Narcissistic Personality - Illegitimate Classification Schemes

Illegitimate Classification Schemes

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My first clue that something is wrong with official doctrine was the diagnostic criteria for NPD in the APA's Diagnostic & Statistical Manual (DSM). They are fuzzy abstractions in which the malignance of malignant narcissism is well camouflaged. It's hidden in the statement that people with NPD "exploit" others.

A statement that goes right through the brain like a neutron.

Only when you stop and think what it means to exploit others, and what narcissists use others for, and how they ab-use others (largely through character assassination and treating them like dirt to dominate, manipulate, and humiliate) — only then does the malignance in NPD hit you.

I wondered why the DSM kept that malignance so well camouflaged. Then, sure enough, I ran across evidence that there are many clinicians out there totally unaware of it. They have narcissism as a mere character trait, confused with the personality disorder (NPD). In other words, they think most people with NPD are non-malignant, that they are just arrogant snobs with inflated self-esteem.

Wrong. You can't class people of inflated self-esteem with malignant narcissists, who have abysmal self-esteem and put on a superiority act to cover it and remain in denial of it. At bottom, this inflated self-esteem and deflated self-esteem are the very opposites of one another. It is only superficially that they resemble each other in some respects.

People with inflated self-esteem really have inflated self-esteem. People with deflated self-esteem only pretend to have inflated self-esteem. (Theirs is a "compensatory" egomania, a psychological "complex.") Therefore, only the second group is pathologically envious and desires to tear others "down off that pedestal" = to dominate, manipulate, and humiliate.

That's a huge and fundamental difference. Therefore, confusing the two groups is like classing bats with birds simply because they both fly, or classing fish with whales simply because they both live in the water. They aren't at all alike.

By putting them in the same class with a much larger group to which they don't belong, you muddy the picture, making the bat seem like just another bird, making the whale seem like just another fish. Which they ain't. Same here: you make malignant narcissists seem non-malignant by dumping them into a much larger group of people who are just full of themselves.

What better way to make NPD seem like no big deal? There are no bad people, you see, so the APA must sweep these bad people under the rug.

Sorry for that inference, but I just can't believe this is an honest mistake by highly educated experts who are supposed to know what they're doing.

And look what they callously did to non-malignant narcissists in order to be so nice to the malignant ones. By inventing diagnostic criteria, some of which apply to non-malignant narcissists, and then (without any research to back the validity of doing so) requiring that only 5 of 9 be present to diagnose NPD, they gave many non-malignant narcissists a personality disorder.

But do non-malignant narcissists really have a personality disorder?

As I noted above in quoting from "Chapter 12 - Personality Disorders" of Abnormal Psychology at by Nietzel, Speltz, McCauly, and Bernstein:

As noted in Chapter 2, the DSM-IV requires the clinician to assign a diagnosis if a client meets a particular number out of a fixed set of criteria. If this number is met (for example, five out of nine for narcissistic personality disorder) the diagnosis is made. But there is little or no evidence to support a particular cutoff (such as five of nine instead of six of nine criteria) as being the "true" boundary between normal and abnormal personality (Widiger & Trull, 1991).

So any five will do, eh? Here they are, and notice which ones you needn't have and still be diagnosed with the stigma of personality disorder:

~~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.

That's a personality disorder? A mental illness so serious that it may affect your employment and career opportunities, not to mention your reputation if word ever gets out? Give me a break.

Apparently the powers that be in the APA need to be reminded of what they say a personality disorder is.

A personality disorder is supposed to be an "extreme and rigid extension of a personality trait." It is supposed to be a pervasive and persistent pattern of fundamentally distorted thinking that affects both feeling and behavior. It's supposed to make a person impulsive and prone to wild mood swings. This distorted way of thinking is so fundamental and so consistent that it preoccupies that person, warping virtually every human interaction and affecting their performance in virtually every area of that person's life. Moreover, a personality disorder originates in childhood and persists throughout life. So, again I ask, do people who are inconsiderate, arrogant, and just full of themselves fit the bill?

Many of these non-malignant narcissists are just people who let fame and fortune go to their heads. When reality brings them crashing back down to earth, they're fine.

This sounds like more of the APA Making Us All Crazy, right? Simply by stretching a personality trait into a personality disorder.

See Our Raison d'Etre by Scott O. Lilienfeld, Ph.D., Editor in Chief of the Scientific Review of Mental Health Practice:

The past several decades have seen a virtual explosion in the use of controversial and poorly studied psychiatric labels, such as codependency, sexual addiction, road rage disorder, infanticide syndrome, parental alienation syndrome, premenstrual dysphoric disorder, and Munchausen's syndrome (factitious disorder) by proxy (see Mart, this issue). Although some of these labels may ultimately be shown to be predictively useful, many are of undemonstrated validity (McCann, Shindler, & Hammond, in press). Nevertheless, such labels are commonly invoked by mental health professionals as scientific explanations of problematic behavior and are introduced by them into courts of law with increasing frequency. In still other cases, there are serious concerns that some psychiatric conditions (e.g., dissociative identity disorder, known formerly as multiple personality disorder) are being substantially overdiagnosed in certain settings.

Then I discovered that the APA are doing the same thing with that other group of bad people — psychopaths — making them disappear into a much larger group with different traits — antisocials, your typical street criminal (i.e., sociopaths, people supposed to have something called Antisocial Personality Disorder, APD/ASPD).

They constitute about 80% of prison inmates, probably because most antisocials will eventually get into trouble with the law.

But 80% of antisocials in prison are not psychopaths. Guess why? Because they aren't malignant narcissists. The only thing imprisoned psychopaths have in common with antisocials is their sociopathic/criminal behavior. (See below.) And the key word there is "imprisoned" psychopaths. Most psychopaths never commit a violent crime and land in prison.

Moreover, antisocials have a much lower rearrest rate than psychopaths. Unlike psychopaths, antisocials can be rehabilitated to go straight. They are also far less dangerous than psychopaths because they aren't perverts going around beating and raping and killing anyone handy just to do it. In other words, antisocials are not predators. In other other words, they are not your serial killer, your serial rapist, and your child molester.

Indeed, anyone can see that there is a world of difference between your typical street criminal (antisocial) and your psychopath.

What's more, like most malignant narcissists, most psychopaths never land in jail. But a small percentage of them ever commit a violent crime, get caught, and sent to prison. Indeed, many are highly successful!

See Snakes in Suits about psychopaths in the corporate world, by Dr. Paul Babiak and Dr. Robert Hare.

See also "Psychopathy and Antisocial Personality Disorder: A Case of Diagnostic Confusion" in the Psychiatric Times by Robert D. Hare Ph.D.

In my book, Without Conscience, I argued that we live in a "camouflage society," a society in which some psychopathic traits — egocentricity, lack of concern for others, superficiality, style over substance, being "cool," manipulativeness, and so forth — increasingly are tolerated and even valued. ...Psychopaths have little difficulty infiltrating the domains of business, politics, law enforcement, government, academia and other social structures. It is the egocentric, cold-blooded and remorseless psychopaths who blend into all aspects of society and have such devastating impacts on people around them who send chills down the spines of law enforcement officers.

In other words, if the American Psychiatric Association has you picturing the psychopath as looking like your common street criminal, look out. He or she looks more like your boss, your therapist, your mother-in-law, your English Literature professor, that cop writing you a ticket, your political party's nominee for President of the United States....

Like any predator, well camouflaged, of course.

Now why camouflage NPD's malignance and dump the glaring malignance of the psychopath on those with APD instead?

See "Hollow Men: Ted Bundy Discusses Possession" by forensic psychologist J. Reid Meloy, author of The Psychopathic Mind.

We know from the research that psychopaths have a core, aggressive narcissism that is fundamental to their personality. If you remove that narcissism, you don't have a psychopath.

Doesn't that make you think that NPD and psychopathy could be the same thing? It should. But apparently it has never dawned on the APA that they should investigate the possibility.

See "This Charming Psychopath" in Psychology Today by Robert Hare. How do these personality traits of psychopath differ from those of a malignant narcissist?

Indeed, follows The Psychopathy Checklist. Now, since this checklist is designed for use among the prison population, you must disregard the items included for convicted criminals only (promiscuous sexual behavior, juvenile delinquency, revocation of conditional release). But how much else do you see here that doesn't fit a malignant narcissist to a "T"?

Your typical street criminal (antisocial) scores high in Factor 2 traits only. Your psychopath and other malignant narcissists score way higher in both factors. In fact, if there's a difference between psychopaths and malignant narcissists here, it can't be detected.

Common sense alone tells you that psychopaths and malignant narcissists are very much alike and may be just different labels for the same thing or varying severity of the same disease. It also tells you that both groups are distinct from antisocials. So does the very low rate of suicide among psychopaths/narcissists and the high rate of suicide among antisocials.

But the APA classes and labels psychopaths as antisocials anyway. Good way to make psychopathy disappear, eh? It's like dumping the bats and whales in with the birds and fish again. You thus create the illusion that they're just birds and fish too. Thus you make psychopaths seem much different than they really are.

Much less bad than they really are. For, you take the predatory malice and sadism out of psychopaths by classing them as antisocials. You make it seem as though they can be rehabilitated like antisocials and set free without reoffending like antisocials. You make them seem like antisocials — generally the fruit of social ills like bad homes (or gang environments) and poverty.

How? You just say that people with APD can be helped by therapy, that they are the fruit of social ills like poverty and bad homes or neighborhoods, that they can be rehabilitated and set free without reoffending, and so forth. But you fail to mention that this is true only for the 80% that are not psychopaths. See how insidious this deception is?

What's more, Antisocial Personality Disorder is no personality disorder. It's probably just a lousy attitude and a depressed spirit. Which is why you really can help these people.

How is the APA getting away with this?

See "Psychopathy and the DSM�IV Criteria for Antisocial Personality Disorder (PDF)," in the Journal of Abnormal Psychology by Robert D. Hare, Stephen D. Hart, and Timothy J. Harpur, University of British Columbia.

In this report, Hare, Hart, and Harpur address criticisms of the current diagnostic criteria for psychopathy, which have wheedled their way into people's heads as a definition of it. The approach focuses on "antisocial behaviors rather than personality traits central to traditional conceptions of psychopathy." Voila, the behaviors/actions themselves become the disease. Hence "psychopathy = committing a violent crime."

Wrong. As we have seen above, only a small percentage of psychopaths ever do that. (Not that they don't commit other crimes like fraud, extortion, bigamy, child abuse, embezzlement, and so forth. And some of the legal things they do are worse than the illegal ones, like driving someone to drink or suicide.) Moreover, when they do break the law, they get away with it far more often than not. Again, just like malignant narcissists.

For a good explanation of what's going on see "Psychopaths Among Us," by Robert Hercz in Saturday Night Magazine.

"There's still a lot of opposition — some criminologists, sociologists, and psychologists don't like psychopathy at all," Hare says. "I can spend the entire day going through the literature — it's overwhelming, and unless you're semi-brain-dead you're stunned by it — but a lot of people come out of there and say, 'So what? Psychopathy is a mythological construct.' They have political and social agendas: 'People are inherently good,' they say. 'Just give them a hug, a puppy dog, and a musical instrument and they're all going to be okay.' "

If Hare sounds a little bitter, it's because a decade ago, Correctional Service of Canada asked him to design a treatment program for psychopaths, but just after he submitted the plan in 1992, there were personnel changes at the top of CSC. The new team had a different agenda, which Hare summarizes as, "We don't believe in the badness of people." His plan sank without a trace.

So why is the APA making mere narcissism (i.e., having a big head) and antisocial behavior (getting into trouble with the law) — why do they hocus-pocus these things into personality disorders and then make NPD and psychopathy virtually disappear into these two different, much larger groups?

Psychopaths are all malignant narcissists. That is known for sure. (What we don't know for sure is whether all malignant narcissists are psychopaths.) Plus, even in the APA's hazy DSM descriptions, psychopaths and other malignant narcissists are far, far more like each other than they are each like the rest of the group they've been dumped into.

And why this stubborn refusal to acknowledge the predatory malignance at the bottom of both NPD and psychopathy? Why do these guys play holier-than-thou bleeding hearts by demonizing (as, of all things, "demonizers") anyone who won't buy what they're selling?

How's that for manipulation?

What? can't the APA admit they were wrong and that some people are bad? That psychopaths/narcissists hurt others because they like hurting others? Just because hurting others makes them feel good? Or is it that, if the APA can't blame an evil on society, they don't believe in it? Or is it just that we commonfolk are too ignorant and reactionary to be trusted with this knowledge? Is this like when the Martians are coming in science fiction and our social nannies must keep it a secret so we don't panic to know that predators stalk easy prey among us?

All the psychopaths and other narcissists in the world thank the APA for keeping their prey so unsuspecting.

Ah, narcissistic elitism. To hell with science: they can just divine the truth.

It was bound to happen. If you took any college courses in the arts, you know that it's cultural: those who consider themselves intellectuals have always felt a compelling need to construe themselves as intellectually superior to "those science types." They just think on a higher plane, you see. So, it's no wonder that there's war in the mental healthcare profession, where they are plagued with science types and must turn up their noses at the research of those "robots."

Notice also that the mainstream of media, social workers, and academia politically exploit the idea of psychopaths in business suits and the analogy of the corporation as a psychopath. That notion goes well with their belief that capitalists are evil.

But they act unaware of the fact that, because of the low risk of accountability and the large audience to show off to, the professions of teaching, writing, acting, and politics swell their own ranks with more psychopaths/narcissists than business attracts. Yes, though the scum may well rise to the top in a corporation, you won't find it as prevalent among the ranks as you do in these "helping" professions.

And here I end where I began. All this evidence undermining the credibility of the mental health profession is just a warning about the true credibility of the prevailing wind in it. There are signs of life in this branch of medicine. The profession's strongest critics come from among its own ranks. There are clinicians who see the light. There are researchers who dare to blow against the wind. And they are slowly but surely winning.

Though I'll bet they feel like Galileo arguing with the Church.

© 2004 � 2008, Kathleen Krajco � all rights reserved worldwide.
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It was last updated on 3/6/2008.
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