November 23, 2010

A Generational Pathology: Narcissism Is Not Grandiosity

something's not right

I like your writings about narcissism, but your description seems to differ from the one in the DSM and everywhere else I look.

Why does that matter if indeed it was true?

I just want to know where you came up with it.

You mean, "I just want to make sure you didn't make it up."  Because if I made it up, then it stands entirely on my back.  Like an American, the shortcut you use for difficult issues is to judge their proponent as a proxy.  If you don't like some ideas, look for hypocrisy, discredit the speaker.  Which will be easy to do with me, I assure you.  Heavy drinking, womanizing, misanthropic... maybe not even a psychiatrist.  There.  Do you win?

That's not what I meant.

It is what you meant, even if it isn't what you meant.  There's plenty of writing on narcissism, you can start with Kohut, even Jung and Freud.  But you're resistant: no, psychoanalysis is bunk.  And impossible to understand.  That stuff can't be right.

You want science, you want something with bullet points and a standard deviation.

Here are the DSM criteria for NPD, of which you must score at least five:

  • grandiose sense of self-importance
  • preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love
  • belief 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)
  • need for excessive admiration
  • sense of entitlement
  • takes advantage of others to achieve his or her own ends
  • lack of empathy
  • envious of others or believes that others are envious of him or her
  • arrogant, haughty behaviors or attitudes

Much easier.  Is that the narcissism you heard about?  Selfish and grandiose.   Looking at that definition, do you even come close to narcissism?

Of course not, because your mind is shielding you from the truth.  The belief that narcissism is synonymous with grandiosity is, itself, a narcissistic defense.  You are being lied to, by yourself.

What happened to the diagnosis?  Why did it favor grandiosity?

How do you quantify something that your mind is working to hide from you?  How do you treat it?  When psychiatry wanted to stop being a Jewish/Marxist/elitist worldview and become a real science, it needed to pretend it had medicines and statistics, and a whole new DSM (III).  
How do you measure the unmeasurable?  Divide the unmeasurable into pieces, and measure the pieces. Too many pieces, too fine?  Start with the obvious.

We found a foot, an eyeball, and a liver.  This must be a man.  Or a triceratops.  Or a...  And now we come to consider that a man is something possessing of three attributes: footness, eyeballness, and liverness, with exclusion criteria of dinosaurization.  Thanks, Aristotle, this helps a lot.

So, too, the scales for narcissism, e.g. the Narcissistic Personality Inventory.  While these scales are supposed to measure something that already exists, in postmodern fashion they  alter your concept of what exists.

You looked up narcissism, saw there were criteria, scales, and read them.  And, like decimate, it was reinforced by hearing it in a sentence.  Oh, it's an egotistical jerk who only cares about himself.  Got it.

I've used this example before: The Hamilton scale for depression contains no questions about sleeping excessively or eating too much:

On a 17 question scale in which a reduction of 10 points is outstanding, a sedating side effect can be the difference between $4B/yr in sales or wasted millions in R&D.  Add two points for drugs that make you hungry:


and that's the whole game. 

Psychiatricians will counter that the Hamilton isn't meant to be a screening tool, but in fact it's used as a screening tool all the time: in clinical trials.  You have to meet a certain threshold to be enrolled in a trial, so you can see that a person who is very depressed but hypersomnic and eating too much will be excluded. 

I just told you something that is obvious; so why isn't Abilify (not sedating) testing their drug on other kinds of depressed people?  Because they can't.  The FDA wants the HAM-D, or the MADRS (which is skewed the same.)  Abilify would have to convince the FDA that their drug worked AND change the entire infrastructure of psychiatric drug approval.  Furthermore, psychiatrists themselves would be suspicious, "why are you doing it differently?"

If it's not grandiosity, then what is narcissism?

Shame over guilt; rage over anger; masturbation over sex; envy over greed; your future over your past but her past over her future...

Imagine what you look like to another person.  Now recall what you looked like in the mirror this morning-- that's really what they see.  They are making instantaneous judgments about your personality based on that mirror image.  They are hearing your voice like it comes form a recording, not as you hear from your mouth.  You're the only person who experiences yourself as you do.

The narcissist feels unhappy because he thinks his life isn't as it should be, or things are going wrong;  but all of those feelings find origin in frustration, a specific frustration: the inability to love the other person.

He's a man in a glass box, unable to connect.  He thinks the problem is people don't like him, or not enough, so he exerts massive energy into the creation and maintenance of an identity: if they think of me as X...

But that attempt is always futile, not because you can't trick the other person-- you can, for an entire lifetime, it's quite easy.  But even then, the man in the box is still unsatisfied, still frustrated, because no amount of identity maintenance will break that glass box.

If the other person is also in a glass box, then you have a serious problem.  If everyone is in their own glass box, well, then you have America.

I guess Facebook is a kind of glass box? 

Facebook is a neutral tool, it's what you do with it that matters.  You think the "I'm better than everybody!" status updates are evidence of narcissism, and maybe they are, but the deeper pathology exists in those who derive their identities from that online presence while simultaneously retreating from the real world.  Show me a man or woman who posts pictures of themselves in bathing suits and I shrug my shoulders.  Show me a person who spends more than an hour a day on Facebook and it isn't their job and I'll show you a future divorce even if they're not married yet.  Show me a middle aged person who spends >1 hr a day on facebook, and I'll show you someone who has been to a psychiatrist.  It's not an insult, it is a statement of fact.  Each person tries to find ways of affirming themselves; but when it is done through identity and not behavior, it always leads to misery. 

Sure, you can convince 5000 people you're anything.  Then what? 

It is self-reinforcing.  The type of person who withdraws into facebook is already stunted in their potential for happiness; and if you're spending all your energy on facebook then you're not spending it in ways that might actually work.  The problem isn't facebook, the problem is you.

But that's how I met my last girlfriend...

Your last girlfriend.  Narcissism has a fail-safe: since you know you tricked them to get them, you can't believe them when they say they love you.  The fact that she loves you means she's not smart enough to know  what love is.  That's why you default to measurable quantities of love: how fast did she get into bed with the past guys?

Just because she thinks you're awesome, doesn't mean you can really feel her.

I know I can love, because I love my son and daughter, totally and unconditionally.

And so now I know your kids are young.  No matter what you do to them: abuse them, yell at them, neglect them, abandon them, withdraw from them, they will love you unconditionally.  But after puberty, when they start to love other people in different ways than you, or more than you (do you remember when you were 17?), even the best parent's status drops.  How will your ego defend against that?  Sports car and drinking?  Cybersex?   "I've started smoking pot again, it really helps me unwind."

What can psychiatry do about this?

Do about what?  According to it there's nothing wrong with you, don't you see? You're not grandiose.  Maybe you get diagnosed with "depression" or a touchy-feely therapist tells you you have "self-esteem issues" but that's like being told you have a hairy back, you make some cosmetic adjustments or you just don't go to the pool, life goes on.  Psychiatry has nothing to say about why you get so enraged when you hear about welfare cheats, or how your wife's giggle at that one joke on TV hit you the wrong way, how everyone seems like shallow, phony jerks  and no one is worth getting to know-- how adamant you are that the government do X or Y, neither of which are feasible or even matter but to you it's the most obvious thing in the world to do and the fact that they're not doing it must mean they are either idiots or corrupt--  and while you're yelling at the TV or the monitor or in your own head your wife is mauling a vibrator or you don't have a wife at all.

But I never yell.

Your rage may not score on the decibels but it is triple digits on the wattage.  Psychiatry can't measure that.  And while this rage makes you miserable there's also a societal effect:  hating black people, hating white people, blaming Goldman Sachs, blaming your parents, declaring war.

And deserving things: shouldn't you be in a nice car? Nautica/Zegna/Underarmor/Polo shirts?  Restaurants?  The fact that you can't get them is someone else's fault; but if you get them, why aren't you happier?  Meanwhile there are bills to pay. 

And you can't make the connection between these things at all.  Even as I say it, you resist: it's not that simple, you don't know her, you don't know them......................................... it can't be all me.

It is you, it is all you, it is always you.  Isn't it odd how narcissism turns everything inward, except blame?

It's not odd, it is by psychic design, and psychiatry has failed you all in this. If individual narcissism is self-defensive, one might presume that societal narcissism will find it's own way to hide in plain sight.  Narcissism became synonymous with grandiosity because that facilitated its measurement.  But in so doing, the most significant social pathology in two generations was rendered undetectable.


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The Other Ego Epidemic

If This Is One Of The Sexiest Things You've Ever Seen, You May Be A Narcissist