*”Pride goeth before destruction, and an haughty spirit before a fall.” (Proverbs 16:8 KJV)

Ron: You probably won’t see this, but it seems that the danger as the quote from your article above indicates, these folks want and get power. Then they do real damage.

Do our current leaders in Washington, especially in order-Nancy Pelosi, Barack Obama, and Harry Reid, meet the diagnostic features of not only Narcissitic Disorder, but I even offer that for Antisocial Disorder?

You read and decide on the latter per the Mnemonic criteria as listed by David Robinson in his book “The Personality Disorders Explained” second edition of 2003: called CALLOUS MAN

‘C’onduct History–behaviors under age 18 that fit the disorder features that almost always lead to the Antisocial Dx over 18
Antisocial ‘A’ctivites–commits acts that are grounds for ‘A’rrest (note not all antisocials end up in the correctional system, like not all alcoholics are on skid row)
‘L’ies frequently
‘L’acunae–lacks a superego, boundaries as set by the culture one resides in
‘O’bligations are not honored, like financial, occupational, etc
‘U’nstable–can’t plan ahead
‘S’afety of self and others is ignored

‘M’oney–spouse and children, responsible financial obligations to others not supported
‘A’ggressive or ‘A’ssaultive
‘N’ot occurring during schizophrenia or mania, as Axis 1 diagnostic features supercede axis 2 until the mood/thought disorders are stabilized and baseline character is restored

So, you the objective reader, decide if these politicians meet this criteria. Remember, one does not have to have all to end up fitting the diagnosis, so don’t split hairs if 2 or 3 do not fit.

I know this comment can be read as outrageous and provocative.

So was their health care deform legislation!

I do believe narcissism is on the rise and that it is celebrated in our culture. It can be annoying at best and dangerous at worst. Most narcissists don’t seek treatment because they don’t believe they’re the problem. They seem to avoid insight and accountability and feel that their only problem is the other people who won’t cater to their wishes. Some do have abuse or neglect histories while others were indulged. Other personality disorders and MH conditions often exist alongside narcissism. They can come on so charming and like the life of the party but then become controlling, insecure, and so obviously of the belief that they should be able to have whatever they want. I believe that, to a narcissist, no one else’s feelings exist. Other people are for their use and amusement. They can be very poor parents, spouses, and employees or they can be high achievers who bask in the respect and acclaim they receive from others. They can be whiney and manipulative or domineering and manipulative. One thing’s for sure, they are about their own interests.

A little is healthy but a little goes a long way.

Carmella Broome EdS LPC LMFT/I
Crossroads Counseling Center, Lexington SC
Author of Carmella’s Quest: Taking On College Sight Unseen (Red Letter Press 2009)
http://CarmellasQuest.LiveJournal.com

One other cause may be marketing.

It seems businesses that give people exactly what they want(or think they want) when they want it, do better than ones that boringly offer what people need. Products based on impulse e.g., junk food do better than vegetable seeds for instance. I’d say the internet’s success is 90% about this( except for my use of it of course).

Realising the market does not have any inherent wisdom (eg thinking everything must be great if there is high spending) may be needed. Perhaps the economy should serve our values not shape them.

But this is what I wanted to say about myself. For me all those more honorable traits Dr. Pies talks about that are in contrast to narcissism, they are not a sacrifice I commit but totally self serving as well. I would feel absolutely horrible if I was prevented from being kind and good, and when I do I feel lousy. I need to practice those higher values for my own health and well-being and there is no greater pleasure for me than to make a difference in the lives of others. And the smallest things are the most important.

First, at the risk of causing many eyes to glaze over with details beloved only to mental health professionals, I’d like to offer a few important distinctions (a number of which readers have already noted).

“Narcissism” as a quality of mind and behavior clearly exists on a continuum, and is not necessarily “bad” or maladaptive. A certain amount of “healthy” narcissism–self-regard or self-love, if you will–is necessary for optimal psychological functioning.(By the way–and this will shock some readers!–physicians, scholars, and academics occasionally have a tad more narcissism than the average butcher, baker, or candlestick maker, in my experience).

Indeed, a degree of narcissism may even be beneficial to society.

So, if Cyrus T. Bigwig wants to contribute 13 million dollars to have Sloan-Kettering Hospital set up the Cyrus T. Bigwig Unit for kids with cancer, I say, “Great! More power to you, Cyrus!” And, the desire to see his name on a brass plate does not make Mr. Bigwig a “malignant narcissist” or one who has DSM-IV “Narcissistic Personality Disorder.” Nor am I convinced–to begin addressing Dr. Schmookler’s question–that someone like Cyrus (all other things being equal) is necessarily expressing “weakness” or lack of self-worth, borne of early “narcissistic injuries” (though, of course, that might be the case).

Those of us who see patients/clients in therapy are exposed, after all, to a small sub-set of individuals with narcissistic traits; namely, the sub-set that isn’t doing very well; feels subjectively disturbed or dissatisfied; or has been pushed into therapy by frustrated family or friends. It is hazardous to generalize from this population, and reach sweeping conclusions regarding the ultimate “truth” about narcissism.

That said, I fully agree with Dr. Schmookler that the more disturbed and aggressive the narcissistic individual, the more likely he or she is to have suffered humiliation, abuse, or neglect in the early childhood years. In such cases, the narcissism is indeed “compensatory”.

When early traumas are extreme, we begin to see a subtle shift from narcissistic personality disorder into so-called “Borderline” personality structures, often mixed with anti-social traits. These issues are taken up in the classic paper by Dr. Gerald Adler, on “The borderline-narcissistic personality disorder continuum”(Am J Psychiatry 1981; 138:46-50). The same general thesis was also set forward in Michael Balint’s book, “The Basic Fault”, for those who want to delve. Many insights on cultural aspects of compensatory narcissism are also found in Dr. Schmookler’s book, “Out of Weakness: Healing the Wounds That Drive Us to War.”

I would also add that not all narcissists are rude and disruptive, nor are all rude and disruptive people narcissists! But when you mix inherent personality traits of entitlement, self-absorption and grandiosity with a culture that richly rewards outlandish and extreme behaviors–witness the “blogosphere”, TV reality shows, etc.–you have the conditions for a “perfect storm”.

Sometimes, looking at our troubled culture, I am put in mind of the famous lines from W.B. Yeats’s poem, “The Second Coming”:

TURNING and turning in the widening gyre
The falcon cannot hear the falconer;
Things fall apart; the centre cannot hold;
Mere anarchy is loosed upon the world,
The blood-dimmed tide is loosed, and everywhere
The ceremony of innocence is drowned;
The best lack all conviction, while the worst
Are full of passionate intensity.

And yet I fully agree with a number of you who pointed out that, notwithstanding our inherent narcissism, humans are also capable of close cooperation, shared goals, and even great compassion (literally, to “suffer with” someone).

To close on a hopeful note, I will cite our great New England sage, Ralph Waldo Emerson, in his essay on the French writer, Michel de Montaigne:

“Things seem to tend downward, to justify despondency, to promote rogues, to defeat the just…But the world spirit is a good swimmer, and storms and waves cannot drown him.”

Best regards, Ron Pies MD