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
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.
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.
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).
Number 6 is the only one that’s defined by the treatment of others
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.
This post kinda scares me. Like the way you frame NPD is that if someone is diagnosed the only moral course of action is to never form relationships with anyone ever because you simply can’t do so without hurting them. This turns any attempt at self reflection from someone with NPD into another form of manipulation and frames rehabilitation impossible. You would condemn someone to a lifetime of isolation from a singular diagnosis. It just doesn’t sit right with me.
This has simply been my experience. It doesn’t sit quite right with me. I want there to be a fix. I’ve just never seen it work.
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.
Hatred and stereotypes from TV.
OP: “god, it’s hard being a paraplegic and trying to run…”
You: “guys, don’t listen to this asshole, being a paraplegic means you can’t run. If this person were actually NPD, it would be an extremely positive sign for them to seek to improve themselves and since we can see this person trying to improve themselves, they are clearly lying and manipulative. Classic NPD.”
Log off and touch grass. You can come back when the stench of your self righteous diarrhea of the mouth fades.
They asked why people are so hateful towards people with NPD… I tried to explain it. People with NPD usually hurt everyone around them, and then SEEMINGLY refuse to recognize the hurt they’ve caused or that they themselves have the problem/are the problem. Which is why people feel so strongly against them.
Wes never said anything like
guys, don’t listen to this asshole
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.
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.
Removed by mod
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.)
As others have written it’s deconstructive towards other people plus NPD are hard to make understand their behaviour is problematic. In their view you are the problem if you have a problem with them. Depression, ADHD and other things do not have that trait. With them you can talk them into therapy and about potential problems they are causing.
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.
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 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
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.
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.
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 diagnose 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.
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.
I dunno dude, it’s super weird. Sarah Z has a video about this, IIRC the explanation there was something like, people have latched on to “narcissist” as a thing one doesn’t need to worry that one is oneself but can be tacked on to anybody one dislikes. Also there are demons involved for some reason.
(Having killed ShortFatOtaku’s Twitter guy, and taken all his stuff, how would “the narcissist” go about extracting the validation??? Sounds made up.)
(Also it’s always “the narcissist” like there’s just one extremely busy person out there.)
NPD might make people struggle with empathy, but nobody, who is out there thinking everyone they meet could be “the narcissist” who is out to get them and not worthy of respect or consideration, is themselves killing it on the empathy front.
How do you cope with NPD?
Also, what kind of things can other people do to support someone with NPD?
