Currently getting my socks clean blown off by Rethinking Narcissism, by Dr. Craig Malkin. Which I found, in a roundabout way, from this video on Midsommar, grief, and narcissism.
Tonight I woke up from a nap and accidentally took my morning meds, so I'm going to be up for a few hours because of the meth. In place of sleep, I'll try to roughly sum up some basic ideas proposed by the research the book is based on:
That traits of "narcissism" like entitlement, grandiosity, and feeling special are not inherently toxic. There are times and places they are appropriate and beneficial. If you show up at a hospital with a gunshot wound to the chest, you should not sit and wait to be seen after people with earaches and coughs. (Actually, medical systems are designed to prioritize people with more urgent needs, and you qualify under that system. You are special and are deserving of different treatment than those others, which is why making your needs known, even insisting on it if you're not listened to appropriately the first time, is an extremely good idea. It keeps you from bleeding to death on the floor, and keeps the hospital from getting its pants sued off by your heirs.)
It is more useful to view "narcissism" not as an inherent immutable personality trait, but as a cluster of coping mechanisms. As previously stated, there are times they are exactly the right coping mechanism for the job. However, people we call "narcissists" tend to cling to these ones even when they become detrimental to themselves and others, often because they lack other ways of regulating their emotions and getting their needs met. And that is something they can change, if a person is willing to put in sincere and difficult work. It is not usually fast change; it's a matter of years, not weeks. But a skillbuilding approach turned Borderline Personality Disorder from an immutable curse to a fully treatable (though not quickly treatable) condition, and there's a lot of hope that it can do the same for Narcissistic Personality Disorder.
Meanwhile, there's an opposite end to the narcissism spectrum, and it is also pathological and destructive to hang out there all the time. It's an aversion, or even a resistance, to expecting yourself or other people to treat your own feelings, thoughts, ideas, needs, or preferences as important. For Greek mythology reasons, its proposed name is Echoism.
Unfortunately, because most of the damage echoism does is, by its very nature, localized to its sufferer and their own personal relationships, its downsides aren't often talked about. In fact, it's often seen as an ideal moral state, a kind of altruism or saintliness everyone should strive for. As a pathological coping mechanism a person is trapped in, though, it's often more a fear-based reflex than a conscious and deliberate attempt to achieve some real and specific good. It's not actually as beneficial as being able to recognize your needs, desires, positive aspects, and areas of competence or excellence, and bring them forward in your relationships with other people and yourself.
To me this has all been a cross between a gut-punch and a cool, sweet drink of water. There have been other ways to describe echoism over the years, but this feels like the most concise and useful one I've seen in ages.
It specifically puts its pin down in the middle of the moral debate a lot of people struggle withâ"What right do I have to put myself forward? What hope do I have of being seen and accepted? Isn't it better not to burden anybody else?"âand says that the problem is not feeling in touch with either side of the equation, but specifically, the inability to move from one part of the spectrum to another when it's merited by circumstances.
When I was a child, I thought Echoism was the answer. It was my ideal. I thought it was what would get me the love and acceptance I wanted, and would keep me safe from the pain of rejection or not being understood. I had no idea it would actually, in fact, be the primary cause of alienation and loneliness for the rest of my life.
Now I'm so deeply thankful I couldn't fully achieve it, in practical terms. As hard as I tried to erase myself, there were always things I loved too much to suppress. I still found ways to express and discover myself in the books I read, the stories I wrote, the intellectual work of school and the experience of pursuing hobbies I loved, my ambitions to be helpful even when they demanded I stop being selfless, and the relationships where I felt safe enough to experience love and acceptance even if I didn't think I deserved them.
There's this question I found a while back that echoed in my bones: Who am I allowed to be around you? Because that's what I felt like, as a child. If I wanted to engage with other people and minimize my risk of harm, it was my job to bend into a pretzel and fit the shape they wanted. And thank god, thank god, thank god, I couldn't fully do it. Despite everything, there were parts of me too strong and bright to lop off completely to get my arms and legs inside the carriage. I was able to take care of myself and let them grow in secret until I found social places I could let them out again. Despite myself, I found ways to grow and thrive, well beyond the trauma that said I shouldn't have.
I know this is going to sound tangential but hear me out.
So a while back I started having a specific really explict and direct conversation with clients. Every time I heard them mention "feeling manipulative" I would point out to them that "manipulation" of others essentially means "intentionally interacting with my space/environment in ways that maximize my chances of getting a desireable/necessary outcome." I remind them that while, yes, it is of course possible to do this in such a way that you are removing other people's ability to make a safe/appropriate choice for themselves, that does not mean that intentional need meeting ITSELF is the problem.
I ask them to think about how they internalized the idea that intentionally seeking to meet their needs and to engage others in helping them do that is a morally negative action, and invite them to consider how that internalization may actually increase their risk of need-meeting inappropriately out of desperation and crisis, and increases the anxiety they feel when considering explicitly asking loved ones for support. I encourage them to explore their relationship with need-meeting generally, and how often they shame themselves for it.
Here's where we tie back to narcissism.
I want to be clear that what follows, while I believe it to be supported by existing research and evidence when extrapolated out of other related contexts, is hard to directly say "this has been studied and proven." So take everything that follows as *my experience* not objective fact.
Over and over again, when I have this conversation with clients, the answer is the same even when details vary.
I had a relationship with someone I loved, heart and soul (a parent, a lover, a friend, etc) who made it very clear to me in ways that were hard or even impossible to challenge, that my needs only mattered when they aligned with this person's needs. If there was a clash, my needs had to take a backseat.
Often this story repeats. Not just one relationship but many. Over and over and over again. Until the person believes that their needs simply do not matter, ir at a minimum should always be the last to be taken into consideration.
This is where I remind clients of the incredible survival skills of the human body to go without having basic needs met for long periods of time, and the toll this takes on our body-mind as hours turn into days, months, years, and decades. I remind clients that when we first started talking, we defined chronic/traumatic stress as "chronic or consistent unstable access to need meeting, or extreme violation of need meeting within an episodic schema" aka, trauma is simply when your body doesn't have what it needs to thrive and is forced to merely survive instead. Werun through the presentation of an overtaxed or chronically/acutely dysregulated autonomic system, and how this can change our ability to choose or act thoughtfully/with intention, falling back on reflexive survival skills adapted for toxic or unsafe environments.
And the last thing I do is remind my client that a person can only really thrive when they are not only allowed but encouraged to meet their needs effectively and comprehensively from within a personalized support community.
Over and over again, I bring to my clients' attention that our society, though deeply individualistic in many ways, is still collectivist in how it shames individuals for having atypical or contextually conflicting needs. How the hierarchies of our social structures both allow for and encourage wielders of power to shame and reduce need-meeting behaviors in their underlings in order to maintain a baseline of exploitable chronic need-restriction. This doesn't mean everyone will act on it, but it does mean that we need to have a strong understanding of how to act under our own power even in contexts where that power is obscured by another's actions.
Narcissist, as a term and a diagnosis, serves as a threat to those of us whose need-meeting goes against the systemic hierarchies of our life, and as a way of demonizing the baseline level of self love that tells us we have, as a basic human right of birth, the right to autonomy, need-meeting, and self-actualization. Calling this process "manipulative" with the implication that this is a bad thing is how we start hearing people say things like "just let the baby cry, she's manipulating you".
A baby cannot and does not experience malice in its actions. It is the most helpless and vulnerable we can be as humans. All we can do to need-meet is cry. To ignore that exclusive form of communication is to exert a dominance of need over a **baby**.
It's also where we get the idea that "lacking empathy" is somehow a moral trait. Because you see, someone "lacks empathy" when they love themselves enough to consistently prioritize their needs over others. But. Why shouldn't they? Especially if they've spent their whole life being told that **no one else will do it on their behalf**
If you're the only one who cares, then OF COURSE your own needs are your exclusive priority. It's how your body-mind survives an environment that tells you your survival is disruptive to the thriving of others.
So who comes in meeting the criteria for a narcissistic personality disorder diagnosis then?
Well. People whose needs have been so consistently and comprehensively disregarded for so long, that they literally lack the bandwidth to spend mental, emotional, or physical resources on anything other than their own need-meeting. That level of chronic deficit is impossible to make up alone. We humans are social creatures, and while this is often used to mean "oh we love being in groups!!" what it actually means is that humans are not capable of surviving, long term (as in more than a generation or two) without a herd (aka a community). Our needs as individuals are so extensive that they simply cannot be met long term in small numbers. The smaller your herd, the more likely its members are to be consistently and chronically stressed from need-restriction.
But humans are INCREDIBLY at surviving. Our body-mind has a truly mind blowing array of strategies to keep itself alive. Many of those are specifically detrimental to the herd because if the herd could help you, it would. The fact that it ISN'T means your body needs to survive alone. And that looks like autonomic dysregulation and all it's long term physiological health outcomes, as well as a cognitive shift to "narcissism" or "exclusively self-focused need meeting" in order to maintain a floor of functionality within that shift.
In other words, as with so much of "personality disorder" research in recent years, it is becoming increasingly clear that EVERY personality disorder, including narcissistic personality disorder, is the cognitive outcome of chronic stress that has become a complex trauma system within the body-mind. And as with any trauma system, one of the most important factors related to healing and recover is our access to social support.
In other words, the fact that those with personality disorders are so stigmatized actually perpetuates and entrenches their survival strategies because it alienates them from social support and their "herd". How they are alienated often correlates with the cognitive restructuring that occurs (e.g. BPD appears to be most common in "choatic" traumatic environments, while NPD appears to be most common in "neglectful and dehumanized" environments, for example). But we also know that the less social support and herd connections a person has, the more deeply felt their traumatic stress will be. Which means that, shockingly, in order for people with personality disorders to change their relationship with others and with their environment, their environment must first stabilize as a consistently safe and supportive one, or else the survival strategies manifesting thru PD presentation remain necessary and valid, and are extremely difficult to change.
Support can look like so many things! Loving and non-judgemental relationships, medication to stabilize brain chemistry during intensive or episodic stressor periods, accommodations to reduce executive functioning demands over time (I know we're used to hearing about executive functioning in ADHD but there's a REASON that untreated/undermanaged ADHD is one of the highest flags of concern for a personality disorder diagnosis - the harder it is for a person to effectively execute need-meeting tasks and activities, the more likely they are to develop chronic/traumatic need restriction that produces PD-specific cognitive restructuring for survival), or coping skills that increase a person's threshhold of tolerance for daily and episodic stressors, whether preventatively or responsively (e.g. grounding and distress tolerance skills, emotuinal processing and communication skills, self-reflection and bio-feedback interpretation skills, etc.).
I do not say this to deny that people can need-meet in ways that are genuinely harmful to others. Rather to point out, if we wanted to cultivate social structures that induced people to do just that more and more over time rather than being able to need meet effectively within the herd, we sure do appear to have done so.
But if we want people to have the best odds of need-meeting without infringing on the need-meeting of others?
Well. We need to make a LOT of changes.
Hello! I am not a therapist but I do have both BPD and NPD and I hope you will hear me out, and see the value in the perspective of people who experience these things that you are talking about.
Firstly, I want to thank @butts-bouncing-on-the-beltway for their very kind, nuanced, and absolutely true discussion of NPD. We don't often get that since NPD is a heavily demonized disorder and it can make seeking a therapist very difficult and scary, so it is very nice to see that some of you are more understanding. I will be building off of some of the points you have made.
OP, the way you have spoken about personality disorders felt very dehumanizing. The way you speak about both NPD and BPD makes it sound like you think they are wholly bad things, and focusing on 'cures' rather than how to cope with these things in a healthy way brings that forward. Especially to describe BPD as a curse. I don't know if you have BPD or not, but you should never speak about a disorder you do not have that way, and even if you do have it, you may talk like that about your own experiences but you should not be speaking that way about everyone since you do not know everyone's experiences.
Personality disorders are named such because they do have a large impact on someones personality, aka, they are part of who you are. Seeing something that is a part of me described like it is only bad and must be changed is hurtful. It does not have the same impact as someone saying negative symptoms can be managed and you can live a happy life with BPD as seeing someone say 'BPD is a curse! but don't worry it can be cured!'
Part of the learning to be healthy and live a happy life is self love and acceptance. And that includes my personality disorders, recognizing I will always be strange, and learning how to navigate that. If you are wondering, how can something like BPD have any positives, look here. I do describe a lot of pain I have gone through as a result of rapid BPD attachments. But I also describe euphoria, forming close bonds with others like me, and getting healthy relationships in the end. I talk about how trying to suppress the symptoms entirely and act like a normal person is harmful. Learning to navigate symptoms in a healthy way is what is important.
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Now let's talk about narcissism. It is less direct, but in your original post it really does come off like you think narcissism is inherently bad, at least when it is at the level where it is a personality disorder. Of course, as a disorder it can be distressing, but it also comes off a bit like you think this 'Echoism' only ever hurts yourself while NPD is dangerous and hurts others.
But.... To me, Echoism is simply describing covert NPD. Someone who still feels that deep need for attention that they have been deprived of (which, like beltway said, is what causes NPD) but does not feel safe to seek it, and is sort of in a perpetual NPD crash. A lot of covert narcs are deep in denial about their NPD partly because they are taught that having Need and seeking to fulfill them is Evil so they are like I could Never have Has Needs Disease. Especially if attention also feels dangerous to them. It makes it very difficult for covert narcs to accept their narcissism, which is something we have gone through when we were covert, especially because that shame was reinforced by so many resources saying NPD is a 'bad person disease' and we knew we were a good person.
But honestly, seeking attention feeling dangerous is why narcs use 'manipulative' means. We were not taught that you can just ask for care and receive it. You have to be aware of the larger social situation and influence it that way to get any attention. We are taught this by abuse that was done to us. It is not our fault. And like was said previously, doing things in this manner does not mean that the things you are doing are harmful! It just means you are doing them with high awareness of the situation and what your actions are likely to cause others to do. My alter Husker talks about this in depth here.
Yes, often you are trying to influence them to do something that you want, but honestly, most social interaction is this, the narc is just more aware of it. And someone with NPD can be doing that in a controlling and abusive way. But they can also be doing it harmlessly, or even benevolently. And people without NPD are frequently controlling and abusive. NPD can flavor an abusers style, but it is not what makes someone abusive or not.
People can abuse others because of their feelings, and personality disorders cause strong, irrational feelings, but what makes something abuse is how someone then chooses to ACT on those feelings, not the presence of feelings. And presence of strong feelings does not mean someone is going to act any specific way. And people can abuse people acting on feelings that are not disordered! Neurotypical people abuse all the time, society it set up and structured to reward abuse, abusive power dynamics are normalized for almost everyone very young with how much total control over their childrens lives parents have, and people will try to then model that in other relationships, personality disorder or not!
And you can have NPD and be a good person without acting entirely normal. And a lot of that comes from unlearning shame for your needs and getting community support, exactly as beltway has said. I have gotten a lot better since knowing I have NPD and being open about it, having language for these strong emotions that I feel, and being able to talk about these emotions honestly. Being able to tell my partner that I felt angry at them, I was jealous of them for an irrational reason, and have them comfort me and tell me my feelings are not evil, is incredibly freeing. Being able to do the same for them and seeing that I am not alone is incredibly freeing. Trying to suppress these emotions and act normal would just lead to more crying alone. My alter Vox talks about it in depth here.
It's incredibly freeing to go to my friends and say "Hey! I have NPD! I need attention please!" And they go "Yes of course Alastor you deserve it you are the best ever and make our lives better thank you!" And they can come to me like "Alastor I need attention or help I am sad help" And I will go "yes of course I adore you you are so special my sweet darling."
And I have told them exactly how I feel about them. I have told them I lack empathy for them. I have told them a lot of my care about them comes from the fact that they pay attention to me. And they still love me. And I adore them. And we are helping each other mutually, to live healthier and happier lives, with connection to others.
The most important thing to help pwNPD is to change the stigma. Let people know we can be great friends, even while still having NPD and not 'cured'. Let people with NPD know that they can be open about symptoms and not everyone will be scared of them and hate them. Change how psychology talks about NPD so people will be less scared of us. Treating pwNPD like monsters is going to make more of us feel we cant change, and either will lead to self hatred or people going "fuck it i guess i will be shitty then if theres no point trying to be nice".
Learn love and acceptance for NPD.
Hey, thanks for speaking up. I apologize for the way I wrote about this, all slapdash and sloppy. I agree with your points! My phrasing was not trying to demonize personality disorders, although I realize it came out sounding that way. I think that, in broad strokes, we agree. I burned out of work as a therapist a couple years ago, and have gotten slightly rusty when it comes to communicating my ideas to a broader audience.
The overriding idea I was trying to express, and regret that I did not get across clearly enough, is that NPD and BPD are not 1) entirely bad, even at their worst, 2) resistant to change, or 3) permanent lifelong conditions that can never get better.
When I called BPD an "immutable curse", I was not representing my own assessment of it. It's not immutable, nor a curse. Unfortunately, back when I first studied Abnormal Psychology, that was essentially the way my professor described it. The view of people with BPD as "impossible" and "nightmare clients" was a very widespread attitude many therapists would discuss openly, without receiving any significant pushback from their peers.
They were wrong. As it turns out, that was a skill issue on their part. It was therapists with BPD themselves who worked to establish treatments that could reliably and predictably help to take people whose lives were in constant crisis to a place where they were confidently able to face life's ups and downs and get the kinds of belonging and acceptance they wanted.
The biggest miscommunication here was when I talked about NPD and BPD as things that could be "fully treatable", in the sense that you could have BPD, go to therapy, and then not have BPD anymore. That is a massive oversimplification. You're right that treatment can't entirely wipe the damage of early childhood trauma away and completely re-structure someone's personality, so that things like self-worth and intimacy just aren't difficult for them anymore.
It's more about the disorder going into remission, where the most problematic and damaging parts have backed off and stopped significantly impairing someone's happiness and functioning. It can always relapse, and the underlying issues that made it a risk in the first place might still be there, but it can stop being particularly relevant all the time.
I think that it makes perfect sense to use diagnoses as a nexus for community, self-advocacy, and identity. To be able to say, "Hi, yes, I'm the person you'd stick with that label, question your assumptions." I think that so long as that continues to serve you and the community of people like you, that's a really good idea. I don't want to come across as saying the way you relate to those labels is wrong, because for you, it isn't.
My approach to diagnostic labels is honestly based on extreme skepticism of them. Like yes, neurodivergence and different psychological conditions exist, no doubt; but I am really not persuaded that the mental health field is anywhere near able to accurately classify and describe them. We simply don't have enough knowledge to do it, and are like the field of biology back when it said there were mammals and not-mammals, and was about to get its whole mind blown by the existence of the platypus. What we call "depression" is probably twenty separate disorders stacked together under a big trenchcoat, the way "headache" can refer to a hangover, a migraine, a concussion, or a brain tumor.
In sum: I'm sorry. I will do my best to speak more carefully and mindfully about these issues. Thank you for being willing to speak up and advocate for yourself and your community. I think you're right and I agree with you on so many points. I hope that I can be a better ally and/or less bad obstacle in the future.
