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 believe ignorance is a common reason even among professionals. They only think of the grandiose traits; they confuse the vulnerable traits with BPD or MDD; and they think it has to be close to ASPD to be diagnosable.
My loved one developed NPD by having a terrible childhood and early teenage years with undiagnosed AuDHD. Bullying, rejection, isolation, school failures, etc. The solution was to start lying, manipulating, trying to get something (anything) going their way, seeking validation… They received a depression diagnosis only at first 🫥.
Did you know people with ASD score higher in vulnerable narcissism traits? That means this story could be common. Traumatized neurodivergent children are already at higher risk of developing mental disorders.
But no, nobody talks about NPD this way. It’s always about grandiose traits being dangerous for others (which can be part of the experience, but there’s so much more). I hope it changes someday.
This:
The solution was to start lying, manipulating, trying to get something (anything) going their way, seeking validation
Is a collection of reasons to be wary of this person. Validation’s not so bad, unless the person gets toxic about how they seek it. But being lied to, manipulated, spending time with someone who has to shape situations into their image, that’s a cost to people who experience it.
Self defense
I just wanted to say that I think it is probably difficult to have a disorder that is stigmatised so much. It makes it harder to acknowledge it and work on it. You do that anyway, which shows strength. I agree that disorders do not make someone a bad person. How you act and what is the effect on others is what is important for that. We all make mistakes. What is important is to acknowledge them and learn from them and to prioritise the needs of people we might have hurt so that they can heal. I think that defines whether someone is a good person, whether they have NPD or not.
How do you cope with NPD?
Also, what kind of things can other people do to support someone with NPD?
“How do you cope with NPD?”
Self reflection helps and listening to other people with NPD gives me a lot of insight into myself.
“Also, what kind of things can other people do to support someone with NPD?”
Just be understanding and don’t come the conclusions like everyone else in this thread
I think you raise a very valuable point here. “Narcissist” is so often used simply as a label for the villain with no consideration for the terms use as a medical diagnosis.
In your case, you may be labeled a narcissist but you make a continual conscious effort to account for the weaknesses implicit in that diagnosis. This is different from the vitriolic insult so often used to condemn people.
This is a failure on our part, in the way we use the term. You may be (technically) a narcissist, but, you are not “evil” in the way that others popularly labeled “narcissists” are. You are a good person.
I understand why “narcissist” will be used in a negative way but I’ve seen people diagnosis anyone they don’t like with NPD. It’s hard to find any good content online about it because everything is just pop psychology clickbait nonsense.
Nobody irl knows about my diagnosis but I’m afraid of if they find out. If this is all they see they may not want to associate with me. I wish people were more understanding like they are for things like depression or anxiety. It’s such a big thing about that I have to keep secret. I’m dating a guy at the moment. I like him but I’m worried about how he would react if he found out. I’m thinking of just keeping it secret forever but I don’t know if I can.
Same with adults who have a sexual attraction to children. They didn’t choose to be like that, and if they make sure to not act on those impulses, they shouldn’t be demonized. Conversion therapy has been demonstrated not to work, but if there’s any way they can receive help with their impulses rather than condemnation and vitriol, that seems it would be more helpful.
So your saying I’m a pedophile?
Personality disorders as a rule are some of the most difficult mental health issues to treat, and Narcissistic is one of the hardest.
Because the narcissist generally manipulates others to achieve their goals, it is one of the more “outward-facing” disorders, and therefore affects others. That’s why you experience “hostility” as opposed to having mental illness like depression, autism, or depression, which affects the person who has it.
Another problem with treating narcissists is they have a complex and often distorted relationship with truth, characterized by a lack of self-awareness, grandiose fantasies, manipulation, and projection. They may use dishonesty and deception to achieve their goals, but can also adapt to situations where honesty is necessary.
Narcissists are highly sensitive to criticism and rejection, which can lead to defensiveness and denial when confronted with the truth. They may become aggressive, hostile, or even violent when their grandiose image is challenged. It could be the root of this post itself.
Narcissists are incapable of understanding and relating to others’ experiences and emotions. This makes it difficult for them to comprehend the harm caused by their dishonesty and lack of truthfulness. They are their own worst judge.
Recognizing and understanding these patterns is crucial for dealing with narcissists and setting boundaries to protect oneself. We shouldn’t soft-sell NPD. It’s a part of the “Cluster B Personality Disorders (of A, B, and C),” which are the most harmful because they aren’t as apparent as Cluster A, who generally are odd enough to draw attention, and they are not needy or anxious like Cluster C.
Cluster B is:
- Antisocial personality disorder: characterized by social irresponsibility, disregard for others, and manipulation
- Borderline personality disorder: marked by emotional dysregulation, unstable relationships, and impulsivity
- Histrionic personality disorder: characterized by attention-seeking and excessive emotionality
- Narcissistic personality disorder: marked by self-grandiosity, need for admiration, and lack of empathy
Some people like and/or need having something to blame. npd just happens to be an easy target.
As someone with an NPD “friend” - I have to look beyond the insults and threats and see the insecurities and vulnerabilities behind them. Most people just can’t or don’t want to do that and will be insulted if not scared away by the things my friend says to them. There’s also a stigma associated with being friends with someone who is abusive - I keep the friendship secret from all but my closest friends, who have a hard time understanding it themselves.
There’s a reason your friends wouldn’t be okay with you putting up with that stuff.
There is also a reason this person is willing to put up with it. A neurotypical doesn’t trying to understand and forgive the behavior, they just find other neurotypical people to hang out with.
Orbiters of a narcissists, fuel the disease and gain their own validation by being someone else’s fuel. That doesn’t make it healthy.
What kind of validation does the fuel person get?
It can vary but being needed is a common one. The feeling that they are helping hold the NPD’s life together.
Ooh fuck that could be me
As someone who has NPD I haven’t abused or manipulated anyone ever.
That you are aware of.
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
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.
Or are willing to acknowledge.
You should definitely say the same thing to the next black man you see saying he hasn’t committed any crimes. Watching you find out what happens would be fun.
The Narcissist Scare by Sarah Z — This explains a lot, the term has been wildly misused and thus people don’t really understand what it actually means.
Plus there is a focus on punitive ‘justice’ very much in the systems we live under instead of either trying to understand people and trying to help them either directly or indirectly.
Allegedly, it is a difficult neurodivergence to live with in a healthy, non toxic way. However, I’ve never personally seen that from anyone I know officially diagnosed with it, in fact they are well aware that they have it and are trying to do better, a lot of people are armchair psychologists and love to diasgnose with no proof, misattributing it to other things, either trauma or the systems we all live under which causes people to act in terrible ways.
For those who have genuinely been affected by the actions of those who genuinely have it though, I suspect they feel as if they have to see as everybody with it as exactly the same to try to defend themselves. However, in actuallity this likely just makes people worse because not having community or people to point out when you are doing harmful things or getting you help is likely going to make people act out or seek out others who will reinforce their beliefs instead of encouraging them to get help in ways that actually work instead of the vitriolic hating ways most do to them. Though yes, I get that people shouldn’t have to be around those that do them harm but by seeing anyone of any group as all the same it may be doing more harm than good instead of getting to know individuals.
Personally, I think a lot of the systems we live under don’t help with the behaviour of anyone with neurodiverse conditions nor those that need protection from actual toxicity because they are stagnating and do not allow those that need help to get it due to being alienating and often lacking the resources they need to get help.
People don’t understand that medicine is about helping the patient. They read the diagnostic criteria for NPD, and they don’t understand that those things are only medically significant if they harm the patient. They think the criteria is a list of bad behaviour that hurts others.
Teach people what medicine is, and the stigma disappears.
A major component of NPD is it’s harm to the sufferer’s interpersonal relationships. I think the behaviors that contribute to this, though diagnostically and medically relevant, are generally deservedly stigmatized.
This is, of course, different from the armchair diagnosing someone with NPD just because they exhibit some of these behaviors, which I do think contributes significantly to the stigma of mental illness.
Ultimately, someone with NPD is more than their diagnosis and can certainly be capable of interpersonal relationships that are worthwhile to all parties involved.
I think the behaviors that contribute to this, though diagnostically and medically relevant, are generally deservedly stigmatized.
Sure, but only one of the nine diagnostic criteria is a behaviour. Most of them are feelings. Oftentimes bad feelings cause bad behaviour, but a bad feeling isn’t enough evidence to call someone an abuser. If we start telling people they can’t feel certain ways, we’re basically inventing the concept of thoughtcrimes.
And yeah, people with NPD are very often attacked by neurotypicals for their thoughtcrimes.
And yeah, people with NPD are very often attacked by neurotypicals for their thoughtcrimes.
Source? I’ve dealt with more than my share of narcissists, and I’ve never seen this. They might say things like “You really do think you’re the center of the universe, unbelievable” but it’s not because of the thought itself, it’s because of a history of harmful behavior linked to that thought. Manipulation, verbal abuse, selfishness at the expense of others, etc.
If you somehow had all the non-behavioral traits, but were able to avoid all the telltale narcissistic behaviors, no one would attack you for your narcissistic thoughtcrimes.
That’s not what drag has heard from people with NPD.
The ableist’s first attack on people with NPD will be to say that the disorder causes abusive behaviour. And they will watch you like a hawk waiting for you to speak out of turn and prove them right. But if you stay on your best behaviour and prove the first stereotype wrong by your own existence, you will see the arguments change. You will still see hate. And the argument for the hate will morph into a new assertion: “Having a big ego is itself an act of abuse.”
https://medium.com/@viridiangrail/why-reactionaries-hate-pride-and-narcissists-938d39261f13
NPD is also typified by not recognizing your behavioral offenses, and reacting to criticism by claiming to be the victim. The narcissists in my life never think they do anything wrong, that their abusive behavior is normal or acceptable, that their critics are attacking them for no reason, out of unfounded hatred or jealousy.
That does not make for a reliable evaluation. Claims of baseless attacks from a person who thinks every attack against them is baseless, does not prove that those attacks are actually baseless.
Well drag doesn’t think neurotypicals with no psychological background can make reasoned judgements on the struggles faced by neurodivergent people either. That’s like asking a white person to explain how it feels to be african american.
Just a few things:
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Bit presumptuous to assume I’m neurotypical.
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I’m pulling my information from psychologists, like the ones who described the signs and symptoms of NPD in the DSM.
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I have extensive experience with more than one narcissist. Failing to recognize their own abusive behavior, and the link to subsequent social fallout, is textbook narcissism.
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I’m not trying to make judgement on their struggles, I’m stating that believing oneself to be unfairly targeted is a symptom of narcissism.
It’s more like someone who is nose blind to their own horrific body odor (thanks to my MtG phase, also something I’m quite familiar with) than race. They think they smell fine, yet people react poorly to them, some even suggest bathing or deodorant. Since they can’t smell themself, they interpret these comments as baseless. They think they smell fine, and other nose blind smelly people will only confirm their self-assuredness.
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The D part of NPD is what is defined as harming the subject.
The N is the part the rest of us are worried about.
Most articles about spotting narcissists are not about spotting people with NPD. They’re about spotting narcissists. That’s a superset of NPD sufferers.
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 paraphilia’s. 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.
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
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.
You are not thinking of the hippocratic oath (there is no mention whatsoever of gossip about patients). The do no harm clause specifies bodily harm/abuse in a physical context. You have supplied a TV or Movie memory concerning diagnosis, or maybe you think HIPAA is somehow related to the oath. Many modern doctors don’t take the traditional hippocratic oath. If you’d ever read the text, you would know why.
You’ve clearly rattled all this off without taking a single second to look at context. The goldwater rule isn’t an actual law, and it does not in fact have an explicit analogue in the current APA ethics guidelines (though you can argue the same instruction is conveyed throughout a couple of the standards). You have made up rules that doctors live by in your brain. American psychologists do not “have to follow the goldwater rule”. Every time I see you post it’s some “I googled it!” regurgitation with absolutely no understanding of the topic, or insane ramblings about how we should be nice to AI. Your five minutes of searching is not going to help you think critically about anything. This is facebook user behavior.
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.
Number 6 is the only one that’s defined by the treatment of others
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).
Perfectly put, thank you
Thank you very much. As someone with a lot of challenges with mental illness myself, it’s something I think about a lot.
What’s your primary occupation?
I don’t presently have one, and when I do it’ll probably be like waiter at waffle-house or something 😅
Why do you ask?
“I think the important thing is really just that mental illness doesn’t shield you from accountability for how you impact other people,”
I never said it did but but everything else you said it’s very reasonable. Easily the best response on this whole thread.
It’s stigmatised because the term has entered common (mis)usage to describe people who are just selfish
Kinda like how “schizophrenia” is used to describe anyone who’s a bit weird or how “autistic” is used to describe someone with a interest in something.
I love how you were downvoted for a totally reasonable take.
I don’t think that’s WHY it’s stigmatised. It had to be stigmatized before that to be applied to selfish people.
It’s a disorder that is harmful to others and difficult to understand. For others to cope with it requires navigating a complex network of negative behaviors. Manipulation and lack of empathy are the traits of a psychopath, and none of us want that. You yourself lack empathy, but evidentally desire it from others. If you understand why you need empathy, then you understand why lack of empathy is stigmatised.
It had to be stigmatized before that to be applied to selfish people.
Good point. I suspect it was a plot point in Medical Drama #17 or Police Drama #12, thus was thoroughly misrepresented.
Actually, it entered pop culture with Christopher Lasch’s book The Culture Of Narcissism
It entered pop culture in ancient Greek theater
