Narcissism Is Not A Diagnosis

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A few months ago I reached out to a high-traffic online magazine that was actively seeking new gay writers and voices. The article idea I pitched was an exploration into the dysfunction commonly found in romantic relationships among gay men.

But then I used the word.

I described these relationships as “narcissistic.” That was probably a mistake.

The editor was gracious. He told me he was happy to look at a finished draft for consideration. But he noted he wasn’t comfortable with the word “narcissism” because it gets thrown around too much; it’s “misused so liberally.”

He then went on to say that it’s improperly used “without an actual diagnosis of NPD.”

Now, look—I’m not sour the editor wasn’t thrilled with my article idea. Scout’s honor. No one knows better than me that a solid chunk of the current mental-health movement is obsessed with narcissism. After all, yours truly writes about it plenty.

But I very much bristled at the mention of narcissism being a “proper diagnosis,” and without that, the word is improperly and wrongly used.

That’s absolute bullshit.

Narcissism Is Not A Diagnosis

Narcissism is not a diagnosis.

Say it with me.

Narcissism is not a diagnosis.

Narcissism is a psychological term that describes a personality style and pattern of (really bad) behavior appearing in a person. It outlines someone who is arrogant, entitled, constantly seeking validation and attention, grandiose, vindictive, inconsiderate, rageful, and plenty more.

That’s it.

That’s all the word “narcissism” is.

It’s completely free and clear of any diagnosis.

A person who is narcissistic doesn’t have a disease. He or she does not have a mental disorder because of narcissism itself. Of course, there could be other issues going on alongside narcissistic behavior.

But the narcissistic behavior itself is just that—really bad, ugly, hurtful, abusive, and inconsiderate behavior.

Yes, I know. I am not a mental-health professional. I am not a psychotherapist. I fully and freely admit it.

So let me quote one.

Dr. Ramani Durvasula talks about this very issue in her new book, It’s Not You: Identifying And Healing From Narcissistic People.

Dr. Ramani’s new book is excellent and reads like a much-needed therapy session. I highly recommend it, and encourage you to buy it here using this affiliate link. By doing so, you’re helping support my writing.

I also highly recommend Dr. Ramani’s other two books on narcissism:

Should I Stay Or Should I Go: Surviving A Relationship With A Narcissist

Don’t You Know Who I Am: How To Stay Sane In An Era Of Narcissism, Entitlement, And Incivility

Dr. Ramani highlights that we use all kinds of descriptive terms to flesh out the personalities of those around us. People can be agreeable, kind, shy, introverted, bombastic, adventurous, sullen, angry—you name it.

So why are we now all uptight about saying “narcissistic”?

The first point Dr. Ramani makes is while it’s a good and powerful word, we do run the risk overusing “narcissism” to describe someone who is simply a jerk or asshole. A lot of traits fall into the narcissism bucket, and they’re all unpleasant. So if you’re going to use the word, use it correctly.

That said, Dr. Ramani Durvasula outlines something very important in It’s Not You:

There is also the pervasive yet misleading idea that narcissism is a diagnosis or illness…

First, narcissism is a personality style, not a disorder. A personality style is the collection of traits that together represent a given individual’s personality, and is associated with how they would behave, cope, approach, and respond to life.

Yes, there is a diagnosis called narcissistic personality disorder (NPD), which is characterized by  all of the patterns we observe in a narcissistic person.

But to receive the diagnosis, the patterns must be observed by a trained clinician as being pervasive, stable, and consistent and patterns must result in significant impairments in social and occupational functioning, or distress, for the person.

As Dr. Ramani continues to explain, the official NPD diagnosis is paradoxical, because when the narcissistic traits are strong enough to warrant a diagnosis, the traits are usually hurting the people around the narcissist, while the narcissist himself or herself doesn’t much care. Its only when life is going wrong personally for the narcissist that concern arises.

But regardless if a person who behaves awfully in most (if not all) areas of life is diagnosed or not, this person is still behaving awfully.

And guess what?

You’re surely on the receiving end of all that terrible behavior if you’re here, now, reading this.

The Spectrum Of Character Disturbance

Over the past five years I’ve read 18 books covering different topics in psychology—mostly dark and manipulative personalities, but others have slipped in, too.

(This doesn’t even account for the untold essays, articles, and blog posts I’ve consumed from across the far reaches of the internet.)

One of the best books I’ve read that explains why people behave badly is Character Disturbance: The Phenomenon Of Our Age by Dr. George Simon.

I highly, highly recommend this book, and encourage that you buy it here using this link, which also helps support my writing efforts.

I also highly recommend In Sheep’s Clothing: Understanding And Dealing With Manipulative People.

After reading Character Disturbance, Dr. Simon convinced me that while words like narcissism are important (especially for those individuals emerging from fraught and abusive relationships), it’s just one word out of many that describes the most important thing you need to watch out for when meeting new people.

Behavior.

You must always, always, always observe the behavior of others, especially new people you are introducing into your life.

Personally, this is something I never did when I was younger.

Me? Well, I was a youthful and naive homosexual desperate for love, attention, and affection. I met many men and offered myself up to them, body and soul, way too quickly.

Oh, sure—I noticed plenty of these guys behaving badly, but who cared?

These were just one-off instances, right? What these men said was what mattered. Who these guys were on the inside was what I truly wanted, and I’d fight damn hard to bring it out of them and win them over.

I could fix them.

But I never did.

Oh, they fixed me but good. But I never fixed any of them.

There was nothing to fix because they were who they were—all adult gay men making their own decisions. And while I was always, always, always concerned with looking out for them, they always looked out for themselves first and foremost. I wasn’t even an afterthought.

All things concerning personality exist on a spectrum in psychology, and Dr. George Simon explore the spectrum of “disturbed characters” in Character Disturbance.

But he always defaults in reminding readers about the all-important behaviors of disturbed characters, and how you absolutely must pay attention to these behaviors before allowing someone into your life. You must move slowly and you must pay attention to the small and subtle clues showing who a person is beneath the projected persona.

I’m not trying to be a cynic, as many people out there are genuine, nice, and agreeable individuals.

But… more than enough are also difficult, entitled, and antagonistic. They will put on an act to get what they want, regardless of whatever label you think they deserve.

As Dr. Simon writes in Character Disturbance:

Disturbed characters can be most insincere, especially when they want something from you or are slickly trying to get the better of you. They may use flattery or “sweet talk,” act congenially, or say whatever it is they think you want to hear so that they can win you over without really earning your trust.

Most of the time, when someone is praising us or giving us complement, we don’t think they’re trying to get something from us. But disturbed characters will say and do whatever it takes to gain our favor. Once they have it, they won’t hesitate to take advantage.

Now, imagine you were on the receiving end of this. You emerge from the fog and start understanding what was happening to you. Then you discover of the word narcissism and it all fits. But then, that’s followed up by some pompous moral arbiter elected by no one telling you you’re wrong in the discernment you’re finally learning to trust.

Fuck that.

A Composite Of Mr. Awful

I’m going to construct a composite.

Let’s call the composite Mr. Awful.

Imagine you’ve been in a three-year-long romantic relationship with Mr. Awful, and during that time he exhibited these behaviors:

– Entitled to always having his way, and your preferences were never considered

– An unending need to always receive attention from others

– Raged whenever the smallest thing did not go his way

– Showed off as a pompous and grandiose blowhard in the company of others

– Was cheap and frugal with you, but wasted lots of money on himself and people he didn’t know well but wanted to impress

– Was rude to service workers, and had no issues arrogantly telling them what to do and accusing them of not knowing how to do their job

– Enjoyed the misfortunes of others and always had a nasty thing to say about others, all the while expecting the world to come to its knees when something bad happened to him

Now, let’s split this composite into two different timelines.

In Timeline 01, Mr. Awful looses his job because of these traits and behaviors, his wife leaves him, the kids don’t want to spend time with him anymore and are withdrawn during visitations, his parents and siblings only invite him to the bare minimum of holidays out of guilt and obligation.

These consequences cause enough upset and frustration in Mr. Awful that he finds himself in a mental-health professional’s office. There, the therapist spends enough time with the man to diagnose him with “narcissistic personality disorder.” Mr. Awful officially has the fabled NPD.

Now, in Timeline 02, Mr. Awful not only keeps his job but gets a promotion because he’s a high earner for his company. The wife of Mr. Awful refuses to give up on the man she met at the beginning of the relationship, so she sticks it out despite the abuse and neglect. Mr. Awful’s kids have been conditioned to accept his love through material rewards like gadgets and vacations, so they, too, deal with his dark behavior. Mr. Awful’s family is proud of the outward appearance of their son and brother, refusing to acknowledge all of those uncomfortable truths that exist just below the surface.

I now ask you this question:

Is Mr. Awful from Timeline 01 any more a narcissist because he received the NPD diagnosis, versus the same exact Mr. Awful from Timeline 02 whose life carried on without interruption, business as usual?

No.

Both versions of Mr. Awful are still narcissistic because Mr. Awful’s personality and the resulting patterns of behavior are still exactly the same.

The only difference is that in Timeline 01, Mr. Awful experienced consequences for his behavior, whereas Mr. Awful from Timeline 02 continued forth without a care in the world.

All a diagnosis of narcissistic personality disorder says is, “yup, you’re narcissistic and it’s affecting your life in a bad way.”

But even without that diagnoses, plenty of antagonistic, entitled, disturbed, dysfunctional, and manipulative people exist in the world who behave narcissistically.

And you have every right in the goddamn world to acknowledge that and call it out for what it is.

No, you certainly don’t know what’s going on in the minds of other.

But you always haver a right to observe and judge the behaviors of other people before allowing them access to your life.

In fact, it is imperative that you do exactly that.

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About Author

Steven Surman has been writing for over 15 years. His essays and articles have appeared in a variety of print and digital publications, including the Humanist, the Gay & Lesbian Review, and A&U magazine. His website and blog, Steven Surman Writes, collects his past and current nonfiction work. Steven’s a graduate of Bloomsburg University and the Pennsylvania College of Technology, and he currently works as the Content Marketing Manager for a New York City-based media company. His first book, Bigmart Confidential: Dispatches from America's Retail Empire, is a memoir detailing his time working at a big-box retailer. Please contact him at steven@stevensurman.com.

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