Narcissists with Aspergers?

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There’s been much written about the relationship between Aspergers syndrome and narcissism, mostly about the way they are often confused with each other (or misdiagnosed as the other disorder) due to the belief that people with Aspergers lack empathy (which is not true). I wrote about this false belief in my article, “People with Autism Do Not Lack Empathy!”

People with Aspergers may SEEM unempathic, because they are not always very good at expressing emotions or knowing how to react when other people share their emotions with them. But an Aspie’s lack of appropriate social reaction to the emotions of others doesn’t mean they can’t FEEL the emotions around them. In fact, some may feel other’s emotions MORE keenly than neurotypicals, and they can be easily overwhelmed, which may cause them to withdraw from the situation and partly account for why they may seem less engaged emotionally or uncaring about the feelings of others.

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Narcissism as an Autism Spectrum Disorder?

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Psychology Today had an interesting article comparing narcissism to high functioning autism (Aspergers) and at least one psychologist thinks they may be the same disorder!:

Khalid A. Mansour (the British Arab psychiatrist), has proposed in an article in the Pan Arab Journal of Psychiatry (link is external) that narcissistic personality may merit classification as an autistic spectrum disorder.

Dr. Mansour writes, “There is now significant level of agreement that emotional processing problems like: lack of empathy, poor self-awareness, self-centredness, poor reciprocation of emotion, poor ability to maintain emotional relationships, anxiety and anger outbursts are more or less central features of autism (10, 50,51).”

Interesting. When I first read the above paragraph, I though Dr. Mansour was writing about severe narcissism. His description fits both narcissism and autistic spectrum disorders. Hmmm.

Dr. Mansour similarly quotes from the ICM-10 listing these features of autism:

–Self-centeredness; inappropriate to developmental level and cultural expectations
–Poor self-awareness, poor ability to develop remorse or learn from mistakes
–Poor empathy or appreciation of others feelings
–Poor ability to reciprocate emotions.
–Hostile dependency on safe relations.
–Failure to develop emotional relationships appropriate to developmental level and social norms
–Treating people as objects or preferring objects over them
Again, this list certainly sounds a lot like narcissism.

Dr. Monsour concludes: “… it is noticeable that people with NPD, do not show a major degree of functioning problems in stress free environment or when they are supported (except that they are perceived as “not pleasant characters” to deal with). However under stress and without support they can become quite dysfunctional in a way not far from what we usually see in Asperger’s syndrome. “

I don’t buy it. This is the opinion of one psychiatrist. While it’s true that on the surface these two disorders may appear similar, the mechanism behind the behaviors are vastly different–in fact, almost the opposite. For the narcissist, their lack of empathy and failure to engage the emotions of others is due to their inability to feel the emotions of those around them, but they can FAKE empathy fairly well, even if they choose not to. If they are trying to obtain supply, they can be pretty good at it. Their social skills are not the problem–their inability to feel other’s emotions are. They are like actors in a play. In contrast, a person with Aspergers or high functioning autism DOES feel the emotions of others around them strongly, but lacks the social skills necessary to be able to convey this to others effectively. Unlike the narcissist, people with Aspergers are very bad actors.

But the question was, can Aspergers and narcissism occur together?

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But we’re talking here about comorbidity. The question I’ve raised is whether Aspergers and Narcissism can be comorbid with each other–that is, can someone have BOTH disorders?

The answer appears to be yes. I found this on Yahoo Answers, from a man who claims to be both a high functioning autistic AND a sociopath:

[…] people with Asperger’s can be sociopaths and or narcissists as well. “CO-MORBID” is the medical term used to describe a disability or group of disabilities that exist another disability in a single individual at the same time. It is possible to be autistic and have cerebral palsy or have aspergers and diabetes. Likewise it is also possible to have both Aspergers and mental disorders including sociopath and narcissism. Asperger’s does not exist in a bubble that protects it from co-morbid disabilities and mental defects.

I have High Functioning Autism and I also have antisocial tendencies I must always keep properly managed. I see my psychiatrist regularly. I take my medications as needed and I have trained myself to always be mindful of my darker instincts to insure they do not express themselves in disastrous ways. I have high functioniong autism but; thanks to early intervention by family, doctors and others I was made keenly aware of my antisocial ways and taught how to manage them in ways that kept everyone safe. It is the single most difficult thing I do in life to keep my antisocial ways well managed but; having seen the monster I become when enraged is motivation enough to keep me always vigilant.

There’s no reason why the disorders couldn’t exist together. Personally, I’ve never known anyone with both disorders, but that doesn’t mean they don’t exist. Using a fictional example, I’m going to speculate here what the behavior of a narcissist with Aspergers might be like.

The Case of Mark F.

Depressed Forty Year Old Man Drinking Alone

Mark F. always had trouble making friends. In grammar school he was bullied due to his inability to fit in with others or show empathy. He was socially awkward and never seemed to know the right thing to do or say. Mark not only was unable to show appropriate reactions in social situations, but rather than suffer in silence and wonder why others didn’t understand or like him (as most Aspies do), he didn’t care about the feelings of those around him. He was easily hurt by the bullying, but reacted in rage due to these narcissistic injuries to himself. He’d lash out at those who injured him and didn’t care if he hurt someone else.

As Mark grew older, he had difficulty keeping a job, not only because of his inappropriate, almost schizoid affect that was very offputting to those around him, but also because he deliberately caused pain to others with his frequent insensitive insults. Due to his Aspergers, Mark lacked the social skills to be able to effectively use the more subtle narcissistic “tools” such as gaslighting or triangulation against others, but he was very good at blame-shifting and projecting his character defects onto those around him. Lacking the social skills to know what behaviors were appropriate, he’d “go off” on those in authority, and was frequently fired from his jobs for insubordination, gossiping openly about his coworkers, missing work due to debilitating hangovers (more about this in the next paragraph), and starting fights.

Mark never married. Though good looking, due to his poor social skills and openly hostile attitude (he was unable to mask his anger, resentment and envy of others), his dates never developed into relationships. No woman would stay with him longer than a few weeks. He had no friends and resorted to frequent drinking to cope with his loneliness.

As you might imagine, Mark was miserable. He constantly felt victimized. He was frequently depressed and wondered why he couldn’t get others to cooperate with his need to use them for supply. In his frustration and envy of all those around him for their “better social skills,” Mark tried to self-medicate by drinking heavily and his frequent drunkenness only served to exacerbate his rages and cause his work attendance to be poor.

Having both disorders would be a recipe for extreme misery. Mark’s behavior is just one way narcissism comorbid with Aspergers could manifest itself. An effective narcissist must possess good social skills to be able to charm others into trusting them and to use their “bag of tricks” in an effective way, and therefore an Aspie with narcissism wouldn’t be particularly dangerous, just very unlikeable. Therefore, I don’t think it would be probable that an Aspie could be a “malignant narcissist” but they certainly could be suffering from NPD. A person with both disorders would have zero charm and therefore not have many opportunities to use others the way a narcissist with good social skills could. My feeling is substance abuse would be a huge problem for such a person, in their attempt to make life more bearable. For those not resorting to substance abuse or alcoholism, severe depression or even suicidal ideation could result.