The APA’s Diagnostic and Statistical Manual of Mental Disorders (the “DSM”) has been around for 50+ years. I have the first edition in my library, and it is maybe 80 pages long. The most recent version is something on the order of 950 pages. Turns out, mental disorders are a growth industry. And within it are oodles are possible labels just ripe for the picking.
Labels are dangerous things. In our culture, we toss them around like so much spaghetti, just to see what sticks. Racist, homophobe, narcissist, liar, sexist … you name it. In the end, the labels attach and can ruin a life. Gone is any sort of aforethought and due process, and our main-stream media comfort themselves with the notion of “absence of malice” as their defense. But malice is precisely the intent, when you stop to think about it. What else could it be?
I am a conservative for the very reason embodied in the definition of the word: cautious about change or innovation. It used to be that the DSM was reserved for practicing professionals and those whose immense training gave them a certain license to peruse the DSM in support of hypotheses regarding a patient’s presenting problem. Yes, the insurance industry got a hold of it and demanded diagnoses to support claims, but even they are cautious in protecting ensuing diagnoses from inadvertent disclosure. The professional in the helping profession has a duty to approach the DSM with caution and considerable forethought.
Consider, if you will, the term (the “label”) narcissist. Google Trends tells us that usage of the term has been rising for the past ten years as lay-persons, bent on applying the “right” label, seek out pop-psychological explanations for other people’s behaviors. The DSM has become an adjunct for feeling good about who we are by diminishing others through labels.
No one could possible enjoy being known as a narcissist, at least not in the casually insulting way that the term is used. But the conservative in me wants to go to a mountain top and scream, “Wait just a minute! Narcissistic needs are normal and universal! We are, ALL OF US, narcissistic to the core.” It is only when the extremes of narcissistic behavior get in the way of everyday functioning that the professional begins to formulate a hypothesis around possible explanations.
Remember this: Everyone needs to be praised by parents during critical childhood developmental periods. Later, everyone has a need to be appreciated by their friends and lovers. We call this “validation” and it is critical to human functioning.
Freud Got It Right
In 1914, Sigmund Freud documented, through considerable observation and testing, that infants pass through a stage of what he called “primary narcissism.” Piaget, a contemporary of Siggy-Baby, called it “ego centrism.” Both saw it as an evolutionary stepping stone: the self-centered frame of mind in which they cannot understand that other people are fully separate beings and not mere extensions of themselves. In other words, primary narcissism is a normal and entirely expected step along the path to becoming a fully functioning adult.
Freud saw what the DSM calls Narcissistic Personality Disorder, as an exaggeration of healthy narcissism. This may be true, by the way, of nearly all the DSM “disorders” – exaggerations of otherwise healthy behavior. Karen Horney, a latter-day Freudian, saw such narcissistic extremes as a consequence of particular parenting styles; to wit, if parents excessively overvalued or undervalued their children, she said, they would then grow up perpetually craving abnormal amounts of praise or validation. I think here of a (former) friend of ours who, as a young girl growing up was treated as a princess (to an extreme) and grew up expecting the world to treat her that way.
Otto Kernberg, another latter-day Freudian, saw narcissism in grown-ups as a kind of false front, or a way of protecting one’s ego – a persona if you will. He said that people with narcissistic personalities derive the validation they need from themselves as much as from others, propping themselves up artificially, which leaves them with no effective way to internally support their own self-esteem.
So, what happens is this: the person suffering from such a disorder looks at the world as a place in which he or she may be paramount in importance; in other words, a world where one’s grandiose sense of self-importance is to be rewarded without commensurate achievements to justify such belief. Why not? Their parents thought they were the apple of everyone’s eye. So should you.
Types of Narcissism – Vulnerable and Malignant
As you trade in labels, so should you know that narcissism doesn’t come in just one flavor. The DSM suggests that Narcissistic Personality Disorder is actually comprised of two types – one positive and the other negative. This helps us to remember that there is “normal” narcissism and “pathological” narcissism. We might see these as “pro-social” versus “anti-social.” In the words of Dr. Loren Soeiro, “the typical grandiose narcissist who has become such a familiar American trope may be overshadowing a less well-known, but equally difficult, personality type: the vulnerable narcissist.”
He writes, further, that…
…inherent in the current perception of narcissism is a quality of being in it for oneself, and often misusing or exploiting relationships for one’s own benefit. This best characterizes the antisocial narcissist — often, an extremely difficult, self-centered individual who expects excessive gratification from others in his or her life. By contrast, pro-social (positive) narcissists derive credit from positive accomplishments. They strive to do good deeds — often in public — and to make other people happy with them. In this way, they derive the validation that they, too, desperately need. If there are pro-social narcissists in your life, you may know them by how much fun they are to be around (and by the way they take deep satisfaction in your reaction to them). They want to be liked — sometimes, too much. They want to be known and appreciated by everyone in their lives, and their intentions are, overall, quite benign. Far from showing a lack of empathy, as in the person with traditional narcissistic personality disorder, these people use their empathy to tune in to what pleases you, and in doing so, they find validation.
His words allow me to “differentially diagnose” (a fancy term for getting it right) someone in the throes of vulnerability versus those truly out for just themselves, everyone else be damned.
The pathological (or malignant) narcissist cannot do anything for your benefit. Period. She cannot recognize or even identify with your feelings and needs. She works hard to render you “one down” so that she remains “one up.” She cannot form long lasting relationships, aside from, say, her husband who works hard to stay out of the line of fire. She becomes overtly aggressive when threatened, and labels anyone as racist who doesn’t agree with her. She is not limited by the truth (in other words, she tells convenient lies) and becomes full of rage when caught in a lie. Mom and Dad, who attended to their “little princess,” are dead and unable to prop up her fragile sense of self (hubby tries but because he may be a narcissist himself, struggles with empathy).
What To Do, What.To.Do
In the end, relationships, like neighbors, are best managed with strong fences. We might otherwise call such fences “healthy boundaries.” Even in the most intimate of relationships, boundaries are crucial for healthy functioning. It is a kind of “Don’t Tread on Me” approach to living. I see it as entirely normal and, quite frankly, quite needed in this age of social media. (#DeleteFacebook).
While we may have some degree of empathy for the vulnerable narcissist – those who are deeply self-absorbed and who maintain an undeserved sense of themselves – they too will demand ever more attention that they get. They will tell you of their constant victimhood and the fact the world, seriously flawed as it is, has not risen to recognize their inherent brilliance. Good fences (boundaries) are needed for them too.
It is the malignant narcissist who deserves a special kind of fence: A very high fence, ringed with shards of glass and razor wire. Keep them out of your life (your yard, as it were) and work to minimize contact in the world around you. Kill them with kindness when you do encounter them and above all, give them no ready reason to scream “racist” or whatever term they conjure up to bolster their own failing sense of worth.
As labels go, they are truly deserving of the term “dangerous.” They prioritize themselves over everyone else and are not good people to hang around with. They are “life sucking” in the truest sense of the word, kinda like Dracula.
Freud had it right: Childhood normalcy (in this case, an abiding sense of self-centrism) usually remits when society works to grind off the rough edges. But the truly malignant will make it through the planer.
Be careful out there.
References
Abby. (2018, May 29). Vulnerable narcissism: The less obvious narcissist. Retrieved from https://www.thrivetalk.com/vulnerable-narcissism/
David, L, “Narcissism (Kernberg),” in Learning Theories, December 4, 2015, https://www.learning-theories.com/narcissism-kernberg.html
Freeman, R. (2017, February 22). How to tell you’re dealing with a malignant narcissist. Retrieved from https://www.psychologytoday.com/us/blog/neurosagacity/201702/how-tell-youre-dealing-malignant-narcissist
Freud, S. (1991). On Narcissism. In Sandler, J., Person, E. S., & Fonagy, P. (Eds.), Freud’s “On Narcissism:” An Introduction (IPA Contemporary Freud: Turning Points & Critical Issues). New Haven: Yale University Press.
Google Trends / Explore. (n.d.). Interest in the search term “narcissist” over time, worldwide, since 2004. Retrieved from https://trends.google.com/trends/explore?date=all&q=narcissist
Greenberg, E. (2018, April 14). White knights & black knights: Pro-social & anti-social NPD. Retrieved from https://www.psychologytoday.com/us/blog/understanding-narcissism/201804/white-knights-black-knights-pro-social-anti-social-npd
Hammond, C. (2017, October 9). The secret façade of the vulnerable narcissist. Retrieved from https://pro.psychcentral.com/exhausted-woman/2016/11/the-secret-facade-of-the-vulnerable-narcissist/
Horney, K. (1950, reprinted 1991). Neurosis and human growth (2nd edition). New York: W.W. Norton
Kernberg, O. F. (1985). Borderline conditions and pathological narcissism. Rowman & Littlefield.
Kernberg, O. F. (1989). The narcissistic personality disorder and the differential diagnosis of antisocial behavior. Psychiatric Clinics of North America, 12(3), 553-570.
Konrath, S., Ho, Meng-Han., & Zarins, S. (2016). The strategic helper: Narcissism and prosocial motives and behaviors. Current Psychology, 35(2), pp. 182-194.
Ni, P. (2016, January 10). Seven signs of a covert introvert narcissist. Retrieved from https://www.psychologytoday.com/us/blog/communication-success/201601/7-signs-covert-introvert-narcissist
Soeiro, L. (2019). Types of Narcisists. Retrieved from https://www.psychologytoday.com/us/blog/i-hear-you/201904/the-four-types-narcissist-how-spot-each-one
Torres, A. (2018, March 19). Do You Have A Covert Narcissist In Your Life? Retrieved from https://medium.com/the-mission/do-you-have-a-covert-narcissist-in-your-life-843348ea694b
