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Oct. 17th, 2002 11:47 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
rivkaDiagnostic criteria for 301.81 Narcissistic Personality Disorder
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:
(1) has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
(2) is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
(3) 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
(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 that others are envious of him or her
(9) shows arrogant, haughty behaviors or attitudes
The Internet is a good place to be a pathology watcher. Not in the way that countless amateur net.pyschologists operate, cataloguing the emotional deficiencies of their opponents in Usenet debates or dispensing diagnoses and prescriptions to anyone with a downcast tone. That stuff drives me crazy. But the Internet is sometimes a good place to catch the feel, the flavor, of a disorder you've only read about. I know lots and lots of people with narcissistic traits - I'm sure you all do, too - but I've only ever once diagnosed someone with full-fledged narcissistic PD. I've never seen a really florid case in my practice. I think I'm seeing one now, though, in an online forum. There's a feeling to it, a sort of flash of illumination: "Oh! So that's what the thisness is behind the list of diagnostic criteria."
The last time I had this feeling online was in July, when my brother pointed me at this site. The scanned letter at the link is from our grandfather, and as far as I can tell the author of the page has paranoid schizophrenia of the coherent, well-organized sort. Reading through the links I had the same feeling of disturbed recognition. Made worse, I think, because my grandfather was involved - even peripherally - as a subject of his delusions.
When I thought this current guy was a fool, I was amused. Now that I'm pretty sure he's got a mental disorder, I'm feeling more sadness than anything else. I'm watching people bounce off his pathology and get angry, and I recognize that this probably happens to him again and again and again and again.
I don't know where I'm going with this. I just wanted to say it.
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:
(1) has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
(2) is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
(3) 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
(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 that others are envious of him or her
(9) shows arrogant, haughty behaviors or attitudes
The Internet is a good place to be a pathology watcher. Not in the way that countless amateur net.pyschologists operate, cataloguing the emotional deficiencies of their opponents in Usenet debates or dispensing diagnoses and prescriptions to anyone with a downcast tone. That stuff drives me crazy. But the Internet is sometimes a good place to catch the feel, the flavor, of a disorder you've only read about. I know lots and lots of people with narcissistic traits - I'm sure you all do, too - but I've only ever once diagnosed someone with full-fledged narcissistic PD. I've never seen a really florid case in my practice. I think I'm seeing one now, though, in an online forum. There's a feeling to it, a sort of flash of illumination: "Oh! So that's what the thisness is behind the list of diagnostic criteria."
The last time I had this feeling online was in July, when my brother pointed me at this site. The scanned letter at the link is from our grandfather, and as far as I can tell the author of the page has paranoid schizophrenia of the coherent, well-organized sort. Reading through the links I had the same feeling of disturbed recognition. Made worse, I think, because my grandfather was involved - even peripherally - as a subject of his delusions.
When I thought this current guy was a fool, I was amused. Now that I'm pretty sure he's got a mental disorder, I'm feeling more sadness than anything else. I'm watching people bounce off his pathology and get angry, and I recognize that this probably happens to him again and again and again and again.
I don't know where I'm going with this. I just wanted to say it.
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no subject
Date: 2002-10-18 11:43 am (UTC)Because, if it's pathological, then, to me, his ideas *don't* matter.
If he's arrogant and annoying, and I get angry at him, then his ideas *do* matter.
And I hate the idea of saying that someone doesn't matter.
Well, I think that he matters as a human being. I'm not letting go of that. Nor am I letting go of the recognition that his ideas are wrongheaded and pernicious, and that it would be a shame and a pity if other people who encountered them believed them. What I'm letting go of is the idea that my input into the system will have some effect on him.
One does have to be very, very careful about attributing someone else's beliefs or experiences to pathological causes, because it can be unfairly dismissive. But... well. If you had a kid in your class with untreated ADHD, and you were telling him to settle down and sit still every two minutes, the only practical effect would be that both of you would be frustrated. Trying to use logical arguments to convince this guy that he's mistaken is pretty much just like that.