![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 7 to 31 of 31. Go back in thread:
Posted by floatingbridge on May 17, 2011, at 18:14:58
In reply to Narcissism no longer in DSM, posted by Christ_empowered on May 17, 2011, at 12:52:39
What are the other four?
> http://well.blogs.nytimes.com/2010/11/29/narcissism-no-longer-a-psychiatric-disorder/
>
> Check it out. No more Narcissistic Personality Disorder. I don't know how I feel about this. On the one hand, I've been labeled narcissistic before, and I think it was a misdiagnosis; my problems were due to stress, bipolar disorder, and improper medication. A shrink later evaluated me and said it was "really" bipolar all along. So, at least shrinks don't have that label to throw on difficult patients they don't like.
>
> On the other hand...I would like to know *why* its being eliminated.
Posted by Phillipa on May 17, 2011, at 18:40:12
In reply to Narcissism no longer in DSM, posted by Christ_empowered on May 17, 2011, at 12:52:39
CE what a great link this is as able to navigate also to other subjects. Thanks for posting this. I do wonder if one of my RN newsletter also has this study and maybe the other four? Phillipa
Posted by sigismund on May 17, 2011, at 18:54:50
In reply to Re: Narcissism no longer in DSM » Christ_empowered, posted by Phillipa on May 17, 2011, at 18:40:12
We need to heal the wound by loving ourselves, or so I have heard.
Posted by SLS on May 17, 2011, at 19:14:23
In reply to Re: Narcissism no longer in DSM, posted by sigismund on May 17, 2011, at 14:28:19
> Maybe it is no longer an illness because it is so common?
That's an interesting idea. It would be nice to know what prompted the removal of NPD from the DSM.
The Plague became far more common than narcissism, but was never considered to be so common as to be ignored as a diagnosis.
- Scott
Posted by floatingbridge on May 17, 2011, at 19:21:03
In reply to Re: Narcissism no longer in DSM » sigismund, posted by SLS on May 17, 2011, at 19:14:23
My first thought is that it's been absorbed into other dx's as a symptom.
Posted by SLS on May 17, 2011, at 19:44:40
In reply to Re: Narcissism no longer in DSM » SLS, posted by floatingbridge on May 17, 2011, at 19:21:03
> My first thought is that it's been absorbed into other dx's as a symptom.
>Yes. In the DSM V, assessing one's mental illness will use a dimensional approach rather than a categorical one. The ten DSM IV PDs have been "collapsed" into five.
I don't know what to think.
- Scott
Posted by dragonblack on May 17, 2011, at 20:31:15
In reply to Re: Narcissism no longer in DSM » Christ_empowered, posted by floatingbridge on May 17, 2011, at 18:14:58
> What are the other four?
>
Paranoid, Schizoid, Histrionic, and Dependent.http://psychcentral.com/blog/archives/2010/11/30/personality-disorders-shakeup-in-dsm-5/
Posted by Dinah on May 17, 2011, at 21:05:59
In reply to Re: Narcissism no longer in DSM » sigismund, posted by SLS on May 17, 2011, at 19:14:23
> The Plague became far more common than narcissism, but was never considered to be so common as to be ignored as a diagnosis.
>
>
> - Scott:-)
I don't understand their thinking. If they are planning to change the system to a dimensional approach, which I think overall is not a bad idea, why leave the five remaining personality disorders in the DSM? If not, why not keep all that are clinically relevant? Using the input of clinicians, not academicians, as a guide. I'm fine with ditching all the personality disorders, considering them characteristic ways of coping, and looking at the underlying biological causes. But this approach is beyond my comprehension.
Posted by sigismund on May 17, 2011, at 21:09:42
In reply to Re: Narcissism no longer in DSM » sigismund, posted by SLS on May 17, 2011, at 19:14:23
>The Plague became far more common than narcissism
It's not more common now.
It's as if narcissism is the defense against feelings of total worthlessness.
This society (maybe every society) does not have much care for losers, as they are vulgarly termed.
Posted by floatingbridge on May 17, 2011, at 22:21:47
In reply to Re: Narcissism no longer in DSM, posted by Dinah on May 17, 2011, at 21:05:59
On the bright side, there will be less categories for me to read and and see if they fit.
Posted by SLS on May 18, 2011, at 4:57:13
In reply to Re: Narcissism no longer in DSM, posted by sigismund on May 17, 2011, at 21:09:42
> > The Plague became far more common than narcissism
>
> It's not more common now.I don't see how this is relevant to the analogy I drew. The Plague is not common now because it has consistently been considered pathological with an urgency to be treated medically.
> It's as if narcissism is the defense against feelings of total worthlessness.
>
> This society (maybe every society) does not have much care for losers, as they are vulgarly termed.You have a good point. It would be better to prescribe for someone a childhood in a functional family with little psychosocial stress. Unfortunately, this is not immediately practicable. Narcissism is a coping phenomenon? Okay. That doesn't make it healthy and best left untreated. Perhaps it is better considered a dimension to be factored in when establishing a diagnosis. I don't know.
- Scott
Posted by Christ_empowered on May 18, 2011, at 11:46:46
In reply to Re: Narcissism no longer in DSM » sigismund, posted by SLS on May 18, 2011, at 4:57:13
Narcissism strikes me as a convenient way to label people that a shrink doesn't like or doesn't understand. It grew out of psychoanalysis, a system which required the analyst to actually understand the inner workings of the patient's mind. How is that even possible when we're dealing with 5 minute med checks every couple months?
Posted by Phillipa on May 18, 2011, at 19:41:49
In reply to Re: Narcissism no longer in DSM, posted by sigismund on May 17, 2011, at 21:09:42
Long and complicated per wiki so many aspects both healthy and non healthy? Phillipa
Posted by Dinah on May 19, 2011, at 8:27:00
In reply to its for the best, posted by Christ_empowered on May 18, 2011, at 11:46:46
I'm finding it very hard to maintain esteem for the profession while seeing this process.
There seems to be no external standards whatsoever. I'm constantly reminded of the immortal words of Theodoric of York.
************************************
In one memorable episode, Theodoric said:
"You know, medicine is not an exact science, but we are learning all the time. Why, just fifty years ago, they thought a disease like your daughter's was caused by demonic possession or witchcraft. But nowadays we know that Isabelle is suffering from an imbalance of bodily humors, perhaps caused by a toad or a small dwarf living in her stomach."
"Wait a minute. Perhaps she's right. Perhaps I've been wrong to blindly follow the medical traditions and superstitions of past centuries. Maybe we barbers should test these assumptions analytically, through experimentation and a "scientific method". Maybe this scientific method could be extended to other fields of learning: the natural sciences, art, architecture, navigation. Perhaps I could lead the way to a new age, an age of rebirth, a Renaissance!...Naaaaaahhh!"
Posted by Questionmark on May 23, 2011, at 18:06:07
In reply to Narcissism no longer in DSM, posted by Christ_empowered on May 17, 2011, at 12:52:39
I loved the second through fourth posts of this thread. Funny and truthful.
But i think you are right. There is no need for a Narcissistic diagnosis because narcissism is not really considered a flaw in American culture anymore, it is an expectation.
Look at reality TV. Narcissism is an admired trait. Very disgusting and depressing to me.
The other thing is, how many narcissistic people are going to think they need treatment for it? i'd say somewhere between zero and zero percent.Dinah, your post was also very amusing. That first quote is a very applicable analogy to even modern psychiatry.
Posted by SLS on May 24, 2011, at 7:48:38
In reply to Re: Narcissism no longer in DSM, posted by Questionmark on May 23, 2011, at 18:06:07
Hi Questionmark.
> Narcissism is an admired trait. Very disgusting and depressing to me
Why is narcissism very disgusting and depressing to you?
- Scott
Posted by sigismund on May 24, 2011, at 13:35:48
In reply to Re: Narcissism no longer in DSM » Questionmark, posted by SLS on May 24, 2011, at 7:48:38
Let me throw my two bob's worth in here, Scott.
My experience of living with self important people is just how cold, empty and unsatisfying it is to the people on the other end.
Posted by floatingbridge on May 24, 2011, at 15:42:17
In reply to Re: Narcissism no longer in DSM » SLS, posted by sigismund on May 24, 2011, at 13:35:48
Why is narcissism the whipping boy of the 'personality disorders'? Beyond the obvious ironies, if it's a disorder that implies to my mind a degree of discomfort. The obvious joke is that narcissists are self-centered bores, thirsty for praise and miserly giving it.
But I have never met a pure narcissist. Only folks who don't take responsiblity for their actions, that blame others for their even harmless errors, even to the point of blaming their children before accepting responsibility for themselves.
As far as reality shows, yes, our culture has become very strange. Rather than DSM or is it DMS, I take a more political view that my country, the US has sanctioned greedy, thoughtless business practices. That is sociopathic to my mind, placing one's gain over the.common good. This is cultural disease transmitted by laws that allow this unconscionable behavior to be rewarded by monetary gain. People Love money; it equals power, sad to say.
Narcissists, well it can be a symptom of other troubles such as an inability to tolerate introspection. I have met egotists, but narcissists? Some days I'd give an arm to be more like a narcissist. According to pop culture, then I wouldn't give a flying f*ck what people thought of me. I could create something, even write a bad novel and be pleased.
I just don't understand the category to begin with, it doesn't seem helpful, I apologize to any self-identified narcissists reading along, and am glad the entire construct is being scrapped.
Posted by SLS on May 25, 2011, at 8:01:05
In reply to Re: Narcissism no longer in DSM » SLS, posted by sigismund on May 24, 2011, at 13:35:48
> Let me throw my two bob's worth in here, Scott.
>
> My experience of living with self important people is just how cold, empty and unsatisfying it is to the people on the other end.Sadly, I must agree with you.
Do you think that narcissism rises to the level of being pathological as we would consider depression? Note that "narcissism" and "depression" are words whose meanings have become diluted over time.
"Everyone gets depressed sometimes."
"Everyone is to a degree narcissistic."Are these conditions described by the DSM as a pathology? Is what the DSM describes as narcissism or depression different from are depicted in the quotes above? Perhaps part of the construct of NPD is that it affects people adversely as you have described.
I really am not familiar enough with NPD to effectively offer answers.
- Scott
Posted by g_g_g_unit on May 27, 2011, at 10:22:30
In reply to Re: Narcissism no longer in DSM » sigismund, posted by SLS on May 25, 2011, at 8:01:05
I can only offer my personal experience as a professionally diagnosed 'covert' narcissist. As others have rightly noted, narcissism's classification as a "disorder" isn't without merit - and I reject the proposal that all narcissists are "self-centered bores" completely oblivious to social reality. Of course, my classification as a narcissist might, by definition, negate any opinion I venture of myself, but I've found that my relationship to the disorder is multifaceted and that, like an illicit drug, it can either be your best companion or your worst enemy.
The irony is that, for all its implied grandiosity, the sense of self-worth conferred by NPD is so shambolic, unpredictable, and barely set to weather the storms of life (let alone the chaos of mental illness). I found that it first became a notable presence in my life at the precise moment that my Axis I disorders (ADHD, OCD) began to take hold, setting out to distract me from the painful ego-violation contained therein.
For a while, there was a point where my narcissistic ambition felt reasonably in sync with my environment, and I suppose if that was sustainable, it might present as less of a 'disorder'. But the ugliest side has emerged now, when I am left to contend with my (vastly) reduced functionality, yet my 'narcissism', like a petulant, irrational child, continues to latch onto any small scrap of achievement as a sign of my 'superiority'. It's a fraught, painful and pathetic process that finds me oscillating between empty highs and crippling lows.
But then I'm always left wondering about how others might react in my position - whether those whose career ambitions and leaps at self-actualization were thwarted, leaving them with dwindled life prospects, would choose to 'settle'?
Is that a question of narcissism, or dignity?
Posted by floatingbridge on May 27, 2011, at 11:27:52
In reply to Re: Narcissism no longer in DSM, posted by g_g_g_unit on May 27, 2011, at 10:22:30
ggg, I hope You didn't find my reference to narcissists as 'self-centered bores' offensive. I meant it ironically. I became uncomfortable with a sense that the thread was becoming a too easily made joke.
Your post explains a great deal about the discomfort of either 'being' a narcissist or having narcissistic tendencies. I prefer the latter, feeling that narcissism is inherently a human trait if the seed truths of enduring myths are considered. Themes of narcissism are multicultural. To be seen and acknowledged and cherished as worthwhile and special are strong drives imho. Anything that interferes with that healthy expression and reception would most likely be painful and seek address through other outlets, perhaps maladaptive ones.
Thanks for speaking up. I find your post helpful.
fb
Posted by Phillipa on May 27, 2011, at 20:13:23
In reply to Re: Narcissism no longer in DSM » g_g_g_unit, posted by floatingbridge on May 27, 2011, at 11:27:52
Like having to give up Nursing the only identity that was mine all mine as earned it all on my own intelligence. So proud and lost. Yes maladaptive behavior can and does occurr in my opinion as it helps to hide the hurt? Phillipa
Posted by g_g_g_unit on May 28, 2011, at 6:50:42
In reply to Re: Narcissism no longer in DSM » g_g_g_unit, posted by floatingbridge on May 27, 2011, at 11:27:52
Oh, no I wasn't offended by your comment at all! It just would be all too easy (and far more reassuring) to presume that narcissism had no basis in reality, whereas I've tended to find that the opposite is often true .. at least when dealing with others who I suspect to have narcissistic traits.
Yes, I agree that the desire to feel special is a common human drive. The pathology probably occurs when that desire comes at the expense of the consideration of others' well-being -- which is something I'm sadly guilty of.
That said, I think that, on the whole, I'm probably too hard on myself. I suspect that the frustration, jealousy, resentment, etc. I feel are a natural consequence of chronic illness - rather than some kind of personality flaw.
> ggg, I hope You didn't find my reference to narcissists as 'self-centered bores' offensive. I meant it ironically. I became uncomfortable with a sense that the thread was becoming a too easily made joke.
>
> Your post explains a great deal about the discomfort of either 'being' a narcissist or having narcissistic tendencies. I prefer the latter, feeling that narcissism is inherently a human trait if the seed truths of enduring myths are considered. Themes of narcissism are multicultural. To be seen and acknowledged and cherished as worthwhile and special are strong drives imho. Anything that interferes with that healthy expression and reception would most likely be painful and seek address through other outlets, perhaps maladaptive ones.
>
> Thanks for speaking up. I find your post helpful.
>
> fb
Posted by floatingbridge on May 28, 2011, at 9:26:32
In reply to Re: Narcissism no longer in DSM » floatingbridge, posted by g_g_g_unit on May 28, 2011, at 6:50:42
ggg, you could be being a little hard on yourself :(
You have superior intellect and abilities and are beset by umpteen health issues.
That's frustration!
Plus, if I remember correctly you live with a younger sibling who falls to torment you out of sport. I am ancient by now, but can still cringe if I really think about early family and sibling stuff. Yikes.
I still think, hard on yourself or not, your post was very enlightening to me.
:-)
fb
Posted by sigismund on June 2, 2011, at 13:11:14
In reply to Re: Narcissism no longer in DSM » floatingbridge, posted by g_g_g_unit on May 28, 2011, at 6:50:42
I have an 86yo friend in a nursing home. She has been performing in provincial musicals all her life. There is a woman from a rich background in there too. One day my friend mentioned that she had been to the Opera House. The other woman was incensed. 'You have not been to the Opera House!' She should have said 'Look matey, I've been to Covent Garden.' It's chronic.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.