Narcissistic Personality Disorder Won’t be in the DSM-V…Oh Heaven Forfend!

Let the outcry begin.

There will be no Narcissistic Personality Disorder (NPD) in the DSM-V. I know, horrifying. But before we take to our torches and maces and 2 x 4’s with nails in them to destroy the committee chairman’s house, let’s consider what this really means. Here’s a preview: nothing.

The people who really care about this deletion in the newest text of mental disorders are:

1) Freudians (who get off on diagnosing the “non-symptom” disorder)

2) Academicians (who will have trouble conducting research studies without a definitive set of criteria to measure their subjects)

3) Perhaps some drug companies who are seeking the “cure” to a personality disorder that most people simply describe as “being an asshole.”

That’s basically it. No one else.

Make no mistake: I’m of the belief that someone so grandiose, self-absorbed and completely out of touch with a realistic sense of his abilities should be characterized as having a psychological pathology. But consider the following:

A clinician is in his office. The patient presents with all of the symptoms formally known as NPD. The shrink strokes his chin and says, “hmmm…this patient seems to have an inflated sense of self that doesn’t coincide with his actual potential. He also believes he is special and hyper-focused on fantasies of success and power. He also lacks empathy, is quite arrogant and takes advantage of others. I think this might be a problem for…wait! That’s not in the DSM-V! Good thing I remembered that. Let’s just drop this whole line of thinking altogether.”

How likely is that to happen? What therapist worth his salt is going to disregard pathological personality structure and behavior, simply because it’s not written in the manual? Clinicians will still be attuned to this issue and address it according to appropriate treatment protocol, whether it has shone its face or not in the false bible that is DSM-V. That is the critical difference between the voices you hear coming out of institutions of higher learning and what the rest call “real world” psychology.

So some may believe apologies are in order to the mental masturbating scholars out there who really have no clue how to actually help a person with his/her life and are instead confined to diagnosing and overanalyzing with no end in sight, simply because the manual has been altered. But to those who are wailing bloody disappointment about the edits for this version’s DSM: until you really grasp with what the manual is really all about, you’re just screaming into a void.

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7 Responses to “Narcissistic Personality Disorder Won’t be in the DSM-V…Oh Heaven Forfend!”

  1. An_Irish_Brit says:

    I’d hazard a guess that the vast majority of clinicians were probably diagnosing people as having narcissistic personality ‘traits’ rather than a ‘disorder’ to begin with. Nothing’s missing. I agree, patients will continue presenting with the same symptoms and treatment to address this will continue much as it always did. However, the REAL challenge for the psyc. community is going to come when treatment begins for the new NPD that replaced it: the notoriously difficult to treat Narcissistic Professor Disorder.

    P.S. Bloody good use of the word ‘bloody’, Rob.

  2. Tanya says:

    In the handful of jobs I’ve had as a psychology peon, the only personality disorders I’ve seen diagnosed are borderline and antisocial. Half the time all a woman has to do to get a borderline diagnosis is be irritating.

  3. John says:

    I predict the biggest number of complaints at NPD being omitted from DSM V will not be coming from professionals involved in the treatment of these disorders. A simple google of the term will result in literally hundreds of “anti-NPD” boards and forums. They often make fascinating reading, but from my own experience seem to largely consist of people (mainly women) trying to pin a label other than “what a bast*rd!” on someone (usually male) who has upset them or rejected them in some way. I would not be at all surprised if one of the motivating reasons for the APA to consider abolishing this term is the fact that it now seems to be used as just a general term of abuse for someone we do not like.

  4. Lee Bunzey says:

    The end of narcissism??? No!!!!!!

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  6. Have Sex says:

    I cannot understand how people can read this and not think “genius alert”. Great work. I’ll keep coming back to read even more.

  7. Kurt says:

    Borderline personality disorder and bipolar are often mistaken as being the same thing. They are also often misdiagnosed, one for the other. This is because the symptoms for both illnesses are startlingly similar.Borderline personality disorder is actually less common and less known than bipolar. Borderline personality disorder accounts for only about twenty percent of hospitalizations for mental illness each year, while bipolar accounts for about fifty percent of hospitalizations. Borderline personality disorder is most common in young women, whereas bipolar is equally common in both men and women, as well as all age groups.^

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