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Narcissists and Negativistic (Passive-Aggressive) Personality Disorder

Uploaded 10/22/2010, approx. 3 minute read

I am Sam Vaknin, and I am the author of Malignant Self-Love, Narcissism Revisited.

The negativistic, passive-aggressive personality disorder is not yet recognized by the committee that is cobbling together the diagnostic and statistical manual. The disorder makes its appearance in Appendix B of the DSM, titled Criteria Sets and Access, provided for further study.

Some people are perennial pessimists. They have what you may call negative energy. They have negativistic attitudes. Such people say, good things don't last, or it doesn't pay to be good, or the future is behind me.

Not only do these people disparage the efforts of others, but they make it a point to resist demands to perform in workplace and social settings. They make it a point to frustrate people's expectations and requests, however reasonable and minimal they may be.

Such persons regard every requirement and assigned task as impositions. They reject authority. They resent authority figures, such as bosses, teachers, or parent-like spouses.

They feel constantly shackled and enslaved by commitment. They oppose relationships that bind them in any manner.

Passive aggressiveness wears a multitude of guises. Procrastination, malingering, perfectionism, forgetfulness, neglect, truancy, intentional inefficiency, stubbornness, and outright sabotage.

This repeated and advertant misconduct has far-reaching effects and consequences.

Consider the negativist in the workplace. He or she invests time and efforts in obstructing their own chores and in undermining workplace relationships and the functioning of others.

But these self-destructive and self-defeating behaviors wreak havoc throughout the workshop or the office.

People diagnosed with a negativistic passive-aggressive personality disorder resemble narcissists in some important respects.

Despite the obstructive role they play, passive-aggressives feel unappreciated, underpaid, cheated, discriminated against, and misunderstood. Passive-aggressives chronically complain, whine, carve, and criticize. They blame their failures and defeats on others. They pose as martyrs and victims of a corrupt, inefficient, and heartless system.

In other words, they have alloplastic defenses and an external focus and locus of control.

Passive-aggressives sulkand they give the silent treatment in reaction to real or imagined slights. They suffer from ideas of reference. They believe that they are the part of derision, contempt, and condemnation. And they are mildly paranoid. They entertain these notions that the world is out to get them.

And this explains, of course, their personal misfortune.

In the words of the Diagnostic and Statistical Manual, passive-aggressives may be sullen, irritable, impatient, argumentative, cynical, skeptical, and contrarian. They are also hostile, explosive, lack impulse control, and sometimes they are reckless.

Inevitably, passive-aggressives are envious of the fortunate, successful, famous, their superiors, those in favor, and the happy. They vent this venomous jealousy openly and defiantly whenever given the opportunity.

But deep at heart, passive-aggressives are craven. When reprimanded or confronted, they immediately revert to begging forgiveness, kowtowing, maudlin protestations. They turn on their charmand they promise to behave and perform better in the future.

Of course, to no avail.

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Passive-Aggressive (Negativisitic) Patient Therapy Notes

Negativistic or passive-aggressive personality disorder is not formally recognized in psychiatric diagnoses but is commonly treated by practitioners. In a simulated therapy session, Mike, a 52-year-old man, displays emotional detachment and resentment towards his wife's demands, viewing therapy as a con. He expresses feelings of being unappreciated at work and copes by ignoring those he deems unworthy, admitting to sulking and engaging in arguments. Despite acknowledging his behavior, he remains dismissive and contemptuous towards the therapeutic process.


Shyness or Narcissism? Avoidant Personality Disorder

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Pathologizing Rebellious Youth: Oppositional Defiant Disorder (ODD)

The Diagnostic and Statistical Manual (DSM) labels rebellious teenagers with oppositional Defiant Disorder, which is a pattern of negativistic, defiant, disobedient, and hostile behavior towards authority figures. The DSM's criteria for this disorder are arbitrary and subject to the value judgments of adult psychiatrists, psychologists, social workers, and therapists. The diagnosis of oppositional Defiant Disorder seems to put the whole mental health profession to shame, and it is a latent tool of social control. If you are above the age of 18 and you are stubborn, resistant to directions, unwilling to compromise, give in or negotiate with adults and peers, you stand a good chance of being diagnosed as a psychopath.


MD (Most Dangerous) Narcissists of All: Medical Doctors, Physicians

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Borderline Personality Disorder Patient Therapy Notes

Do is a 26-year-old female diagnosed with borderline personality disorder. She struggles with maintaining a stable sense of self-worth and self-esteem, and her confidence in holding onto men is low. She has had six serious relationships in the past year, all of which ended due to violent fights over trivial matters. Do admits to physically assaulting three of her ex-partners and has suicidal ideation, which sometimes manifests in minor acts of self-injury and self-mutilation. She also struggles with drug use, shopping addiction, and binge eating.


Borderline's Miracle Healing

Borderline personality disorder (BPD) is less prevalent than commonly believed, affecting about 1-2% of the general population, yet it accounts for a significant portion of mental health treatment cases due to crises. The prognosis for BPD is generally positive, with many individuals experiencing spontaneous remission or significant improvement through therapies like Dialectical Behavior Therapy (DBT), leading to a high percentage of patients no longer meeting diagnostic criteria over time. While symptoms related to impulsivity and behavior tend to remit more quickly, some underlying traits and dysfunctional behaviors may persist even after the disorder itself has resolved. Effective treatment should not only address the core symptoms of BPD but also focus on helping individuals develop functional skills for social and vocational success, particularly in younger populations.


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.


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PCL-R (Psychopathy Checklist Revised) Test

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