Tuesday, 27 January 2009

NARCISSISTIC: The Word of the Week

The Springfield State Journal Register had a recent article that was exploring the state of our current Illinois Governor's mental health. Several local mental health professionals were consulted and all agreed that the gov surely fit, at least some, of the criteria for Narcissistic Personality Disorder (NPD). Of course, any professional would hesitate to make any sort of definitive diagnosis without a diagnostic interview.

Below is the list of diagnostic criteria, 5 of which must be present to qualify a candidate for winning THE diagnosis. Most people with NPD won't be asking for your vote because they'll know you've voted for them and if you didn't they wouldn't want your ignorance backing them anyway. Nothing personal there, just trying to help you climb inside and take a ride in the gas/energy guzzling ride of a narcissistic personality.

1. has a grandiose sense of self-importance
2. is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
3. believes that he or she is "special" and unique
4. requires excessive admiration
5. has a sense of entitlement i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
6. is interpersonally exploitative i.e., takes advantage of others to achieve his or her own ends
7. lacks empathy; is unwilling to recognize or identify with the feelings and needs of others
8. is often envious of others or believes others are envious of him or her
9. shows arrogant, haughty behaviors or attitudes

I don't know the actual number of individuals having been diagnosed but I can say with certainty that we have many people with narcissistic traits walking among us. I have known people with these characteristics in my personal and professional life.

It isn't pretty.

The sense of self-entitlement-- getting what they want or think they deserve with no concern about anyone but themselves, "you owe me," is pathological and destroys foundations of relationships (personal and professional) left and right.

One of the quoted professionals on the SJ-R article mentioned that individuals with NPD do not frequently get therapy because they do not think they are the problem. I would add that a narcissistic person will drag others to therapy (when it sometimes more disruptive than helpful) to try and prove that others have a problem and they do not; and they may also attend alone giving the professional their one-sided view of their life and their relationships without confirmation of their stories/experiences, and use that as an opportunity to grab some validation, "see, I got help and they think I'm fine (or right, or best . . .)."  In other words, they haven't gone to get help but to stage a scenario where, once again, they can be told they are right.

The children of the person with NPD suffer most. They are so confused about what is true and what isn't, what is right and what is wrong, what is an appropriate emotional response and what is emotional drama and overreaction-- their foundation for successful emotional and social development is at great risk.

Children will likely either fall into the parent's footsteps and have similar narcissistic qualities or be at risk for severe self esteem issues; after all, they were never important enough for the parent to put their own issues and agendas aside and parent appropriately. These children have been brought up seeing such inconsistencies in the words, actions and values their frame of reference is skewed.

Imagine that you are a child and your parent would lie and put the blame about an issue on you instead of accepting responsibility for something that the parent did and the child KNOWS the parent did. And imagine the parent does it with a big smile on their face, all the while insisting that they are reporting the truth. There stands the child, knowing they can't question their parent (who is ALWAYS right), unable to stand up and defend their own integrity; there is no foundational breeding ground for core values of honesty, integrity, loyalty. Unless, you hope and pray, they have other adult role models that model positive values and can give the child a reality check when needed.

I am not a proponent of putting individuals into a diagnostic box, which our insurance system forces us to do in this day and age, because many of the emotional and behavioral health issues, I believe, fall into a spectrum of severity as well as overlap with other diagnosis. Many people with the narcissistic traits will also have characteristics of borderline personality disorder-- in both cases people learn they must walk on eggshells around these folks so as not to catch their wrath; of course that rarely works because the people thrive on the drama they create and manipulate.

So when you hear our infamous current governor, as I did on NPR today, sounding so nonchalant about his predicament and comparing himself to situations in movies and the movie characters and people that have historically been done wrong and then hear the list of television talk shows he is going on later in the day and all the while you are thinking, if that was me I would be so embarrassed I'd want to hole up somewhere they would never look for me-- like the Springfield Governors Mansion . . . Don't worry, you haven't lost your mind.

But also understand, you don't have to be in government or Hollywood to be brushing shoulders with people with narcissistic traits. And when you brush up to someone with similar characteristics, what the best thing to do? Take care of yourself. Helping others is not on their list of things to do.

Many professionals have the opinion that folks with personality disorders typically will not get or accept treatment, for one reason because PD's aren't something that can be cured with medicine and it takes a true willingness to change.

But I've seen people decide to get better and do so.

Just like with addictions, the person has to hit their own personal rock-bottom and decide, "ENOUGH, I cannot live like this anymore." 

Unfortunately it isn't usually the piles of those they have wounded that announces that their "bottom" is near, but an assault to their own person. For some people, being indicted could be that bottom. 

For others, it never happens.

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