Asperger's Disorder Misdiagnosed as Narcissistic Personality Disorder (NPD)

Uploaded 8/6/2010, approx. 4 minute read

My name is Sam Vaknin. I am the author of Malignant Self-Love, Narcissism Revisited.

Asperger's Disorder, erroneously known as Asperger's Syndrome, can be diagnosed in toddlers as young as three years old. Narcissistic personality disorder cannot be safely diagnosed until late adolescence.

And still, Asperger's Disorder is often misdiagnosed as Narcissistic Personality Disorder.

In both types of patients, both types of disorders, the patient is self-centered and engrossed in a narrow range of interests and activities.

Social and occupational interactions are severely hampered. In conversational skills, this give and take of verbal intercourse, these skills are primitive.

The Asperger's patient body language, his eye-to-eye gaze, his body posture, his facial expressions, this body language is constricted and artificial and it's in this sense very similar to the narcissist's. Nonverbal cues are virtually absent in their interpretation in others, lacking again in both types of patients.

And yet, the gulf between Asperger's and pathological narcissism is vast.

First of all, the narcissist switches between social agility and social impairment voluntarily.

His social dysfunctioning is the outcome of conscious haughtiness and arrogance. It's the result of his reluctance to invest what he regards as scarce mental energy in cultivating relationships with people he deems to be inferior and unworthy.

But when confronted with potential sources of narcissistic supply, the narcissist suddenly transforms. He easily regains his social skills. He suddenly becomes charming, possessed of social graces and gregarious.

So in the narcissist, social awkwardness is a choice. In the Asperger's, it's an inevitability. It's a feature.

Consequently, many narcissists reach the highest ranks of their community, church, firm or voluntary organization. They become pillars of the community. Most of the time, they function flawlessly.

And this is not true of the Asperger's patient. The Asperger's patient often wants to be accepted socially. He wants to have friends, to get married, to be sexually active, to sire offspring or children. He just doesn't have a clue how to go about it.

The Asperger's affect, his ability to express emotions is limited. His initiatives, for instance, to share his experiences with his nearest and dearest or to engage in foreplay with an attractive counterparty, his initiatives are thwarted. His ability to divulge his emotions, this ability is tilted.

He is incapable of reciprocating and he is largely unaware of the wishes, needs and feelings of his interlocutors or counterparties.

Inevitably, Asperger's patients are perceived by others to be cold, eccentric, insensitive, indifferent, repulsive, exploitative or emotionally absent.

And to avoid the pain of rejection, Asperger's patients confine themselves to solitary activities. They are like schizoids.

But unlike the schizoids, they don't do so by choice. They limit their world to a single topic, hobby or person, and they dive in with the greatest all-consuming intensity, excluding all other methods and everyone else.

It is a form of hurt control. pain regulation. Asperger's patients are subject to so much ridicule, so much mockery and so much censure, social censure, that they simply withdraw.

Thus, while the narcissist avoids pain by excluding, devaluing and discarding others, the Asperger's patient achieves the same result by withdrawing and by passionately incorporating in his universe only one or two people and one or two subjects of interest.

Both narcissists and Asperger's patients are prone to react with depression to perceived slights and injuries.

But Asperger's patients are far more at risk of self-harm, mutilation or suicide.

Narcissists rarely engage in such behaviors.

The use of language is another differentiating factor between Asperger's patients and narcissists.

A narcissist is a skilled communicator. He uses language as an instrument to obtain narcissistic supply or against his enemies or perceived enemies as a weapon, to obliterate them, to discard sources.

Cerebral narcissists derive narcissistic supply from the consummate use they make of their innate verbosity, not so the Asperger's.

The Asperger's patient is equally verbose at times and taciturn on other occasions, but his topic are few and thus tediously repetitive. He is unlikely to obey conversational rules or etiquette. For instance, Asperger's patients never let others speak in their turn.

Nor is the Asperger's patient able to decipher nonverbal cues and gestures or to monitor his own misbehavior on such occasions.

Narcissists are similarly inconsiderate, but only towards those who cannot possibly serve as sources of narcissistic supply. When they come across people whom they believe can supply them with attention, adulation and admiration, narcissists are attentive, they are considerate, they are empathic, they fake emotions wonderfully.

Asperger's want to, but cannot.

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