Monday, 28 July 2014

A few responses to N personality disorder blogs

I have written elsewhere of my view that much popular writing on narcissistic (N) psychopathology and N personality disorder satisfies itself with making of disordered individuals demons and evil-doers.

Typically writers employ language of ownership of personality disorder which conveys the idea that what is, for N-disordered individuals, a pervasive, wall-to-wall psychological defence (against narcissistic injury), is consciously deployed by a thinking and fully aware self somewhere "behind the scenes"; a homunculus operating a mask known as the "false self".
Adopting this language gives writers (and readers) the satisfaction of seeming objective and simultaneously presenting the N as outright wicked.

This kind of language is, in my view, inappropriate and inadequate to conveying the nature of disorder. My main reason for objecting to it is that I believe Donald Winnicott was right to identify a "false self" as emerging (in adverse conditions of infancy) where the true self ought to be. So, for a N to become aware of themselves as N-disorder, that is, become aware of their own psychopathology, is for them to become aware that the true self is lost, and was lost at some time in (early) childhood. Experiencing this loss and being able to feel sadness over it could be the beginnings of someone recovering from N-disorder.

I do not wish to excuse N-disordered individuals, or N-abuse. Personality disorder is a social phenomenon, and creates massive suffering for individuals and those with whom they are close. I say: don't put up with N abuse! Seek professional help! But after the rage and hurt and anger we may feel, compassion is called for.

Since 2012, when I first encountered it, I have been mindful of the work on personality disorder by Dr Hanna Pickard of Oxfird University. In a nutshell, her work encourages a clinical and general stance towards personality disorder (or what, significantly, she calls "disorder of agency") that stresses an individual's responsibility for harmful behaviours but without blame. For example, in her paper "Responsibility without blame: philosophical reflections on clinical practice" (Oxford Handbook of Psychiatry and Philosophy, OUP), Dr Pickard points to disordered individuals' awareness of their harmful behaviours. They have "conscious knowledge" of these behaviours and it is therefore right to assert that they have choice to desist from them. But Dr Pickard also makes it clear that by "conscious knowledge" she does not intend that disordered individuals necessarily know "why" they might behave in those harmful ways, or what those behaviours might be achieving in terms of protecting them against (for example) narcissistic injury.

[Dr Pickard is an analytic philosopher and clinician (psychotherapist). I seem to remember some of her writing addressing a problem that may be a characteristic pre-occupation of that school of philosophy, i.e. the question whether or not minds exist. It's never occurred to me to doubt that other minds exist. My view is informed by the practice of psychotherapy, in which "self-objects" (aspects of one's mind, one's personality) may be acquired through a therapeutic relationship that enable psychological growth. This points to some sort of merged infant-mother mind in early life. How can any mind be without other minds to act as it's container?]

So here are some responses I have given on the culprit blogs I have stumbled over. The comments I made appear out of context (I won't identify the blogs themselves), so it may be tricky to understand what I have been responding to. But the gist of my comments has been towards denying the idea that there is, in the N-disordered individual, someone else present behind the mask who, therefore, must be evil-doing.

In response to a blog on what James F Masterson called "Closet" Narcissistic Personality Disorder:

The word "malign" accurately describes the effect of personality disorder on lives. Unfortunately, it also encourages the idea that PD sufferers are also "malign", that they are self-conscious, that behind the narcissistic "false self" there is another, conscious self, manipulating things. I appeal to readers of this blog, which has attracted thoughtful comments, to consider that there is no self-consciousness in NPD sufferers (whether of the "closet" or "overt" kind). The damaging thought-feeling-behaviour patterns are sub-consciously driven. In total they are geared towards maintaining self-esteem, getting external validation/love/admiration of a false-self-image. The false self emerges in response to unempathic parenting (usually a mum who has her own un-met narcissistic needs). Disordered individuals lack real self-esteem, lack self-love, which is the same thing as lacking authentic "self" - something virtually unimaginable if not directly experienced. Personal setbacks, contradicting the false-self-image of the NPD sufferer, may drive the individual to seek psychotherapy. It's only in the therapeutic environment that the individual can achieve (with great pain) self-awareness, i.e. awareness of the disorder.

The blog author maintained that CN's "are aware of their traits but choose to repress them out of  denial which is one of the main characteristics of the disorder".
I responded with the following comment.

You are right to say that cheating on one's partner and maintaining a double life could not appear to an individual as anything other than wrong, whether they have a narcissistic personality disorder or not. (I would encourage anybody whose partner cheats to not tolerate the behaviour in any way. The same goes for any kind of "narcissistic" abuse - "passive-aggressive" or anything else - in a relationship. Don't put up with it!).
The denial and stress and tears and overall defensiveness, when challenged, reflects the anxiety induced when the N's false self-image is threatened.
(I would say that in "overt Ns, this image is typically of superiority or "greatness", in "covert" Ns, it is typically of perfection or saintliness. See V. Tonay at )
The intense anxiety is because there is nothing "behind" that self. If it goes, then there is nothing. For such a person, the false self has been a way of surviving childhood that has continued into adulthood. That self cannot be simply discarded, because no other (empathic) ways of relating are known.
You are right that CNs (and ONs) are aware of their traits. But the manner of speaking suggests the kind of awareness of a person who knows he is vain, or a perfectionist, or big-headed.
Thus, I would say, such a person, if he or she is an N, is aware of the traits of the false self.
But that, I would say, is very different to awareness that the self is a disordered or false self.
To put it another way, I am precisely saying that the N is unaware of the behaviours as narcissistic in the special sense of their being pathological.
Such self-awareness can only come through breakdown and psychotherapy.
I realise this sounds like I'm splitting hairs and I acknowledge that to highlight the lack of self-consciousness in Ns appears to "give them an excuse" to carry on or even encourages them to keep up their bad behaviour. I certainly don't intend this. But neither do i think it makes much sense to speak in those terms.
When I see a mum constantly using her children like objects to win admiration for herself, I might say to myself "Hm. Narcissistic abuse of the children". But I would be pretty sure that the mum feels, and would say, she is loving the children, and is precisely unconscious of the underlying compensation going on (i.e. her lack of self-love that compels her to derive others' admiration from things around her that she can say are "hers"). With that kind of lack of self awareness, the individual would not perceive some anonymous writing in a blog about narcissists' lack of self-consciousness as an "excuse" to continue the abusive behaviour. The N mum simply continues to "love" (pathologically). My point is that there is no conscious abuser there, but a person who thinks and believes her behaviour to be "normal".
My aim, in contributing to this blog, is to empower people in narcissistic or co-dependent relationships to not put up with abuse. Little children who are treated unempathically by parents can't not put up with it, they have to adapt to it in order to survive. The people who tolerate narcissistic abuse in a relationship, but stay in the relationship, must be getting some sort of compensation to make it worth while. Both partners, in this way, collaborate to maintain the status quo. (I'm saying that that's what goes on in co-dependency and other forms of damaging love relations. It might be asked here: to what extent would the abused partner of an N accept that he or she was self-consciously enabling the abuse?). If the abused partner has the strength to leave, or to challenge the abuse, that is a very powerful and potentially empowering act. (It might even bring about a change in the N). It is predictable, and understandable, that those who have been abused should demonise the abusers. But we should recognise that this reaction may itself be a form of denial of the part we have had to play in enabling (or, if you like, "excusing") the abuse.
I do not wish to excuse abuse, or let Ns off the hook. My aim is to shift the tone of discussion away from "good" and "bad" polarisation, towards a point of view that sees pathological narcissism as something that occurs in a thousand small ways (not just in violence and infidelity, though these are the extreme and horrible manifestations of abuse), and as a function of socialisation, in which we are all, to some degree, involved.

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