Abolish Narcissistic Personality Disorder (NPD) in DSM V?
The Diagnostic and Statistical Manual (DSM) is criticized for its inadequate classificatory model and diagnostic criteria, which are vague and equivocal. The DSM-5 committee proposes to abolish some personality disorders and merge them into a single diagnostic category, using a dimensional approach that reflects reality better. The DSM-5 is expected to address the longitudinal course of disorders, genetic and biological underpinnings, and effectiveness of various treatments. The DSM-5 is expected to be a significant improvement over the DSM-4 in addressing personality disorders.
Mourning the Narcissist
Victims of narcissistic abuse often struggle to let go of the idealized figure they fell in love with at the beginning of the relationship. When the relationship ends, they experience a cycle of bereavement and grief, including denial, rage, sadness, and acceptance. Denial can take many forms, including pretending the narcissist is still part of their lives or developing persecutory delusions. Rage can be directed at the narcissist, other facilitators of the loss, oneself, or be pervasive. Sadness is a paralyzing sensation that slows one down and enshrouds everything in the grave veil of randomness and chance. Gradual acceptance leads to renewed energy and the narcissist being transformed into a narrative, another life experience, or even a tedious cliché.
Narcissist: Socially-anxious, Schizoid
Schizoid personality disorder is characterized by a lack of interest in social relationships and interactions, limited emotional expression, and a preference for solitary activities. Schizoids are often described as robotic and uninterested in social bonding. While there are similarities between schizoid and narcissistic personality disorders, the two are distinct in that schizoids are uninterested in bonding, while narcissists are both uninterested and incapable due to their lack of empathy and grandiosity. Narcissism is not about self-love, but rather a broken ego or self that withdraws from society to protect itself.
Narcissist: Masochism, Self-destruction, Self-defeat
Narcissists exhibit self-defeating and self-destructive behaviors that are pernicious and subtle. These behaviors include self-punishing, guilt-purging behaviors, extracting behaviors, default behaviors, and frustrating, negativistic, and passive-aggressive behaviors. Narcissists are terrorized by intimacy and interpret it as co-dependence, emotional strangulation, and imprisonment. They are also fiercely independent and want to be free to frustrate themselves by inflicting mental havoc on their human environment.
Pathologizing Rebellious Youth: Oppositional Defiant Disorder (ODD)
The Diagnostic and Statistical Manual (DSM) labels rebellious teenagers with oppositional Defiant Disorder, which is a pattern of negativistic, defiant, disobedient, and hostile behavior towards authority figures. The DSM’s criteria for this disorder are arbitrary and subject to the value judgments of adult psychiatrists, psychologists, social workers, and therapists. The diagnosis of oppositional Defiant Disorder seems to put the whole mental health profession to shame, and it is a latent tool of social control. If you are above the age of 18 and you are stubborn, resistant to directions, unwilling to compromise, give in or negotiate with adults and peers, you stand a good chance of being diagnosed as a psychopath.
Children Psychopaths? Conduct Disorder
Children and adolescents with conduct disorder are budding psychopaths who repeatedly and deliberately violate the rights of others and breach age-appropriate social norms and rules. They are socially, occupationally, and academically dysfunctional, and their diagnosis changes to antisocial personality disorder or psychopathy beyond the age of 18. These children are in denial and tend to minimize their problems and blame others for their misbehavior and failures. Adolescents with conduct disorder are often embroiled in fights, both verbal and physical, and many underage muggers, extortionists, hearse snatchers, rapists, robbers, shoplifters, burglars, arsonists, vandals, and animal torturers are diagnosed with conduct disorder.
Narcissist Mother’s Pet: Her Child
The study of narcissism is still unresolved, with two central debates remaining undecided. The first is whether there is such a thing as healthy narcissism or if all manifestations of narcissism in adulthood are pathological. The second debate is whether pathological narcissism is the result of abuse or spoiling. Narcissism is a defense mechanism intended to shield the narcissist from an injurious world, but as they turn adult, it becomes the main source of hurt and the main generator of injuries. Some narcissists are forced to retreat into a land of delusion and fantasy, even into psychosis.
Narcissists: Difficult and Hateful Patients
Patients with personality disorders often evoke dislike or hatred in their physicians, with the narcissistic patient being the worst. They insist they are equal to the psychotherapist in knowledge, experience, or social status, and resist psychotherapy. Management of personality disorders consists largely of helping the person find a way of life that conflicts less with their character, and aims should be modest. Healthcare professionals who treat patients with personality disorders may experience resentment, alienation, and burnout.
Daughters of Narcissistic Mothers
Narcissistic mothers can have a significant impact on their adult daughters’ relationships, with children of narcissistic parents being ill-adapted and prone to deploying psychological defense mechanisms. They can become co-dependent, needy, demanding, and submissive, fearing abandonment and displaying immature behaviors. Some children of narcissistic parents become inverted narcissists, craving relationships with narcissists, while others become counterdependent or even narcissists themselves. Narcissistic mothers micromanage their child’s life and encourage dependent and infantile behaviors, emotionally blackmailing them and threatening to disinherit them if they do not comply with their wishes.
Cope with Narcissists: Abandon or Mirror
The best way to cope with a narcissist is to abandon them or threaten to abandon them. The narcissist is a binary person, and the carrot is also the stick in their case. If they get too close to someone emotionally, they fear abandonment and immediately distance themselves, acting cruelly and bringing about the very abandonment they feared. If one chooses to accept the narcissist, to live with them, to remain in an intimate relationship with them, it is a package deal. All their needs, demands, and requirements are included.