Can You Diagnose Your Narcissist?

Uploaded 5/4/2011, approx. 3 minute read

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

Can anyone diagnose a narcissist? Can you diagnose your narcissist?

Narcissistic personality disorder is a disease. It is defined only by and in the Diagnostic and Statistical Manual, the DSM. All other so-called definitions and compilations of criteria are irrelevant and very misleading oftentimes.

People go around putting together lists of traits and behaviors, usually based on their experience with one person who was never officially diagnosed with Narcissistic Personality Disorder. They decide that these compilers decide that these lists constitute the essence and definition of narcissism, but often they don't.

People erroneously use the term narcissist to describe every type of abuser or obnoxious and uncouth person. That is wrong. Not all abusers or jerks are narcissists, although all narcissists are abusers and jerks.

Remember, only a qualified mental health diagnostician can determine whether someone suffers from Narcissistic Personality Disorder in this following lengthy tests and personal interviews.

It is true that narcissists can mislead even the most experienced professional, but this does not mean that laymen possess the ability to diagnose mental health disorders.

The same signs and symptoms apply to many psychological problems, and differentiating between them takes years of learning and training and exposure to case studies.

So here's a list of the diagnostic criteria in the Diagnostic and Statistical Manual of the DSM augmented by findings from recent studies and research.

The narcissist feels grandiose and self-important. He exaggerates accomplishments, talents, skills, contacts and personality traits to the point of lying. He demands to be recognized as superior without commensurate achievements.

The narcissist is obsessed with fantasies of unlimited success, fame, fearsome power or omnipotence, unequal brilliance, bodily beauty or sexual performance.

The narcissist believes in ideal, everlasting, all-conquering love or passion. The narcissist is firmly convinced that he or she is unique, and being special can only be understood by and should be treated by or associate with other special, unique or high-status people or institutions.

The narcissist requires excessive admiration, adulation, attention and affirmation, or failing that, wishes to be feared and to be notorious. This is what I call narcissistic supply.

The narcissist feels entitled. He demands automatic and full compliance with his or her unreasonable expectations for special and favorable priority treatment.

The narcissist is interpersonally exploited. In other words, the narcissist uses others to achieve his or her own ends and goals.

Most importantly, the narcissist is devoid of empathy. He is unable or unwilling to identify with, acknowledge or accept the feelings, needs, preferences, priorities, wishes and choices of other people.

The narcissist is constantly envious of others, and he seeks to hurt or destroy the object of his or her frustration.

The narcissist suffers from persecutory, paranoid delusions, as he or she believes that they feel the same about him or her, and are likely to act similarly.

The narcissist behaves arrogantly and haughtily. He feels superior, omnipotent, omniscient, invincible, immune, above the law, and only present.

This whole complex is known as magical thinking.

The narcissist rages when he is frustrated, contradicted or confronted by people he or she consider inferior to him or her. The narcissist regards other people with contempt. This dame is unworthy.

So this is an exhaustive list. It is enough for five of these criterias to coexist in a patient, for that patient to be diagnosed with narcissistic personality disorder.

But remember, you cannot diagnose people. You cannot go around labeling them. It is not proper. You are not qualified.

It is true that narcissists rarely attend therapy, and they rarely subject themselves to diagnostic tests.

But that does not mean that it grants you the right to label them.

If you enjoyed this article, you might like the following:

Narcissist: Is He or Isn't He?

Narcissism is a spectrum of behaviors, from healthy to pathological, and the Diagnostic and Statistical Manual specifies nine diagnostic criteria for narcissistic personality disorder (NPD). A malignant narcissist is someone who has NPD and wreaks havoc on themselves and their surroundings. They feel grandiose and self-important, exaggerate accomplishments, and demand recognition as superior without commensurate achievements. They require excessive admiration, adulation, attention, and affirmation, and are interpersonally exploitative, devoid of empathy, and constantly envious of others.

Lonely, Schizoid Narcissist

Narcissistic personality disorder is often diagnosed with other mental health disorders, such as borderline, histrionic or antisocial psychopathic personality disorder. Narcissism is often also accompanied by substance abuse and other reckless and impulsive behaviors, and this we call dual diagnosis. There is one curious match, one logic-defying appearance or co-appearance of mental health disorders, narcissism, together with schizoid personality disorder. A minority of narcissists, therefore, choose the schizoid solution. They choose to disengage, to detach both emotionally and socially.

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

Asperger's Disorder can be diagnosed in toddlers as young as three years old, while Narcissistic Personality Disorder cannot be safely diagnosed until late adolescence. However, Asperger's Disorder is often misdiagnosed as Narcissistic Personality Disorder. Both types of patients are self-centered and engrossed in a narrow range of interests and activities, with severely hampered social and occupational interactions. The gulf between Asperger's and pathological narcissism is vast, with the narcissist switching between social agility and social impairment voluntarily, while the Asperger's patient's social awkwardness is an inevitability.

Narcissistic Personality Disorder Diagnostic Criteria (DSM IV-TR)

Narcissistic Personality Disorder (NPD) is an extreme form of pathological narcissism, which is one of four personality disorders in Cluster B. The International Classification of Diseases, Edition 10, does not recognize NPD as a personality disorder, while the Diagnostic and Statistical Manual, 4th Edition, text revision, provides a diagnostic criteria for NPD. The DSM defines NPD as an all-convasive pattern of grandiosity in fantasy or behavior, need for admiration or adulation, a lack of empathy, usually beginning by early adulthood and present in various contexts such as family life or work. The narcissist feels grandiose and self-important, is obsessed with fantasies of unlimited success, and is devoid of empathy.

Schizoid and Paranoid Narcissist

Narcissistic personality disorder is often diagnosed with other mental health disorders, other personality disorders such as borderline, histrionic or antisocial. This phenomenon of multiple diagnosis in the same patient is called co-morbidity. Narcissists are often paranoid and some of them are schizoid. The narcissist depends on people, but hates them and despises them. A minority of narcissists choose the schizoid solution.

DSM V Alternative Model for Narcissistic Personality Disorder (NPD)

The Diagnostic and Statistical Manual (DSM) is the bible of the psychiatric and psychological profession. The DSM-5 provides diagnostic criteria for Narcissistic Personality Disorder, but these criteria are deeply flawed and do not reflect the knowledge accumulated over the last 14 years. The DSM-5 attempts to remedy these shortcomings by proposing an alternative model of narcissism, which is more advanced than the DSM-4 but still falls short in certain areas. Overall, the DSM-5 is light years more advanced than the DSM-4 in subsuming and synthesizing current knowledge about narcissists, but there is still a long way to go.

Signs You are Victim of Narcissistic Abuse, Not Common Abuse (Stress, Depression Management Webinar)

Narcissistic abuse is a subtype of abusive behavior that is pervasive, sophisticated, and can be practiced either covertly or overtly. Victims of narcissistic abuse often experience depression, anxiety, disorientation, and dissociative symptoms. This type of abuse can lead to complex post-traumatic stress disorder (CPTSD) and even elements of post-traumatic stress disorder (PTSD). The way individuals process and react to trauma can lead to either regression into infantile behaviors or personal growth and maturation, depending on their emotional regulation and maturity.

Why Narcissists Commit Suicide? To Be Great Again!

Narcissistic personality disorder is associated with a high risk of suicide, especially during narcissistic mortification. Suicide in narcissists is not driven by depression, but rather by a desire to restore a sense of grandiosity and control. Suicidal ideation in narcissism is suffused with grandiosity and reflects an underlying cognitive distortion. The characteristics of suicidal behaviors in narcissistic personality disorder include perfectionism, lack of self-disclosure, dissociation, body hatred, and inconsistent self-representation. Suicidal ideation in narcissists is a form of acting out and a way to assert control over themselves and others.

Narcissism: Multiple Personality Disorder/Dissociative Identity Disorder?

Narcissistic personality disorder is not a form of dissociative identity disorder (DID) because the false self of a narcissist is not a full-fledged personality, as happens in DID. The false self is a mere construct, a reactive pattern, and lacks many functional and structural elements. DID alters have a date of inception, but the false self is a process without a cut-off date. Narcissism is a total, pure solution of self-extinguishing and self-abolishing, while other personality disorders are diluted versions of self-hate and perpetuated self-abuse.

Depressive Narcissist

Pathological narcissism is often considered a form of depressive illness, with the life of a typical narcissist punctuated with recurrent bouts of dysphoria, sadness, hopelessness, anhedonia, loss of the ability to feel pleasure, and clinical forms of depression. Narcissists react with depression not only to life crises but to fluctuations in narcissistic supply and to the internal dynamics that these fluctuations generate. There are several types of dysphoria and depression in pathological narcissism, including loss-induced dysphoria, deficiency-induced dysphoria, self-worth dysregulation dysphoria, grandiosity gap dysphoria, and self-punishing dysphoria. Many narcissists end up delusional, schizoid, or paranoid to avoid agonizing and knowing depression.

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