The elimination of NPD from the DSM would be a disaster


Apparently, the removal of Narcissistic Personality Disorder (DSM-V code 301.81; ICD-10 code F60.81) from the Diagnostic and Statistical Manual of Mental Disorders is still being considered.   Sam Vaknin talks about it in this video.

I think its removal would be disastrous. It already scares me that narcissism seems to be increasingly regarded as an advantage in today’s winner-take-all society and that we even have a potential US President who is a poster boy for malignant NPD. Trump has even been given the NPD label by many mental health professionals. Yet he still remains popular and is a serious contender for our next President.

But narcissism (not the healthy, but the pathological type) is definitely not a positive thing. Narcissists are actually miserable people even if they become successful (and many of them do not). These are people without a real sense of self, who have constructed a false one to compensate and must feed off others like vampires to keep their false self intact. They do others a lot of damage, even if they think they don’t have a problem. Under the facade, these are people who have a vast well of emptiness inside and if the false self is removed through loss of narcissistic supply, will become deeply depressed, possibly psychotic, and even suicidal. NPD is a serious mental illness, but I think people tend to forget that, because on the surface, people with this disorder can seem so functional. SEEM is the operating word here.

Many self-help books, especially those that tell you how to be successful, encourage you to develop narcissistic traits. I think these books are dangerous, not only because they encourage people to become narcissists, but also because they have caused a shift in thinking about NPD to the point that many no longer consider it a mental illness and in fact think of it as something to strive for. We need to stop pretending narcissism isn’t a problem. More attention needs to be paid not only to the damage narcissists cause others, but also to the internal world of the NPD, which is a painful and bleak one. NPD is a serious mental illness, not a “personality type.” Its removal from the DSM would cause untold damage to the world.

We also need more mental health specialists who are actually trained to treat people with NPD. I think part of the reason why it’s under consideration for removal is because most therapists don’t want to treat people with NPD. If you have the diagnosis, you are shown the door. They don’t want to deal with you and assume you are incurable. Hence, there are more narcissists walking around doing damage to themselves and others than ever before. I don’t think the non-malignant type of narcissist is as incurable as people think; it’s just because it isn’t an easy disorder to treat and therapists don’t want to be bothered working with people who have it. Old-school psychiatrists and psychologists such as Kohut, Kernberg, Masterson, and Lowen treated people with NPD successfully in their practices, but we seem to have forgotten that and just assume it’s incurable and worse, that it’s not even a mental illness but a personality type. This needs to change!


21 thoughts on “The elimination of NPD from the DSM would be a disaster

  1. Did Sam say they are thinking of combining the Cluster B “disorders” into one? That doesn’t strike me as all that crazy as they really do seem to bleed into each other. You kind of do it when you describe “malignant” narcissism as merging into or becoming ASPD or sociopathy/psychopathy. I, myself, see lots of histrionic traits in myself which seem to flow into narcissism without much difficulty. As distinguished a person as Robert Hare has questioned whether psychopathy is a “disorder” when he said, “Psychopaths are not disordered. They don’t suffer from a deficit, but they’re simply different”. I am planning a blog exploring the whole concept of “mental illness” from a critical perspective. The idea that the function of our minds can be defective in the same way our physical bodies can deserves some scrutiny if for no other reason because we can say with a great deal more certainty what a healthy body looks like. What a healthy mind looks like involves philosophy and can be debatable.

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    • Cluster B disorders do share similarities (which is why they are grouped together), but there are very distinct differences and are not the same! Treatments for one may not work for another. In a narcissist, for example, a therapist must work toward breaking through the mask before any real progress can be made; this is probably not necessary for someone with BPD, who does not have a true mask. I definitely do not think they should all be grouped as the same disorde, and I think that would make the stigma for all of them even worse than it is. Borderlines in particular would be hurt, since in most cases, BPDs are the most amenable to therapy and have the most empathy for others and can be treated more easily than the other cluster Bs–they are already associated too closely with NPDs and ASPDs in my opinion; to put them all in the same group would re-stigmatize people with BPD.


  2. I just watched the video. It was a bit difficult for me to follow what Sam Vaknin was saying, because of his accent. Also, my hearing isn’t as good as it used to be. But I believe Sam said that abolishing the different personality disorders would be a good thing, because the symptoms blend into one another. Is that correct?

    If so, then maybe we need to abolish the color green, since it is only a blend of blue and yellow.

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  3. Agree 100%!!! Good post. I had read about that too and it frightened me to no end. It is bad enough that most narcissists do not even get diagnosed and their victims are never taken seriously… If the diagnosis would go, it would be horrible for all the victims of narcissists, they wouldnt have any model of explaining or understanding what happened to them. Thanks for raising awareness about this. ⚘

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  4. Sooooo….. let me get this straight. Since there are soooo many dangerous personalities in society today, all of a sudden these people are not a danger to themselves and others?

    It kind of reminds me how they eliminated gender dysphoria, also proven to be triggered by trauma in early childhood development, when transgenderism became “trendy”. (Even though going through with gender change surgery still dramatically increases risk of suicide and comorbid complications..)

    Modern Freudian psychiatry (no moral absolutes) stopped trying to unravel patients from childhood trauma, even though old fashioned Thomistic psychiatrists cured many mental patients without drugs for years doing patient unraveling.

    The acceptance and promotion now of self help therapies designed to destroy that nasty little bugger, human empathy, by suppression of expression of grief, sorrow and just anger for oneself and others, is horrific. It’s like we are breeding a new army of little Trumps, to take over the world. I don’t know if you can wade through it (it’s lengthy) but my blog on David Clayton is an expose of how he slipped this cultish brainwashing technique right into so called Catholic schools of thought. He even has his clients memorizing simple lies, like sorrow (empathy for oneself and others) is really resentment, and creating oratory courses for home schooling families.

    Of course when I wrote a critique of his work, I was the one called “disturbing.”

    In other words, people who have charity for themselves and others are the new “bad” people.

    This is so creepy I cannot believe only those of us victimized by dangerous individuals is noticing the seriousness of it all. What, are they going to strike sociopaths from the DSM, even though they, even more, according to criminal psychiatrists, are the most dangerous personalities in the world?

    Just for the record, I think Trump is one. If he gets to be president he’ll probably find a way to say those who mind being victimized by criminal sociopaths are just sociopathaphobic.

    Because there are more sociopaths in the world than diabetics.

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    • Let me add that a possible reason Freudian (atheism biased) psychiatrists are eliminating any disorders that contain a pathological lack of healthy empathy, is because humans having empathy in the first place is something that can’t be explained with an atheist evolutionary bias. Mere mammals do not have it as humans do.

      There is simply no evolutionary survival of the fittest evidence for empathy to have been a continuing trait. If you’ve ever heard Richard Grannon trying to explain how empathy “evolved” your head will pop off. It’s like well, we inherit this instinct from a parent molecule by mistake, to self sacrifice to our own evolutionary detriment, for a herd of cells so they can evolate living across the ocean, instinctively.

      No. Human empathy points to there being a non genetic difference between all mere mammals and human beings, and a more than physical connection between all human beings. In other words, a God.

      This could be why they are simply getting rid of calling those who lack it sick.

      By the way, what was that “kind” of empathy Sam Vaknin speaks of that narcissists have? Started with an L, but I couldn’t understand him. It’s so funny watching him, in a rather triggering way, because though he doesn’t look the same, he “looks” the same when he speaks, his mannerisms or lack there of in his face, like my narcissist ex. Does anyone else see a resemblance to narcissistic or sociopath people they knew, or is it just me?

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      • He does sound like a robot, doesn’t he? 😆 He shows very little emotion in his videos.
        As for your last question, I think malignant narcs have NPD + ASPD, so they are sociopathic/psychopathic too.
        I hope you are not right about the reason why disorders involving lack of empathy are considering being eliminated. Why not then Schizoid PD, which is also characterized by a lack of empathy? Or even Aspergers (though I think the problem with Aspies is that they have a lot of emotional empathy so they can FEEL the emotions of others, but they lack cognitive empathy which would enable to them be able to react in socially acceptable ways). I don’t really know. I also wonder what would happen to the criminal justice system, since many sentencing decisions are based on whether the defendant has a mental illness (schizophrenia, bipolar, major depression, etc.) or a “character disorder” (the cluster B disorders and psychopathy, mainly). In courts, having a character disorder is very damning.
        Maybe the plan is to make these disorders more legal terms rather than psychiatric terms, and they will re-appear in the law books? But that would really hurt those BPDs and low level NPDs who are not evil and don’t commit crimes and make the stigma even worse.
        I don’t have the answers. I wish I did.


        • I do not know for sure if I’m right about causes but do note that modern psychiatry “seems” to be heading toward “normalizing” or “trivializing” the most dangerous non empathetic personalities, (if what Vaknin says is true) while at the same time empathy is being eliminated through structured “self help” pop gurus. To me it’s so unbelievable I cannot even think about it. Unless psyches are, as you say, just relabeling . Perhaps Sam as a narc overstates therapists desire to “give up on treating narcs” because they are so hard to treat. Think about it, malignant narcs like to present as “winners” even if they come off sounding bad for it. (Look at Donald Trump. ) There is something about Vaknin I do not trust, as if he’s playing nice so he can really control our opinion of narcissists. Maybe narcs DO and are getting helpful treatment all the time and he has an agenda to downplay their successes. Narcissism must win! What do you think?

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          • I’m not sure. It’s possible. Theres no way to know for sure. I’m not sure if I trust Vaknin or not either. Many people think he has some kind of agenda, but I don’t know what that could be. Really, I think his only agenda is making money for himself and being a sort of “guru.” Nothing more than that. He doesn’t do it because he cares about helping anyone, that’s for sure. Even he’s said so much.

            As for Trump? He’s in trouble right now, for some things he said about women back in 2005. I certainly hope people get smart and don’t cast their vote for him.


            • I guess what a mean about Sam is he’s well, narcissistic. So his “agenda” if you will, would be to overstate the effects of being narcissistic, that narcissism has on therapists, as if they use therapists for supply too. In layman’s terms, narcissism is a big ego, right? As for Trump I think he’s one of the most dangerous underestimated sociopaths around. He has made it “ok” even popular to show contempt for other human beings in the most repugnant and dehumanizing was possible. He has made everyone who disagrees with Hillary look like a knee jerk angry lying buffoon. I still think they are shills for one another.

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            • I don’t care much for either candidate. I don’t like either one of the parties. I have to hold my nose voting for Hillary but I’ll vote for her as a vote against Trump.
              Vaknin admits he does what he does for narcissistic supply.


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