Was there ever a more confusing psychiatric classification than narcissism? The term was first introduced into psychiatry to describe a special sexual practice, one where individuals made love to their own bodies.
Then Freud came along and cleaned it up, making our relationship with our mirror image into the basis for our self-esteem, both normal and pathological.
It is a familiar notion.In its pathological form narcissism is the therapeutically correct version of what religion has called the sin of pride.
From there the concept has proliferated and mutated like a virus, to the point that it infects much of our thinking about psychological motivation.
Writing in Slate.com Emily Yoffe makes this important point. She shows how an ever resourceful psychiatric profession has trotted out pathological narcissism as a catch-all diagnosis for the mental ills that have caused the nation's financial problems. Link here.
From investment bankers to entitlement kings and queens, our culture was supposedly infected by this pathological version of normal self-esteem. If only we could cure pathological narcissism, all would be well. Sort of.
Once you give something a clinical diagnostic label, that assumes that there is or should be a way to treat or cure it. Thus, pathological narcissism, now enshrined as narcissistic personality disorder, is supposed to be a treatable offense. But as Yoffe correctly notes, it rarely if ever responds to classical talk therapy.
We should not be too surprised. A therapeutic technique that leads from introspection to insight is more likely to sustain pathological self-involvement than to cure it.
I would ever argue that most talk therapy produces far more narcissism than it cures. You cannot draw someone out of himself by teaching him to improve his ability to talk about himself.
Given the imprimatur of therapists, narcissistic habits have become the norm. Once you tell a narcissist that his bad habits can lead to therapeutic benefits, you will never get him to stop.
When therapy encourages patients to speak whatever comes to mind or to express their feelings no matter how it might hurt other people, it is granting approval to narcissistic behavior.
When therapy encourages patients to ignore what other people think about them, and to denounce anyone who disapproves of their behavior as judgmental, it is feeding narcissism.
As Yoffe notes, psychiatry has correctly labeled narcissistic personality disorder a character disorder. One wonders, however, why it does not take the next logical step and recommend that this disorder be treated with exercises that involve character-building?