Narcissistic Personality - NPD - A Male Disease? An Adult Disease?

NPD — A Male Disease? An Adult Disease?

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Another thing that warps our picture of NPD is double standards that are the fruit of stereotypes and sloppy thinking:

Women are nicer than men and therefore less likely to be narcissists.

What's okay for men to do is wrong for women to do.

All old people are nice and deserve a pass to treat young people without respect if they want.

Physically hitting someone is worse than verbally abusing them or destroying their life through slander and calumny.

Children are all innocent and, by nature, good.

Rubbish. So, another thing that invalidates current statistics is mental-healthcare workers applying double standards of both age and sex.

An example of such a double standard is this: if we see an action photo of an angry male coach with his mouth wide open and his face contorted, we see no ugliness. But if we see a photo of a female coach with but an intense look on her face, she is ugly. Right? So, we think nothing of this behavior in our male hero, but she strikes us as a bitch. We can hardly help that, because it's a cultural thing.

Again for example, personality traits regarded as distinguishing a man as worthy of admiration as a good, tough businessman are regarded as distinguishing a woman as a bitch. That's just a fact, and mental healthcare workers are taking few (if any) precautions to avoid applying such sexual double standards in diagnosis.

Broverman, Broverman, Clarkson, Rosendrantz, and Vogel (1970), in probably the most publicized study of criterion bias, demonstrated how clinicians viewed typical male traits (i. e., independent, forceful, domineering) as more closely associated with a healthy adult than they did typical female traits (i. e., nurturing, deferential, reserved). This study demonstrated diagnostic criterion bias by showing how a prejudice towards typical male traits over female traits can cause misdiagnosis.

— Jerry McLaughlin, "Reducing diagnostic bias," 01-07-02, Journal of Mental Health Counseling

In Abnormal Psychology, Chapter 12, Nietzel discusses this very issue in noting that women get diagnosed with Antisocial Personality Disorder far less frequently than men and with Histrionic Personality Disorder far more frequently than men. He cautions that the reason may be cultural factors affecting the mere expression of a personality trait so that it manifests itself differently in men than women but is due to the same underlying personality disorder in both. He also cites evidence of a sexual bias in clinicians diagnosing the disorder. Finally, he notes that the overall rate of diagnosis for any personality disorder may be faddish, following trends of popular interest in one personality disorder or another over time. Let's look again at what he writes:

Histrionic personality disorder occurs in about 2 to 4 percent of the U.S. population (Weissman, 1993), and it appears to be diagnosed more often in females than in males. The reasons for this gender difference remain controversial. It may reflect cultural influences that lead females, especially, to believe that physical beauty is necessary for a satisfying life, or it may be due to the diagnostic biases described in Chapter 2. Recall the study by Maureen Ford and Tom Widiger in which clinicians were asked to diagnose fictitious cases. One case involved a typical description of antisocial personality disorder for which the person was said to be either a man or a woman; the other described a histrionic personality disorder, again presented as either a man or woman. The results showed that clinicians were more likely to diagnose a female with histrionic personality disorder even when she met the criteria for antisocial personality disorder. Likewise, histrionic behavior attributed to a female increased clinicians' use of the histrionic diagnosis. On the other hand, being identified as a male had a smaller effect on the differential use of the two diagnoses. Researchers' interest in histrionic personality disorder appears to have declined recently; it may be diagnosed less frequently in the future since it overlaps considerably with other personality disorders in the dramatic/emotional/erratic cluster.

Which cuts the legs out from under the widespread belief that NPD is far more prevalent in men than women.

The high preponderance of male patients in studies of narcissism has prompted researchers to explore the effects of gender roles on this particular personality disorder. Some have speculated that the gender imbalance in NPD results from society's disapproval of self-centered and exploitative behavior in women, who are typically socialized to nurture, please, and generally focus their attention on others. Others have remarked that the imbalance is more apparent than real, and that it reflects a basically sexist definition of narcissism. These researchers suggest that definitions of the disorder should be rewritten in future editions of DSM to account for ways in which narcissistic personality traits manifest differently in men and in women.

— Encyclopedia of Mental Disorders

Indeed, aggression, for example, will tend to express itself differently in women than in men. For cultural and perhaps even biological reasons. But aggression is aggression. It should not go unnoticed in women just because it acts-out in a different, perhaps more subtle, way. For example, what's worse? Shooting someone or destroying their career, calumniating them to make a social outcast of them and driving them to suicide? There's no flip answer to that question.

In my own slice of the world, the ratio is 50-50. And in my own understanding of the disease I see no reason why men should be any more prone to it than women.

But I do see many reasons why male narcissists are exposed as narcissists more frequently than female narcissists are. Put another way, I see many reasons why female narcissists get away with it more often. You can't just chalk this up to the fact that men are more likely to use their fists than their mouths. For, the only narcissist I have observed physical violence in is an extremely violent woman — who has everyone but those who've seen her with her mask off thinking she's a regular Mother Theresa.

And anyone who thinks male narcissists are worse because they're more prone to physical violence is dead wrong. If anything, that makes them less dangerous than female narcissists. The law deals with physical attacks. It does almost nothing to protect us from non-physical attack. Indeed, the non-physical violence the woman I referred to above has done is by far more damaging and more sadistic than any beating she ever gave someone. Any of her victims would prefer her beatings to her life-ruining slanders and vicious psychological abuse.

The professional literature on NPD and other personality disorders candidly admits that mental-healthcare workers tend to diagnose by sex, viewing certain behaviors in women as histrionic and in men as narcissistic. They readily spot attention-getting behaviors in women and diagnose them as histrionic, while being blind to attention-getting behaviors in men and diagnosing them as narcissistic.

In other words, they don't realize that narcissists are attention getters. Attention-getting is characteristic of both disorders. The difference is that in NPD this need for attention becomes so rapacious that it can't tolerate anyone else getting any attention.

That's the key. That's what distinguishes narcissistic personality disorder from other attention-getting disorders: the malignant narcissist doesn't just seek attention — he or she is hostile toward anyone else getting any attention. He or she must have it all. It would kill him or her to just be in a place where anyone else is getting attention.

Mental-healthcare workers also don't seem to realize that women must grab attention in different ways than men, and they seem oblivious to a man's way if it is at all subtle instead of overtly childish. Consequently, many attention-getting behaviors in men go right over their heads, unrecognized as such. A narcissistic man often passes himself off as a modest, no nonsense sort of regular guy — while screaming at the top of his lungs (between the lines) for attention nonstop. Just because he doesn't hit you over the head with his attention-getting behaviors, just because he dissembles to camouflage them, doesn't mean they aren't there.

Similar double standards are applied between adults and youths or children. In other words, a behavior that is perceived as malignant in an adult is regarded as innocent in a youth or child. Yet we know that children can possess the will to evil. That is, they can want to harm others just to harm them = they may like hurting people. We see children do this in everyday life and read shocking instances of it in the daily news. Yet, because it rattles our cage, we stubbornly keep forgetting it.

Every narcissistic adult was a narcissistic youth, and before that, a narcissistic child. He or she abused their siblings and classmates and animals, never learning to empathize. He or she was as big a bully as they could be in their world. These behaviors, whenever found in children of six or older, should be taken seriously as a warning sign. It doesn't get any better. They don't outgrow it. They just gain experience to make them ever more cunning, more manipulative, more sure that they can get away with anything, and more dangerous.

Who hasn't had to leap up and protect some small animal from a little child who, on a whim, just starts pounding it? And with no feeling whatsoever — nothing but machinelike and fascinated interest in its agony?

When this happens, it's a startling reminder to us that a very little child lives in a mind that's much different from ours. We would understand psychopathy a lot better if we realized that this mental state, which is perfectly normal in the developing personality of the three-year-old, is abnormal and extremely dangerous when it persists in the older child, the youth or the adult.

NPD begins in childhood. If it were diagnosed in childhood or youth, there might be a chance to save that narcissist and everyone he or she would otherwise someday destroy.

By the same token, though conventional wisdom says that most malignant narcissists are men, the double standards mentioned above make that not necessarily so. If NPD truly does originate in infancy, toddlerhood, and the very early years of childhood, it is hard to see why boys should be more frequently affected than girls, unless NPD is tied to some sex-linked genetic trait. And there is no evidence of that.

There are probably other reasons, too, why most cases of NPD that come to light are in men.

One might be that, on average, men acquire power more easily than women. Since the only reign on a narcissist's behavior is what he thinks he can get away with, on average, male narcissists probably go farther than female narcissists feel it safe to go. For example, male narcissists are likely to hold higher positions of authority than female narcissists. So, on average, they have more power. They are therefore more able to get away with illegal acts. They are bolder, daring to commit more illegal acts and to commit them with less cautious cunning than female narcissists do. So, they are bound to get caught more often and show up in greater numbers in the statistics.

Nonetheless, power goes to a woman's head as easily as to a man's. Consider Madam Mao, for example. If women were as likely to become dictators as men we probably would find the names of more women on this list of famous narcissists: Stalin, Hitler, Saddam Hussein, etc. So, we must view these statistics as the tip of an iceberg and not necessarily representative of the sexual prevalence of the disease.

Also, society raises men differently than women. It puts fewer reins on men than women. It's more acceptable for men to get physical. It's more acceptable for men to be rude. And so forth. So, male narcissists avoid censure more easily and get away with more, on average. They therefore push the envelope farther on their runaway freight-train ride, becoming more physically violent and abusive . . . just because they can.

But that just gets them over-represented in the extant statistics: we cannot assume it means that female narcissists don't exist in equal numbers and don't do just as much harm.

Moreover, their upbringing makes men tend to express themselves physically, as the "manly" way to behave. For the most part, the subtle, manipulative men are the ones who can't get away with that approach. In contrast, their upbringing makes women tend to express themselves morally, subtly. Consequently most arrestable offenses are committed by men. But anyone afflicted with both physical and psychological abuse will tell you that the psychological abuse is far worse.

And that says nothing of employee-abuse, libel and slander that affects the status of employment, which are easy to get away with, especially in private, nonprofit institutions that can operate in secret. (Visit BullyOnLine.org for more information.) In fact, the extant statistics indicate that this class of narcissists are mostly women, probably because these secretive, nonprofit, private institutions tend to hire women as administrators. These people are harmless? How many suicides do they drive people to annually? Not harmless at all: it would be kinder and less wicked for them kill with a gun.

So, most female narcissists probably remain below society's radar, committing fewer arrestable offenses. But we can't assume that means they're doing less damage to people, or even that they are not busting the law to smithereens. In fact, neither I, nor those I know who have had experience with narcissists, regard the female as one bit less dangerous or malignant than the male.

Indeed, every narcissist is a bully, and bullies pick an unfair fight. If a narcissistic man hits on his wife, he may go to jail. If she turns around and hits on her child, she is very unlikely to go to jail. If the child then goes outside and kicks the puppy, he always gets away with it. And so you have three narcissists, but only the adult male is recognized as one.

© 2004 � 2008, Kathleen Krajco � all rights reserved worldwide.
The URL of this page is: http://www.narcissism.operationdoubles.com/npd_male_adult_disease.htm.
It was last updated on 3/6/2008.
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