Why is it that compared to other mental illness’s like depression, ADHD, autism and anxiety people seem to be so hostile to NPD? I always see things about ‘mental health awareness’ yet this is never applied to personality disorders.
Just look up “narcissism”, “NPD” or “narcissistic personality disorder” and the results are about how dangerous people with NPD are and how to spot somebody with NPD or if your ex boyfriend is a narcissist etc… etc…
I was watching this video earlier by a YouTube user ‘ShortFatOtaku’ called “Low IQ Twitter Discourse Awards!” and there was this one guy on twitter who said that if you claim advocate for the mentally ill you such do so with personality disorders as well. A statement I completely agree with:
https://youtu.be/3EJedJ8MhNA YouTube
ShortFatOtaku response with “wow your going to let that narcissist kill you and take everything from you?” I shouldn’t have to explain how bad faith and unhinged that is.
Why do people think this way about narcissists? Having NPD doesn’t make someone an inherently bad person. As someone who has NPD I haven’t abused or manipulated anyone ever. Sure, I struggle with empathy, I have to make an effort to think about other people and ok I have a never ending need for validation but that doesn’t mean I’m a bad person I understand I have a problem I didn’t choose to be like this. Manipulation and grandiosity are awful traits that I have but they don’t define me. I’m a good friend, I’m a good sister, I’m a good coworker and there are people out there who benefit from my existence. NPD doesn’t have to define me I’m more then my diagnosis.
I think the important thing is really just that mental illness doesn’t shield you from accountability for how you impact other people, and for a personality disorder that primarily manifests in traits that harm people, that’s a hard thing to reconcile with that person’s merits. Doesn’t mean you can’t or shouldn’t, just that because you are still responsible for potentially hurting people, and have a disorder that makes you very likely to do so, those things will be very hard for people to square.
Another example is paraphilias. Paraphilias can include things like pedophilia, which manifests in a desire to do something that would subject someone to profound amounts of trauma, the likes of which most of us couldn’t even begin to appreciate. Can someone with such a paraphilia be a good person who is kind, and does not harm people in that way? Yes. Can that person be largely a good person in most contexts, but cause people enormous harm as a result of their paraphilia? Also yes.
In some ways we are all people with conditions that affect who we would be otherwise, and in other ways we are all just people, and conditions are used descriptively to communicate the traits that we have.
At the end of the day, the thing that matters is how you treat people. If you cause people harm, it might be more understandable given the context of a personality disorder, but it doesn’t absolve you of any responsibility. And if you don’t, then you haven’t done anything wrong. And I mean that for each moment in time, each interaction. Humans are messy and complicated, and generally ideas like “good person”, “bad person”, are reductive.
I’m sorry you feel trapped or defined by your diagnosis. That can be a painful place to be. I have a close friend with borderline personality disorder who has at times felt similarly. Only thing that matters is whether you’re an asshole. Only thing that ever has mattered, only thing that ever will.
Edit: just want to be very clear- the fact that it will be hard for people to engage with you purely based on your behaviour in a given interaction is not something you deserve. Its the actions and how they affect people that count, even if I can empathize with why it’d be hard for people
for a personality disorder that primarily manifests in traits that harm people
Drag thinks you’ve misunderstood the diagnostic criteria. The criteria specifically refer to manifestations of the traits that harm the patient. Traits that harm others aren’t counted as diagnostically significant. Like, take the “excessive need for admiration” criterion. That one’s only medically significant if the patient is suffering because of their need. If they’re abusing other people into praising them and getting what they want, then they don’t have NPD.
For example, Donald Trump has the traits as a layperson would understand them, but not as a psychiatrist would understand them. Because they’re not hurting him. Doctors only care if the patient is suffering. No pain, no disorder.
Are you positive that’s entirely correct? There are definitely disorders who’s definitions are shaped by their impact on others, like Munchausen’s by proxy, but I’m not a psychologist or psychiatrist. I could see it being described as a form of impairment to an important area of life to not being able to form healthy non-destructive relationships, and I think impairment is one of the criteria by which a disorder can be defined
I could also just be wrong though, and it’s a fair point regardless. Perhaps “defined by” wasn’t quite the right way to word things
Edit: upon rereading I didn’t actually say it was “defined by”, but the wording is still imperfect. I can only be but so anal about technicalities though; communicating my point is more important
The caregiver or partner then continues to present the person as being sick or injured, convincing others of the condition/s and their own suffering as the caregiver.
The causes of FDIA are generally unknown, yet it is believed among physicians and mental health professionals that the disorder is associated with the ‘caregiver’ having experienced traumatic events during childhood
The primary motive is believed to be to gain significant attention and sympathy, often with an underlying need to lie and a desire to manipulate others
Drag isn’t especially familiar with MBP, but this is what Wikipedia says in the introduction. That the caregiver is convinced that they’re suffering and that they need attention and sympathy. Those are the actions of someone who’s in pain, and a link to trauma makes it all make sense.
But yes, the fact that medicine is for helping patients is controversial in the psychiatric community. There’s considerable debate on the subject. But the guy who wrote the DSM IV criteria for NPD has stated in multiple interviews that Trump doesn’t have NPD, because he isn’t suffering.
American psychiatrists have to follow the Goldwater Rule, which says not to speculate on the disorders of public figures. Why? Because that’s not what diagnosis is for. Diagnosis is the first step in a plan to treat a patient and help them. Diagnosis should never be about insulting, labelling, or stigmatising a patient in the eyes of others. That’s a violation of the Hippocratic Oath.
That’s not true. NPD diagnostic criteria in the DSM-5-TR (latest version) still contains manipulation efforts and similar behavior. Quote:
A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
- Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).
- Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
- Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions).
- Requires excessive admiration.
- Has a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations).
- Is interpersonally exploitative (i.e., takes advantage of others to achieve his or her own ends).
- Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.
- Is often envious of others or believes that others are envious of him or her.
- Shows arrogant, haughty behaviors or attitudes.
So… Donald Trump probably meets criteria for a narcissistic personality disorder diagnosis (if he ever agrees to start a “mental health journey”).
And it’s true that many disorders need to cause “clinically significant distress”, but personality disorders can be diagnosed even if they don’t cause distress to the person but causes it to others (e.g. ASPD). The DSM had to consider egosyntonic disorders, after all.
All 9 of those criteria only apply if they distress or impair the patient. Also, they’re outdated. That’s the DSM-IV’s criteria. And they’ve been criticised -
The NPD diagnosis in DSM has been criticized for being one-sided and relying primarily on external socially and interpersonally striking and provocative features.
As such, it has failed to capture the full range of narcissistic personality pathology, especially the internal vulnerability and insecurity characterized by severe self-criticism, insecurity, confusion, shame, aloneness, and fear.
Instead, the diagnosis has primarily emphasized external characteristics related to boasted grandiosity, and obviously adverse interpersonal functioning.
That’s why the DSM 5 criteria have more focus on the individual’s impairment and distress:
The essential features of a personality disorder are impairments in personality (self and interpersonal) functioning and pathological personality traits.
To diagnose a narcissistic personality disorder, the following criteria must be met:
A. Significant impairments in personality functioning manifest by:
- Impairments in self-functioning (a or b):
a. Identity: Excessive reference to others for self-definition and self-esteem regulation; exaggerated self-appraisal may be inflated or deflated, or vacillate between extremes; emotional regulation mirrors fluctuations in self-esteem.
b. Self-direction: Goal-setting is based on gaining approval from others; personal standards are unreasonably high to see oneself as exceptional or too low based on a sense of entitlement, often unaware of their own motivations.
- Impairments in interpersonal functioning (a or b):
a. Empathy: Impaired ability to recognize or identify with the feelings and needs of others; excessively attuned to reactions of others, but only if perceived as relevant to self; over- or underestimate of own effect on others.
b. Intimacy: Relationships largely superficial and exist to serve self-esteem regulation; mutuality constrained by little genuine interest in others‟ experiences and predominance of a need for personal gain
B. Pathological personality traits in the following domain:
- Antagonism, characterized by:
a. Grandiosity: Feelings of entitlement, either overt or covert self-centeredness; firmly holding to the belief that one is better than others, condescending toward others.
b. Attention seeking: Excessive attempts to attract and be the focus of the attention of others; admiration seeking.
C. The impairments in personality functioning and the individual’s personality trait expression are relatively stable across time and consistent across situations.
D. The impairments in personality functioning and the individual’s personality trait expression are not better understood as normative for the individual’s developmental stage or socio-cultural environment.
E. The impairments in personality functioning and the individual’s personality trait expression are not solely due to the direct physiological effects (e.g., a drug of abuse, medication) or a general medical condition (e.g., severe head trauma).
Oof… This is a tough one. First, I’ll point out that this post is EXACTLY what I’d expect from a narcissist. Woe is me, zero accountability. Assuming you’ve actually been diagnosed by a psychiatric Dr, they didn’t diagnosed you with NPD on a whim. You were diagnosed with NPD after you did something, or more likely after a lot of times doing harmful things, and finally taking some initiative to figure out what’s wrong with you. Maybe friends or family had to really push you towards getting help. Maybe your just young enough that seeking mental health help is normalized, so you were able to go for it.
“As someone who has NPD I haven’t abused or manipulated anyone ever.” -As someone with NPD you wouldn’t be able to recognize if you had ever done these things. This entire post is pretty manipulative actually.
NPD is a very tragic illness. One of the worst parts imo is that, almost always, one of the symptoms is the person not being able to truly recognize their own disorder. This can be dangerous, and also infuriating. A person’s entire life can fall apart around them, and they are incapable of doing the self reflection necessary to understand why, let alone do the work to fix the problem. People will spend years trying to “save” a loved one, to get that person to recognize that it’s THEM who is the problem and needs to do the work, just to get to the exact same spot a decade later because that person CAN NOT recognize it. Recognizing there is a problem is the first step towards fixing yourself. Since NPD usually precludes the person from being able to recognize the problem in themselves, it becomes impossible for them to save/fix themselves. It’s truly insidious.
All those things you listed would make you a bad person if you didn’t try to correct them. And maybe you actually are. I certainly hope so.
Edit to add: asking someone with NPD to be able to self reflect and do the work to change, is like asking a paraplegic to run a marathon. It might seem to others that the person is REFUSING, when in reality they literally cannot physically do so. However, unlike the paraplegic person, a person with NPD causes harm to everyone around them, and the only thing a healthy person can do is cut toxic people from their lives. It’s not the person with NPDs fault (one of the other great tragedies is that it is almost always a result of shit parents) that they are toxic, but they are toxic none the less, and unable to stop it. I’m sorry you ended up this way, I truly hope you can let yourself be treated.
As someone with NPD you wouldn’t be able to recognize if you had ever done these things.
Since NPD usually precludes the person from being able to recognize the problem in themselves, it becomes impossible for them to save/fix themselves.
Asking someone with NPD to be able to self reflect and do the work to change, is like asking a paraplegic to run a marathon… they literally cannot physically do so.
This isn’t true. What are you even basing this on?
Experience… And perhaps a little over zealous. I was trying to convey that it’s not the person with NPDs fault, but I think it came across as hopeless.
Here’s a quick grab from a Google search:
Targeting the Defenses That Sustain Narcissism
"Treating narcissism can be complex and multi-faceted. That’s because many of the hallmark behaviors of narcissism are the very ones that create enormous barriers to change.
Creating a therapeutic alliance in the face of defensiveness, denial, and a lack of self-awareness can sometimes feel like a hopeless cause. It can also seem uniquely challenging to execute even the gentlest intervention without activating the client’s defenses."
They asked why people are so hateful towards people with NPD, and I tried to explain it as simply as I could. With experienced, professional help, there’s hope for people with NPD… But the disease itself is resistant to treatment, and almost any lay person trying to help is likely going to burn out fast.
The hope comes from the fact that we all have some degree of narcissism. It’s an aspect of humanity. NPD is when a person’s narcissism gets so big and unruly that it controls them and ruins their life.
The reason this is hopeful is that our culture is full of exercises and practices designed to counteract and transcend narcissism.
Someone with NPD may have a lot more work to do, but the kind of work they need to do is just an extreme version of the kind of work we all need to do in order to keep that particular demon at bay.
I completely agree. Lived around narcissists my entire life, even covert narcissists that try to act humble, and this post is exactly what a narcissist would write. I don’t mean to bash OP, but their traits are obvious to those who are experienced with them. I hope they seek treatment before they hurt anyone.
“Oof… This is a tough one. First, I’ll point out that this post is EXACTLY what I’d expect from a narcissist. Woe is me, zero accountability.”
accountability for what? Being born? Should I have known as a fetus that I would have a personality disorder one day? What did you expect me to do? Refuse to be born.
“Assuming you’ve actually been diagnosed by a psychiatric Dr, they didn’t diagnosed you with NPD on a whim. You were diagnosed with NPD after you did something, or more likely after a lot of times doing harmful things, and finally taking some initiative to figure out what’s wrong with you.”
How do you know? You think your some expert because you watch some psych2Go and pop psychology slop? I know how I treat people and I have never received any complaints from anyone I know about how I treat them and no one else convinced me to seek therapy.
“NPD is a very tragic illness. One of the worst parts imo is that, almost always, one of the symptoms is the person not being able to truly recognize their own disorder. This can be dangerous, and also infuriating. A person’s entire life can fall apart around them, and they are incapable of doing the self reflection necessary to understand why, let alone do the work to fix the problem.”
While I agree with most of what you said I do disagree with the “not being able to truly recognize their own disorder.” part. For me it’s not that I can’t recognize theres something wrong with me it’s that it hurts to think there’s something wrong with me. Maybe it’s true for most other narcissist but not for me. A another big problem is that personality disorders are not like diseases. They can’t be cured and you live with them for the rest of your life. I really wish I could get rib of my NPD and be like everyone else but I’m suck with this burden.
“People will spend years trying to “save” a loved one, to get that person to recognize that it’s THEM who is the problem and needs to do the work, just to get to the exact same spot a decade later because that person CAN NOT recognize it.”
Again, how do you know? There are plenty of people who live normal lives with NPD. Believe it or not the real world isn’t some Amazon bookstore romance novel where the big bad narc will kill and eat you. NPD is a disorder like any other so it may put you in a disadvantage but it doesn’t define you. I understand there’s something fundamentally wrong with me and I need help. My narcissism is a awful thing I live with but I won’t let it define me.
“However, unlike the paraplegic person, a person with NPD causes harm to everyone around them, and the only thing a healthy person can do is cut toxic people from their lives. It’s not the person with NPDs fault (one of the other great tragedies is that it is almost always a result of shit parents) that they are toxic, but they are toxic none the less, and unable to stop it. I’m sorry you ended up this way, I truly hope you can let yourself be treated.”
For someone who’s accusing me of being manipulative you sure are doing a lot of gaslighting. You’re probably never read a psychology book in your life and the only experience you have is pop psychology videos on YouTube and horror movies but I suppose it’s not the choice of a stupid person. They just can’t help themselves but however a stupid person is a stupid person and all you can do is disregard everything they say. I truly hope you can let yourself be treated.
I’m a mental health clinician.
You asked why people reject people with NPD… I tried to explain it. Your response was even more like what you’d expect from someone with NPD than your post was btw. You could have been curious, I am after all, just an internet stranger; who gives a shit what I think? But you went hard on the defensiveness.
You aren’t born with NPD. It’s a defense mechanism against trauma you went through when you were younger. So I am really truly very sorry you went through whatever you went through.
I’m glad you have a therapist, and I hope they are a good fit for you to really feel comfortable opening up about your childhood, and how that might have affected you.
Being able to recognize that SOMETHING is wrong is not the same as truly comprehending WHAT is wrong. I worded my original statement poorly, sorry about that. But that hurt, when you think that something is wrong with you, is the reason most people with NPD can’t face it, not even to fix it. To fix it a person needs to be able to not just think about it, but really dig into it. A full embrace of and deep dive into that thing you say hurts just to think about. Most people can’t bring themselves to even think about it, which is why they get so defensive if you get anywhere near it, on purpose or not. Good on you for facing it.
And I know there’s no cure, but with a lot of work there are work arounds you can train into your brain. I really do hope we find a cure someday. For all personality disorders. They are truly horrible afflictions.
One of the hardest parts is that it’s a non-stop 24/7 battle you didn’t sign up for and never ends and ALWAYS feels completely unfair (this is why people with NPD NEED professional help with it). NPD might not define you, but in order to beat it you will have to be defined by your fight against it… You’ll need to be “spacefox3 the narcissist who’s not going to let it win today” everyday. And we both know you can do it.
Neat job. In the context of your profession, do you think Theramintrees YouTube channel is a good resource? “Good” is probably dependent on the audience.
When I was in college in the early 2000s, I took psychology classes.
In one class the professor told us that one of the best predictors of NPD was describing the disorder to someone and then asking them “Do you have this?”
According to that professor, NPD sufferers were more likely than most other disorders to recognize it in their self.
This directly contradicts what you just said about it.
You’re thinking of the “single item narcissism scale” which is the question
To what extent do you agree with this statement: “I am a narcissist.”
The disconnect is that while a narcissist can recognize they are narcissistic, they cannot accept that it rises to the level of a disorder or acknowledge the harm they cause others.
That sounds incorrect. Maybe they could recognize their behaviors if you spelled it out for them and put it in a context that in no way indicated you were trying to get them to admit something about themselves… but they’re unlikely to believe there’s actually something wrong with them that they need to work to fix.
That didn’t happen. And if it did, it wasn’t that bad. And if it was, that’s not a big deal. And if it is, that’s not my fault. And if it was, I didn’t mean it. And if I did, you deserved it.
The Narcissist’s Prayer (by Dayna Craig)
As someone who has NPD I haven’t abused or manipulated anyone ever.
That you are aware of.
Or “…yet”.
The possibility is there, yes. But I think the best way to prevent it is to talk about NPD in a more medical way and focus on effective treatments. Honestly, I haven’t found anything like “DBT for BPD” or “lithium for BD” for this disorder. It’s very much needed.
What do you mean by “aware of”? That’s quite the accusation your pushing. You must have some great evidence of my treatment of other people to make such a statement
Nah I won’t be providing any evidence. You’ve just provided it.
You are a failable human, unless you never interacted with anybody else ever you can’t be sure that you never made anybody feel manipulated or abused.
As someone else pointed out, this post is manipulative. You’ve set yourself up as a victim and when people posit that you could potentially have some self improvement, you are doubling down about it.
Because they have a tendency to not take accountability. Nothing is ever their fault, there’s always an excuse, there’s never an unqualified apology. If you are an exception to the rule, good on you.
I know two people in my life with NPD. One person is capable about having conversations about how he impacts the group socially. The other has just been cut out of my life permanently for refusing to address his issues.
People with at least certain types of NPD tend to use/manipulate/victimize people in ways that hurt, scare, and anger. People who have experience dealing with such NPD sufferers often have unresolved grudges which they project onto anyone with NPD. (Similarly, they tend to label NPD anyone who triggers their unresolved issues.)
In a perfect word, everyone would be emotionally mature enough not to be triggered or even injured in the first place by someone exhibiting manipulative/narcissistic behavior. But we don’t live in a perfect world. Victims of emotional abuse have valid reason to hurt and be scared and angry. It’s reasonable to say that they don’t have valid reason to demonize people with NPD. But whether demonizing people with NPD is “valid” or not, it’s understandable. At least as understandable as is any sort of projection.
So, this is a personal question, and definitely don’t feel obligated to answer it, but if you “haven’t abused or manipulated anyone ever”, can I ask if you’ve gotten any verification of this assertion from an impartial observer? For instance, has a therapist used a term like “covert NPD” to refer to you?
Also, being honest here and speaking personally, I have suffered abuse and manipulation of a distinctively narcissistic sort for a number of years. I don’t feel like I harbor hatred toward the individual in question today. (Though I’d really rather not ever interact with them again.) But it definitely was a long process to reach the point where I could say that. And it’s pretty certain that even if the individual to whom I refer had/has issues that lead them to abuse and manipulate me, I must admit that I similarly had preexisting issues on which they wouldn’t have been able to prey had I not had such issues. (And, full disclosure, if this individual ever had an NPD diagnosis from anyone with more authority than my own armchair, I’m unaware of it.)
I’ve since run into and worked closely with at least one other individual who habitually acted in very narcissistic ways toward me and others and I was able to mostly view them with empathy and avoid being triggered to an extent that wouldn’t have been possible had I not previously worked closely with the former individual I mentioned above. I can’t say I’m thankful to the first one per se, but at very least I can admit that having interacted with them, in some ways I’ve become a stronger person. (Even if in others I’ve become weaker.)
