcissism: How Common Is It" and the 9 defining characteristics of the disorder from the current DSM.
Richard