The new edition of the DSM (Diagnostic and Statistical Manual of Mental Disorders) will eliminate five personality disorders, including Paranoid, Schizoid, Histrionic, and Dependent. But the real biggie, the one getting all the attention (naturally), is Narcissistic Personality Disorder. *gasp* NO! How will all those narcissists deal with being told that they don't rate their own personality disorder any longer? This could be very damaging to them.
This decision is causing a lot of disagreement among psychologists and psychiatrists. The rationale is that a patient can be diagnosed with a personality disorder with elements of the various disorders that have been eliminated. A smorgasbord, if you will, of personality disorder symptoms. Practicing psychologists and psychiatrists feel that there is a wide gap between what researchers see in their studies and what they see in their practices, and are none too happy about this decision. Although psychology is a bit of a hobby of mine, and I've read a few books about it, I am by no means an expert, so can't really comment on whether this is a good decision or not.
However, as someone who has been accused in the past of being a narcissist, I can certainly comment on that. I'm really not sure what prompted this person to decide that I am a narcissist, since I really don't fit the pattern of Narcissistic Personality Disorder symptoms (RIP, NPD). I think all of us exhibit certain of these behaviors at times; I am definitely easily hurt, and can appear unemotional at times. However, there is a big difference between exhibiting certain behaviors that many of us show at times, and being classified as having a personality disorder. I can only put on my psychologist hat and wonder if that accusation wasn't a classic case of psychological projection. Hmmm. There is also a big difference between exhibiting a healthy sense of self and self-worth, having self-confidence, and being a narcissist. While looking for a picture for this entry, I saw several that portrayed President Obama as being a narcissist. I think that is just silly.
He is obviously very self-confident. What politician isn't? I would think it's a prerequisite for the job. As for myself—and no, I am not comparing myself to our President—I worked hard to get past my feelings of inferiority, my self-doubts and insecurities. Although I still have those things, I have tried to replace them with a stronger self-confidence and a faith in my own abilities. My job did a lot to help me with that. I was good at what I did, but a lot of that came from my dedication towards learning as much as I could and keeping up with changes. My supervisor placed a lot of faith in me, giving me extra tasks and pushing me to learn more. I'm pretty sure that she was happy with my efforts. I have never pretended to know it all. Good grief...my Bachelor's degree doesn't qualify me as an expert! But I think it's okay to have confidence in your abilities, knowledge, and experience, as long as you have the equal and ever-present realization that there is always, always more to learn.
Does that make me a narcissist? I don't believe it does, and I would be interested to see if any psychologist would diagnose me as such. I saw one several years ago, and I wasn't diagnosed then, so I'm not sure what the person I mentioned previously based their diagnosis on. However, they might be happy to know that both borderline personality disorder and obsessive-compulsive personality disorder (not the same, but related to OCD) are still in the DSM!
It most likely was a bit of projection by the person damning you as a narcisist, not to mention a person who had a insecurity about their lack of 'whatever'. That is why it most likely was a case of projection, because you made them feel insecure about their own self-worth and abilities. By your accomplishments and hard work, they feel less worthy of their one estimations of their ability, beauty, talents and character.
ReplyDeleteEff-'em! (at least that what I tell them!!)
Not even qualifying as a layman, I do think that it is better to lable things under one umbrella rather than say you only have 'this or that'. If you are narcissitic or nearly any of the other disorders (though schizo should still have its own designation, IMO), the idea that they spring from the same cental disorder is not that far-fetched.
You only have one brain with one function. Same for everyone on earth. Generalizing things in this case may make things easier to diagnose and treat.
Oh know! What will we call Sarah Palin now?!? Just plain "nuts"?
ReplyDeleteI never realized I had a former personality order until today!!
ReplyDeleteAnd how did they get that picture? Surely it's photoshopped!
A disorder is a disorder no matter what you call it. On the mental sea there are frquent storms and who ever khows which way the boat will rock.
ReplyDeleteR. D. Laing made a point of trying to harmonize the diffeence between treating a psycosis and treating a human being.
D
hi Beth...My son has narcissistic thoughts and ideas and it very draining when hes around and expects us to live his way of undesirable life and causes havoc within the family and outside too, its a nightmare half the time not knowing whats going to happen next and i've had to call the police on him many times in the past and i will again if he gets out of hand...we like to run our lives as smooth as possible,but we have got the same problem here in the UK our health services are being cut in that area too...Astra!
ReplyDeletei liked when they redefined the austism spectrum because that made sense- this decision to narrow down the BP spectrum seems like it will do more harm then good in the long run, especially in matters where custodial parenting might be at issue.
ReplyDeletexxalainaxx
I'm not a narcissist, I know I'm better than everyone else.
ReplyDeleteAlso, I used to be indecisive but now I'm not so sure.
D.
One of the things I "am"(vocation-wise) is a certified medical coder so I have heard quite the buzz about this, pro & con.
ReplyDeleteI have a mental disorder, though it is not a personality disorder; one of the problems I have is with everyone labeling themselves something(with doctor assistance or not) & then blaming that or using it as an excuse for behavior that could be better controlled(and I am not saying all behavior can be, but SOME most definitely can).
It would take up a bit too much room to explain exactly how all this affects my opinion on the DSM change(and this ain't my blog :-), but I will say that because of what I know from medical, plus what I can conceptualize on a personal level, I agree they should be eliminated, plus a few more.
I've read you for quite a while, and I've read my share of narcisistic bloggers as well-- you aren't one of them. Strong confident opinions at times, yes---freaky OH MY GOD I SO LOVE ME--no, that isn't you. ~Mary
Hmmm ... maybe they've eliminated these personality disorders so they can claim more people have been cured ...?
ReplyDeleteBest,
Marty
Does that mean I have to stop kissing my hand?
ReplyDeleteBeen reading you for over a year and I don't see a narcissist here through your writing. My diagnostic skills are almost three years' worth of rusty, but diagnosing personality disorders played a big role in my practice; you didn't want to throw those diagnoses out too freely.
ReplyDeleteI recall when DSM-IV came out, it took about three years for most of us to become fluid in using it. For the first year, everybody kept a copy within reach at all times. I do see the point in the dimensional approach. It was clinically critical to be able to recognize a personality disorder, but the more carefully you looked at the human in front of you, the more the diagnosis of Mixed Personality Disorder seemed to fit.
Looks like they kept OCD and BPD as discreet disorders, which makes some sense, too. As a clinician, I would not object to learning the new drill, but, if I was an academician/clinician who based his claim to fame on PD's (like Gunderson or Theodore Millon), I'd have to come out swinging...at least until I got up to speed, myself. Then I'd write a new book.
What constitutes a disorder, you ask?
ReplyDeleteIf the underlying condition causes economic and/or social impairment, and/or difficulty in interpersonal relationships, and/or trouble with the Law. Sort of reminiscent of the U.S. Congress.
In any research discipline, there are always “splitters” and “lumpers.” If you are a ‘lumper,” the reason why “mixed personality disorder” is perhaps the better term is that many signs and symptoms overlap what used to be termed individually and separately Avoidant/Dependent, Obsessive-Compulsive, Paranoid, Histrionic, and Narcissist, etc. Unfortunately, Borderline Personality Disorder should probably be reclassified as a Dissociative Disorder since its etiology is trauma based.
The terms “dystonic” and “syntonic” are useful in understanding the personality disorders. If a person acknowledges having a problem and seeks help, “dystonic” is the appropriate term. If a person lacks self-awareness and thinks everyone else is wrong (i.e., “why isn’t everyone like me!”), then “syntonic” is the right term. Many personality disorders are syntonic (which is why psychologists do not always relish having to work with them). Here is a handy guide to psychotherapy:
Q: How many psychologists does it take to change a light bulb?
A: It only takes ONE, but only if the bulb really wants to change.