Can Narcissism be Cured?
Pathological narcissism is difficult to cure, and most narcissists resist psychotherapy. However, some progress has been made in effecting small changes in personality disorders through talk therapy and medication. The earlier the therapeutic intervention, the better the prognosis, and aging tends to moderate or even vanquish some antisocial behaviors associated with pathological narcissism. The existence of empathy is a serious predictor of future psychodynamics, and the prognosis for a classical narcissist with grandiosity, lack of empathy, and all is not good as far as long-term, lasting, and complete healing.
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.
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.
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.
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.
Narcissist’s Pathological Grandiosity
Daydreaming and fantasizing are healthy activities that prepare individuals for eventualities and planning. However, pathological grandiosity is different and has four components: omnipotence, omniscience, omnipresence, and perfectionism and completeness. The narcissist believes in his own omnipotence and is convinced that he can do anything he chooses to do and excel in it. The narcissist is shattered when he discovers that the collection he possesses is incomplete, that his colleague’s wife is more glamorous, that his son is better than he is in math, that his neighbor has a new flashy car, that his roommate got promoted, or that the love of his life signed a recording contract.
Narcissist: Is He or Isn’t He?
Narcissism is a spectrum of behaviors, from healthy to pathological, and the Diagnostic and Statistical Manual specifies nine diagnostic criteria for narcissistic personality disorder (NPD). A malignant narcissist is someone who has NPD and wreaks havoc on themselves and their surroundings. They feel grandiose and self-important, exaggerate accomplishments, and demand recognition as superior without commensurate achievements. They require excessive admiration, adulation, attention, and affirmation, and are interpersonally exploitative, devoid of empathy, and constantly envious of others.
Compulsive Narcissist
Narcissism is an all-pervasive obsessive-compulsive disorder, with the narcissist seeking to recreate and reenact old traumas and conflicts with figures of primary importance in their life, mainly their parents. The narcissist develops a unique defense mechanism, constructing a story, a narrative, and another self, which is perfect, brilliant, omnipotent, omniscient, and omnipresent. The child worships this new deity, succumbing to what they perceive to be the false self’s wishes and needs, making sacrifices of narcissistic supply to the false self. The narcissist’s compulsive acts are merely an element in their complicated personality, and shaving them off does nothing to ameliorate the narcissist’s titanic inner struggle for survival.
Narcissist’s Shame and Guilt
The grandiosity gap is the difference between self-image and reality, causing feelings of guilt and shame in narcissists. Narcissistic shame is the pervasive feeling of worthlessness experienced by the narcissist due to the absence or deficiency of narcissistic supply. The narcissist adopts primitive psychological defense mechanisms to counter this shame, such as addictive or impulsive behaviors. Guilt is an objectively determinable philosophical entity, while shame is the outcome of avoidable outcomes.
Narcissist’s False Modesty
False modesty is a defense mechanism used by narcissists to protect their grandiosity from scrutiny and to extract narcissistic supply from others. The narcissist publicly chastises themselves for being unfit, unworthy, lacking, and not formally schooled, but this is only to hedge their bets and secure adoring, admiring, approving, or applauding protestations from the listener. False modesty is a bet, and having received the narcissistic supply, the narcissist feels much better. The narcissist is a pathological liar, and with false modesty, they seek to involve others in their mind games and manipulate them.