Will they or won’t they? Will the psychiatrists who are currently working on the latest revision of their Diagnostic and Statistical Manual of Mental Disorders keep or delete the category of narcissistic personality disorder?
The debate has led to much soul-searching, because many psychiatrists hesitate about flinging narcissistic personality disorders into the dustbin of psychiatric history.
How would they survive without being able to classify malefactors as pathological narcissists? Beyond the dubious procedure of classifying what appear to be character flaws as illnesses, psychiatrists have been more than happy to label their enemies, whether Adolph Hitler, Saddam Hussein, or George Bush as pathological narcissists. As though that tells us something.
Of course, they do this in order to pretend that they are relevant and to propagate the absurd idea that if only these people had been in therapy they would have been cured of their narcissism.
Even though narcissistic disorders have found their place in the psychiatric diagnostic Bible, no one has ever imagined that such disorders could be treated or cured through medical means.
We have pills and potions to treat schizophrenia, depression, bipolar illness, and many other psychiatric disorders. The reason might be that they have more to do with the brain than the mind.
Yet, no one has ever imagined that science was going to find a medical cure or treatment for narcissistic personality disorder, or for any one of the other personality disorders that the DSM recognizes.
Why then, is narcissism classified as an illness? One suspects that psychiatry is simply engaged in a form of self-marketing. If people believe that character flaws are an illness then they will have that many more reasons to undergo psychiatric treatment. Isn’t that the bottom line?
Personality disorders are good for business, in roughly the same way that marital counseling is good for business.
No one believes that a couple undergoing marital counseling is sick, in any sense of the word. If they are not sick, then why do they need to be treated by a physician or a paramedical professional?
Of course, narcissism comes down to us from Greek mythology, from the same folks who gave us the Oedipus complex. It refers to a love story involving a character called Narcissus.
In the best known version Narcissus was a beautiful young warrior who attracted the amorous attentions of more than his fair share of nubile maidens. He rejected all of them, apparently because he thought that none of them were good enough for him.
He seemed to have an overweening sense of his own greatness, accompanied by a condescending attitude toward women.
Eventually, Narcissus was punished for his narcissism. One day he knelt down to drink from a forest pool and he fell in love with the beautiful image that the water was reflecting back at him. He was so infatuated that he could not tear himself away from it, even to eat, so he wasted away and died.
If one were to look at his story as a moral fable, it is not about love as much as it is about a failure to mate, thus, to reproduce the species and to add new members to the community.
If Narcissus had been so in love with himself that he wanted the world to have many little Narcissi, and if he had chosen to mate and produce them, he would not have been punished. But would he still have been a narcissist?
Another interpretation, clearly stated in some versions of the myth, emphasizes the homoerotic element in the story. By that interpretation Narcissus rejects female suitors because he is fatally attracted to male beauty.
In that case, the myth is about revenge, with an admixture of homophobia. It represents the revenge of a woman scorned, a woman who misinterprets the youth’s disinterest and makes it a sign of personal rejection.
You might say that it reflects one culture’s attitude toward the imperative to reproduce. And you might also say that shows a high level of intolerance of homosexual attraction.
Whatever the case, the myth refers to a specific moral issue. And it limits itself to the context of courtship and seduction.
Once psychiatry took over the myth, it broadened its scope to include hubris, arrogance, haughtiness, egotism, superciliousness, pride and other forms of excessive self-confidence.
As it happens, none of these would necessarily prevent you from accepting the sexual entreaties of a nubile young maiden. They might actually lead you to believe that it was perfectly normal for said maiden to seek your affections.
Today’s psychiatry has modernized the issue and would reply that while narcissists often do reproduce they are incapable of sustaining long term loving relationships.
Among the Greek gods and goddesses, and among the citizens who worshipped these deities, that would have been a non-issue.
We can also ask what psychiatry would think of a person who is avoiding social intercourse, and not just the sexual variety, because he has often been hurt by others and is afraid of sustaining further psychic harm?
His behavior might be counterproductive, but it would be a reasonable adaptation, given his experience. At the least, it would not have very much to do with how much he loves himself. He may simply love himself enough to protect himself.
Of course, if narcissism is really a character flaw, then the cure would not involve a medical intervention. The cure would be an infusion of humility, something that the world is often more than happy to visit upon narcissists and others who suffer from excessive arrogance.
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