Back when DSM III first classified Narcissism as a personality disorder,
Freudian psychologists who felt that a transference relationship with
the therapist was an essential part of the healing process had little
hope for someone with Narcissism to be able to benefit from
psychotherapy. Not only did the client first have to recognize they had
a debilitating problem, they would have to trust that someone else would
have the expertise and "specialness" to help their very unique symptoms.
Some psychoanalysts felt that the narcissistic disorder had to be
treated first before the psychotherapy could be useful. Kohut felt that
an analyst would have to first get into the client's skin before
assessing the situation objectively.
The likelihood is twofold with respect to removing it as a distinct
personality disorder from DSM IV: They cannot get enough people with the
disorder to come in for treatment, and those who have made it are so
few, and their response to help so varied and statistically unsuccessful
because psychotherapists haven't got the time to truly empathize with
their clients before the objective assessment initial requirement. The
disorder easily overlaps other personality disorder types, as do most of
the other personality disorders, and if anyone now shows up bearing such
similar symptoms, they will treated for Borderline, Avoidant, Dependent,
or what have you. They will usually only show up for help if the other
disorders symptoms are more dominant or debilitating, or if they've
been referred by a government social agency.
The problem, of course, is that the disorder almost inevitably results
in an inability to function, let alone maintain relationships with
significant others or friends. This leads to scornful dependency,
depression, underlying emptiness, which in turn lead to dysfunctional
lifestyles, physical ailments, both real and imagined, that get left
untreated, and in general a spiraling towards other more debilitating
psychological disorders. Not simply a matter of the human vanities.
Treatment might occur in the more advanced stages once catastrophe
culminates, but now the symtomology will simply be re-categorized.
(continued below the following)
From Wikipedia:
The /Diagnostic and Statistical Manual of Mental Disorders
<http://en.wikipedia.org/wiki/Diagnostic_and_Statistical_Manual_of_Mental_Disorders>/
fourth edition, DSM IV-TR, a widely used manual for diagnosing mental
disorders <http://en.wikipedia.org/wiki/Mental_disorder>, defines
narcissistic personality disorder (in Axis II Cluster B
<http://en.wikipedia.org/wiki/Personality_disorder#Cluster_B_.28dramatic.2C_emotional_or_erratic_disorders.29>)
as:^[1]
<http://en.wikipedia.org/wiki/Narcissistic_personality_disorder#cite_note-DSM-IV-TR-0>
A pervasive pattern of grandiosity
<http://en.wikipedia.org/wiki/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
<http://en.wikipedia.org/wiki/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
<http://en.wikipedia.org/wiki/Entitlement>, i.e., unreasonable
expectations of especially favorable treatment or automatic
compliance with his or her expectations
6. Is interpersonally exploitative
<http://en.wikipedia.org/wiki/Exploitative>, i.e., takes
advantage of others to achieve his or her own ends
7. Lacks empathy <http://en.wikipedia.org/wiki/Empathy>: is
unwilling to recognize or identify with the feelings and needs
of others
8. Is often envious <http://en.wikipedia.org/wiki/Envious> of
others or believes others are envious of him or her
9. Shows arrogant <http://en.wikipedia.org/wiki/Arrogant>,
haughty behaviors or attitudes
It is also a requirement of DSM-IV that a diagnosis of any specific
personality disorder also satisfies a set of general personality
disorder criteria
<http://en.wikipedia.org/wiki/Personality_disorder#General_diagnostic_criteria>.
Diagnostic criteria (ICD-10)
The World Health Organization
<http://en.wikipedia.org/wiki/World_Health_Organization>'s ICD-10
<http://en.wikipedia.org/wiki/ICD-10> lists narcissistic personality
disorder under /(F <http://en.wikipedia.org/wiki/ICD-10_Chapter_F>60.8
<http://apps.who.int/classifications/apps/icd/icd10online/?gf60.htm+f608>)
Other specific personality disorders/.^[16]
<http://en.wikipedia.org/wiki/Narcissistic_personality_disorder#cite_note-narcissistic-15>
It is a requirement of ICD-10 that a diagnosis of any specific
personality disorder also satisfies a set of general personality
disorder criteria
<http://en.wikipedia.org/wiki/Personality_disorder#General_diagnostic_criteria_2>.
Theodore Millon <http://en.wikipedia.org/wiki/Theodore_Millon>
identified five subtypes of narcissist: Any individual narcissist may
exhibit none or one of the following:
* *Unprincipled narcissist* - including antisocial
<http://en.wikipedia.org/wiki/Antisocial_personality_disorder>
features. A charlatan <http://en.wikipedia.org/wiki/Charlatan> -
is a fraudulent, exploitative, deceptive and unscrupulous individual.
* *Amorous narcissist* - including histrionic
<http://en.wikipedia.org/wiki/Histrionic_personality_disorder>
features. The Don Juan <http://en.wikipedia.org/wiki/Don_Juan> or
Casanova
<http://en.wikipedia.org/wiki/Casanova_%28disambiguation%29> of
our times - is erotic, exhibitionist
<http://en.wikipedia.org/wiki/Exhibitionist>.
* *Compensatory narcissist* - including negativistic
(passive-aggressive
<http://en.wikipedia.org/wiki/Passive-aggressive>), avoidant
<http://en.wikipedia.org/wiki/Avoidant_personality_disorder> features.
* *Elitist narcissist* - variant of pure pattern. Corresponds to
Wilhelm Reich's <http://en.wikipedia.org/wiki/Wilhelm_Reich>
"phallic narcissistic" personality type.
* *Fanatic narcissist* - including paranoid
<http://en.wikipedia.org/wiki/Paranoid_personality_disorder>
features. An individual whose self-esteem was severely arrested
during childhood, who usually displays major paranoid tendencies,
and who holds on to an illusion of omnipotence. These people are
fighting delusions of insignificance and lost value, and trying to
re-establish their self-esteem through grandiose fantasies and
self-reinforcement. When unable to gain recognition of support
from others, they take on the role of a heroic or worshipped
person with a grandiose mission.
Differential diagnosis
The following conditions commonly coexist (comorbid) with narcissistic
personality disorder:
* Anorexia nervosa <http://en.wikipedia.org/wiki/Anorexia_nervosa>
* Antisocial personality disorder
<http://en.wikipedia.org/wiki/Antisocial_personality_disorder>
* Borderline personality disorder
<http://en.wikipedia.org/wiki/Borderline_personality_disorder>
* Dysthymia <http://en.wikipedia.org/wiki/Dysthymia>
* Histrionic personality disorder
<http://en.wikipedia.org/wiki/Histrionic_personality_disorder>
* Hypomania <http://en.wikipedia.org/wiki/Hypomania>
* Major depressive disorder
<http://en.wikipedia.org/wiki/Major_depressive_disorder>
* Paranoid personality disorder
<http://en.wikipedia.org/wiki/Paranoid_personality_disorder>^[18]
<http://en.wikipedia.org/wiki/Narcissistic_personality_disorder#cite_note-mentalhealth-17>
* Substance-related disorders
<http://en.wikipedia.org/wiki/Substance-related_disorders>
(especially cocaine <http://en.wikipedia.org/wiki/Cocaine>)
Treatment
Prominent clinical strategies are outlined by Heinz Kohut
<http://en.wikipedia.org/wiki/Heinz_Kohut>, Stephen M. Johnson
<http://en.wikipedia.org/w/index.php?title=Stephen_M._Johnson&action=edit&redlink=1>
and James F. Masterson
<http://en.wikipedia.org/wiki/James_F._Masterson>, while Johns ^[9]
<http://en.wikipedia.org/wiki/Narcissistic_personality_disorder#cite_note-Johns-8>
discusses a continuum of severity and the kinds of therapy most
effective in different cases.
Schema Therapy <http://en.wikipedia.org/wiki/Schema_Therapy>, a form of
therapy developed by Jeffrey Young
<http://en.wikipedia.org/w/index.php?title=Jeffrey_Young&action=edit&redlink=1>
that integrates several therapeutic approaches (psychodynamic
<http://en.wikipedia.org/wiki/Psychodynamic>, cognitive, behavioral
etc.), also offers an approach for the treatment of NPD.^[19]
<http://en.wikipedia.org/wiki/Narcissistic_personality_disorder#cite_note-18>
It is unusual for people to seek therapy
<http://en.wikipedia.org/wiki/Therapy> for NPD. Subconscious fears of
exposure or inadequacy often cause defensive disdain of therapeutic
processes.^[20]
<http://en.wikipedia.org/wiki/Narcissistic_personality_disorder#cite_note-Gol3-19>
^[21]
<http://en.wikipedia.org/wiki/Narcissistic_personality_disorder#cite_note-20>
Pharmacotherapy <http://en.wikipedia.org/wiki/Pharmacotherapy> is rarely
effective.
Epidemiology
Lifetime prevalence is estimated at 1% in the general population and 2%
to 16% in clinical populations.^[3]
<http://en.wikipedia.org/wiki/Narcissistic_personality_disorder#cite_note-AMN-2>
<http://en.wikipedia.org/w/index.php?title=Narcissistic_personality_disorder&action=edit§ion=11>History
and Examples
The history of narcissism
<http://en.wikipedia.org/wiki/History_of_narcissism> predates the
discovery of narcissistic personality disorder. The term "narcissistic
personality structure" was introduced by Kernberg
<http://en.wikipedia.org/wiki/Otto_Kernberg> in 1967^[22]
<http://en.wikipedia.org/wiki/Narcissistic_personality_disorder#cite_note-21>
and "narcissistic personality disorder" first proposed by Heinz Kohut
<http://en.wikipedia.org/wiki/Heinz_Kohut> in 1968.^[23]
<http://en.wikipedia.org/wiki/Narcissistic_personality_disorder#cite_note-22>
Proposed removal from DSM-5
The /Personality and Personality Work Group/ has proposed^[24]
<http://en.wikipedia.org/wiki/Narcissistic_personality_disorder#cite_note-23>
eliminating NPD as a distinct disorder in DSM-5
<http://en.wikipedia.org/wiki/DSM-5>^[25]
<http://en.wikipedia.org/wiki/Narcissistic_personality_disorder#cite_note-24>
as part of a major revamping of the diagnostic criteria for personality
disorders, replacing a categorical with a dimensional approach based on
the severity of dysfunctional personality trait domains, raising
objections from some clinicians who characterize the new diagnostic
system as an "unwieldy conglomeration of disparate models that cannot
happily coexist" and may have limited usefulness in clinical
practice.^[26]
<http://en.wikipedia.org/wiki/Narcissistic_personality_disorder#cite_note-25>
hese behavioral patterns in personality disorders are typically
associated with severe disturbances in the behavioral tendencies of an
individual, usually involving several areas of the personality, and are
nearly always associated with considerable personal and social
disruption. Additionally, personality disorders are inflexible and
pervasive across many situations, due in large part to the fact that
such behavior is ego-syntonic
<http://en.wikipedia.org/wiki/Ego-syntonic> (i.e. the patterns are
consistent with the ego integrity
<http://en.wikipedia.org/wiki/Ego_Integrity> of the individual) and are,
therefore, perceived to be appropriate by that individual. This behavior
can result in the client adopting maladaptive coping skills, which may
lead to personal problems that induce extreme anxiety, distress and
depression in clients.^[4]
<http://en.wikipedia.org/wiki/Personality_disorder#cite_note-3>
The onset of these patterns of behavior can typically be traced back to
late adolescence and the beginning of adulthood and, in rarer instances,
childhood.^[1]
<http://en.wikipedia.org/wiki/Personality_disorder#cite_note-DSM-0> It
is therefore unlikely that a diagnosis of personality disorder will be
appropriate before the age of 16 or 17 years. General diagnostic
guidelines applying to all personality disorders are presented below;
supplementary descriptions are provided with each of the subtypes.
Diagnosis of personality disorders can be very subjective; however,
inflexible and pervasive behavioral patterns often cause serious
personal and social difficulties, as well as a general functional
impairment. Rigid and ongoing patterns of feeling, thinking and behavior
are said to be caused by underlying belief systems and these systems are
referred to as fixed fantasies or "dysfunctional schemata
<http://en.wikipedia.org/wiki/Schema_%28psychology%29>" /(Cognitive
modules <http://en.wikipedia.org/wiki/Cognitive_module>)/.
On 1/9/2011 9:38 PM, Keith Hudson wrote:
I don't think that narcissism (or egotism, vanity, conceit,
selfishness) are socially deviant. They are part and parcel of human
nature. We may be social mammals but we are also individuals
underneath. A male, given the opportunity will have sex with the
youngest and most beautiful woman he can find. A woman, looking for a
parental partner will choose the most economically secure man she can
conveniently find. Neither gives a great deal of thought to the longer
tomorrow, only to their immediate needs.
Narcissism , egotism, vanity, conceit, selfishness, among other "sins"
were abstractions used as control devices by male religion organizers,
not to mention the very real sufferings they've imposed on others
throughout history.
Keith
*As to what you have contributed above, socially unhealthy
characteristics become deviant once their chronic manifestation results
in dysfunction or disability. That suit-psychos keep their jobs, grow
rich and get to pursue young prey does speak to societal acceptance of
the pursuit of wealth, but it does not exempt them from personality
disorder categorizations such as Antisocial Personality Disorder or
Conduct Disorder.
You still haven't provided your sources for presumptions about mating
drives. Though one can find numerous examples of such behaviour,
historical, cultural or otherwise, I strongly disagree with your
insistence of these as patterns which wholly established our current
state of evolution, or patterns reflecting today's emotional or sexual
drives, or people's sense of security. Rather, they seem to describe
societal matrimonial mistakes that most often lead to early divorce.
Further, these patterns are commonly found in those seeking therapy for
a variety of problems. That there are many such individuals should not
lead anyone to conclude that all of society is thus driven, nor that it
is the nature of humans to be thus inclined.
*
*Natalia Kuzmyn*
At 17:31 09/01/2011 -0800, Mike Gurstein wrote:
-----Original Message-----
From: [email protected]
[mailto:[email protected]] On Behalf Of marc garrett
Sent: Sunday, January 09, 2011 2:36 PM
To: NetBehaviour for networked distributed creativity
Subject: [NetBehaviour] Narcissism normalised.
Narcissism normalised.
"Recently a NYTimes (http://is.gd/i3Cj9) article announced that
narcissism is being deleted from the tomb for psychiatric disorders.
Narcissism will not appear in the fifth edition of the Diagnostic and
Statistical Manual of Mental Disorders (due out in 2013, and known as
DSM-5). What happens when what was once morally objectionable behaviour
( egotism, vanity, conceit, selfishness) is no longer a 'legitimate'
social deviance? Is narcissism now so deeply embedded in the collective
psyche that it is now 'normal'? Is this the ultimate end of the
neo-liberal exhalation of the individual, celebrity culture, a century's
worth of advertising and the corporatisation of everyday life?"
http://ecolabs.posterous.com/narcissism-normalized
_______________________________________________
NetBehaviour mailing list
[email protected]
http://www.netbehaviour.org/mailman/listinfo/netbehaviour
_______________________________________________
Futurework mailing list
[email protected]
https://lists.uwaterloo.ca/mailman/listinfo/futurework
Keith Hudson, Saltford, England http://allisstatus.wordpress.com/2011/01/
_______________________________________________
Futurework mailing list
[email protected]
https://lists.uwaterloo.ca/mailman/listinfo/futurework
_______________________________________________
Futurework mailing list
[email protected]
https://lists.uwaterloo.ca/mailman/listinfo/futurework
