This post was written for GWNI by former blogger One Angry Daughter, who explains narcissism, and her personal experiences with navigating it, on her blog.
Labels May Come and Labels May Go, but the Toxic Behavior Remains the Same
At the end of 2010, the Adult Children of Narcissists (ACON) support circles were abuzz with the news the Diagnostic Statistical Manual (DSM), the standard for diagnosing mental illness, would be removing Narcissistic Personality Disorder (NPD) from its 5th edition. The DSM-4 description of NPD reads like a checklist making it digestible even for a person without professional mental health training. For many of us, the checklist was among the first things we discovered that finally gave clarity to what could be causing hardship in our relationship. Having that description removed from the DSM may seem threatening in that a well-regarded source of validation is changing. However, while the label may be deleted and the diagnosis modified, it should not hinder our path towards choosing healthy behaviors over toxic ones.
The DSM-4 model is a prototype approach where a personality disorder is defined by a cluster of related traits. For those of us who have pegged someone in our lives as having Narcissistic Personality Disorder, chances are we spent time analyzing this checklist. As a refresher, here is the current definition:
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:
· has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
· is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
· 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)
· requires excessive admiration
· has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
· is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
· lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
· is often envious of others or believes that others are envious of him or her
· shows arrogant, haughty behaviors or attitudes
Likely, we spent some time studying the other Class B personality disorders (also known as the dramatic, emotional or erratic disorders (Cluster B)) and found ourselves swimming in more confusion. The traits for Borderline, Histrionic, and Antisocial personality disorders intersect and relate in ways that can cause confusion over what is the most fitting label. If we were really brave, or just a glutton for punishment, we may have even ventured into the Cluster A (odd or eccentric disorders) or Cluster C (anxious or fearful disorders) trying to pin down a more fitting reason why someone who is suppose to love us can treat us so horribly.
DSM-5 Proposed Changes to Personality Disorders
The Personality Disorders Work Group is the body of individuals responsible for proposing a “hybrid dimensional-categorical model for personality and personality disorder assessment and diagnosis” to be included in the 2012 DSM-5. The new model is designed to help clinicians make a diagnosis of a general category of personality disorder which could then be further refined by selecting particular traits from a list to describe the patient’s disorder in detail. If you want to dive deeper into the new model’s personality disorder types and list of characteristics, point your browser over to the American Psychiatric Association’s DMV-5 Development website for Personality Disorders.
According to Andrew E. Skodol, MD, chair of the Personality Disorder Workgroup, “The model is flexible and focuses attention on personality psychopathology with increasing degrees of specificity, depending on a clinician’s available time, information, and expertise.” Ultimately, the Personality Disorder Work Group hopes that the new model will help professionals determine if a patient has a personality related problem and if so, how severe it is. The new model also helps to classify those individuals that do not closely match just one personality disorder, but shares traits across any number of the currently defined disorders. For example, the new model would better define an individual who exhibits both narcissistic and borderline personality traits.
Making Sense of the Change
So great, the new model should ease the process of treating patients who are already in therapeutic care. What does it mean for those of us who studied a rather easy to understand checklists, slapped a psychological label on a person who was hurtful and thought we had tidied up the chaotic painful mess in a neat three letter acronym. Where does it leave us?
Basically right where we stand now. No matter what goes into the final version of the DSM-5, it will not change the experiences we had with a narcissistic relationship. It is an individual decision whether we use the prior label or decide to reformat our narrative with the new classification. What I do know is that NPD will not suddenly cease to exist.
Randi Kreger, author of the book Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder blogged “Whatever happens, you can bet that NPD will still be with us for a while. While you can take NPD out of the DSM, you can’t as easily take NPD out of the people who have it. Also, the publishing industry takes a great deal of time to catch up to the DSM. Authors like me will still be writing about it.”
That goes for blog authors as well. There exists an ever growing community of bloggers who discuss their experiences of emotionally freeing themselves from the ties of narcissistic relationships. The NPD label gives us a common vocabulary in which we can relate. Anna Valerious, author of the blog Narcissists Suck summed it up quite succinctly when she stated: “I used the label of NPD on this blog because of the ease of communication. It was a convenient label for a couple of reasons. First, because it was an objective listing of behaviors to compare someone’s actions to in order to know that we’re talking about the same animal. Second, the description of the behaviors and the attitudes that this label represents has become rather well known to the general public which means that people who are searching for answers on this subject will usually use the label NPD. So it made sense for me to use the psychological term for ease of communication to reach as many people out there looking for answers as I could.”
At the end of the day, it does not matter what label you use to describe someone who is treating you poorly. Re-branded, re-packaged or re-defined, there will always be a type of person who is so consumed with their inner pain that they only see those around them as pawns used to maintain their comfortable false reality. No matter what new definition the DSM-5 presents, it will still describe a personality who crosses boundaries without regard, who does not care who they step on to feel like they are on top, and who will manipulate others at every turn to get what they want.
Assigning labels to those who have hurt us offers a sense of control and the ability to put logic to the chaos we had been living. In this way, it is an exercise in learning how to detach from a dysfunctional relationship system, providing a view to what you do and do not have control over. The lessons are internalized as we build our self-esteem. Over time, the importance of the label diminishes as we achieve the best lesson learned – we no longer allow others to victimize us with their toxic behavior.
Most ACONs know the NPD label only helps us define and learn from our situation. Some of us have learned the hard way that sharing this information with those still enmeshed in the narcissistic behavior is futile. Until they are able to come to their own awakening, the enmeshed will not only reject the label, but they will strike out harder at the label-assigner. Like the Aesop tale about the Wounded Lion and the Fox (Aesop’s Old Lion fable), if we try to help and get too close to root of the pain the narcissistic lion will claw and bite at us. We have to be like the fox in the fable – the one that understands the nature of the lion, is respectful of him, but keeps a safe distance. If given the opportunity, it is the trained psychiatric professionals who know how to safely enter the den of personality disorder, get to the root of the pain and help lead the lion down a healing path. The experts believe changing the DSM to exclude Narcissistic Personality Disorder is going to help in that effort. Here’s to hoping that they are right.
Illustration by Milo Winter
Image source: Project Gutenberg
The Full Four-Part Series:
Part 1 – How to Break Free from a Parent’s Narcissistic Personality Disorder, by OneAngryDaughter
Part 2 – How to Break Free from a Parent’s Narcissistic Personality Disorder, by OneAngryDaughter
Part 3 - How to Break Free from a Parent’s Narcissistic Personality Disorder, by OneAngryDaughter
Part 4 - How to Break Free from a Parent’s Narcissistic Personality Disorder, by OneAngryDaughter