Letter no 3 November 1, 2004
We had agreed to keep out any personal experiences in our
exchanges, but it is very hard to intellectualize, at least for
me, my interactions with narcissistic people and NPDs. So I hope
you will allow me to temporize, to talk about two experiences
that illustrate how difficult it is to communicate with other
people, especially NPDs. Not being a psychiatrist I cannot make
a legitimate diagnosis.
Don't worry about it. You are in good company. Though first
proposed by Freud in 1915, the construct of pathological
narcissism didn't make it into the DSM - the bible of the
psychiatric profession in North America - until 1980! Even now,
the ICD-10, published by the World Health Organization (WHO),
and used throughout the rest of the world, contains no separate
mental health diagnosis of narcissism! As far as Europe, Asia,
and Africa are concerned, NPD still does not exist!
Moreover, narcissism is still very difficult to diagnose,
even by seasoned professionals. In many cases, it is comorbid
with other mental health disorders. Often, Asperger's
Disorder and Bipolar
I are misdiagnosed as NPD!!!
Now I have no idea if the two people I am going to mention
suffer from Narcissistic Personality Disorder, or not. They may
have been having a bad day, week or year. As they were women,
it could be blamed on PMS or the moon, but I hate to dismiss
women in that manner, and think they are equal to men, and equally
responsible for their actions.
The first incident took place years ago. I was a student
and this woman and I socialized in class. I thought there was
a Platonic relationship developing, or at least camaraderie,
but instead she told me she could tell by my "non-verbal"
communication that I liked her, and even more. After inviting
her to my home for a party of friends, so that she could meet
my wife and son, she persisted in this strange obsession with
me. I finally told her where to get off, and essentially told
her she was a liar.
Now, years later, she has published a book on how to tell
if people are lying. I have not read it, but during a TV interview
she read parts of it, and in the final pages she had written
that people begin lying by lying to themselves.
How true. It gave me some satisfaction that I might have
inspired the book, though I doubt it, and that maybe she had
gained some 'self-reflexivity".
For all I know, she may be following the same behaviors
with other people.
Now in her case, and with some hindsight, I wonder if she
did not suffer from 'border line personality' disorder. Such
cases tend to be self-disillusioned; they think people who are
kind to them are in reality in love with them. They then reject
people they are involved with. They play a sort of love-hate
dance, with the refrain playing in the background of, "I
love you, go away." The actress Glen Close played a 'border
line' in the 1987 movie, Fatal Attraction.
Narcissists are often self-delusional.
Don't get me wrong, I think that confabulations are an important
part of life. They serve to heal emotional wounds or to prevent
ones from being inflicted in the first place. They prop-up the
confabulator's self-esteem, regulate his (or her) sense of self-worth,
and buttress his (or her) self-image. They serve as organizing
principles in social interactions.
Father's wartime heroism, mother's youthful good looks, one's
oft-recounted exploits, erstwhile alleged brilliance, and past
purported sexual irresistibility - are typical examples of white,
fuzzy, heart-warming lies wrapped around a shriveled kernel of
But the distinction between reality and fantasy is rarely
completely lost. Deep inside, the healthy confabulator knows
where facts end and wishful thinking takes over. Father acknowledges
he was no war hero, though he did his share of fighting. Mother
understands she was no ravishing beauty, though she may have
been attractive. The confabulator realizes that his recounted
exploits are overblown, his brilliance exaggerated, and his sexual
irresistibility a myth.
Such distinctions never rise to the surface because everyone
- the confabulator and his audience alike - have a common interest
to maintain the confabulation. To challenge the integrity of
the confabulator or the veracity of his confabulations is to
threaten the very fabric of family and society. Human intercourse
is built around such entertaining deviations from the truth.
This is where the narcissist differs from others (from "normal"
His very self is a piece of fiction concocted to fend off
hurt and to nurture the narcissist's grandiosity. He fails in
his "reality test" - the ability to distinguish the
actual from the imagined. The narcissist fervently believes in
his own infallibility, brilliance, omnipotence, heroism, and
perfection. He doesn't dare confront the truth and admit it even
Moreover, he imposes his personal mythology on his nearest
and dearest. Spouse, children, colleagues, friends, neighbors
- sometimes even perfect strangers - must abide by the narcissist's
narrative or face his wrath. The narcissist countenances no disagreement,
alternative points of view, or criticism. To him, confabulation
The coherence of the narcissist's dysfunctional and precariously-balanced
personality depends on the plausibility of his stories and on
their acceptance by his Sources of Narcissistic Supply. The narcissist
invests an inordinate time in substantiating his tales, collecting
"evidence", defending his version of events, and in
re-interpreting reality to fit his scenario. As a result, most
narcissists are self-delusional, obstinate, opinionated, and
The narcissist's lies are not goal-orientated. This is what
makes his constant dishonesty both disconcerting and incomprehensible.
The narcissist lies at the drop of a hat, needlessly, and almost
ceaselessly. He lies in order to avoid the Grandiosity Gap -
when the abyss between fact and (narcissistic) fiction becomes
too gaping to ignore.
The narcissist lies in order to preserve appearances, uphold
fantasies, support the tall (and impossible) tales of his False
Self and extract Narcissistic Supply from unsuspecting sources,
who are not yet on to him. To the narcissist, confabulation is
not merely a way of life - but life itself.
We are all conditioned to let other indulge in pet delusions
and get away with white, not too egregious, lies. The narcissist
makes use of our socialization. We dare not confront or expose
him, despite the outlandishness of his claims, the improbability
of his stories, the implausibility of his alleged accomplishments
and conquests. We simply turn the other cheek, or meekly avert
our eyes, often embarrassed.
Moreover, the narcissist makes clear, from the very beginning,
that it is his way or the highway. His aggression - even violent
streak - are close to the surface. He may be charming in a first
encounter - but even then there are telltale
signs of pent-up abuse. His interlocutors sense this impending
threat and avoid conflict by acquiescing with the narcissist's
fairy tales. Thus he imposes his private universe and virtual
reality on his milieu - sometimes with disastrous consequences.
There is another possibility. She may be an erotomaniac. If
I am right and she is, you are one lucky target. It often takes
years to shake off an erotomanic stalker. Telling them off is
On the other hand, maybe she isn't so pathological. Simply
a lonely, narcissistic, and self-deluded personality. As you
correctly observe, in my view, Borderline is also a strong possibility.
The erotomanic stalker believes that she is in love with you.
To show her keen interest, she keeps calling you, dropping by,
writing e-mails, doing unsolicited errands "on your behalf",
talking to your friends, co-workers, and family, and, in general,
making herself available at all times. The erotomaniac feels
free to make for you legal, financial, and emotional decisions
and to commit you without your express consent or even knowledge.
The erotomaniac intrudes on your privacy, does not respect
your express wishes and personal boundaries and ignores your
emotions, needs, and preferences. To her, "love" means
enmeshment and clinging coupled with an overpowering separation
anxiety (fear of being abandoned). She may even force herself
upon you sexually.
Moreover, no amount of denials, chastising, threats, and even
outright hostile actions will convince the erotomaniac that you
are not in love with her. This is why I am not sure about your
The erotomaniac knows better and will make you see the light
as well. You are simply unaware of what is good for you, divorced
as you are from your emotions. The erotomaniac determinedly sees
it as her task to bring life and happiness into your dreary existence.
Thus, regardless of overwhelming evidence to the contrary,
the erotomaniac is convinced that her feelings areÃ‚Â reciprocated
- in other words, that you are equally in love with her. The
erotomanic stalker interprets everything you do (or refrain from
doing) as coded
messages confessing to and conveying your eternal devotion
to her and to your "relationship".
Erotomaniacs are socially-inapt, awkward, schizoid,
and suffer from a host of mood and anxiety disorders. They may
also be people with whom you have been involved romantically
(e.g., your former spouse, a former boyfriend, a one night stand)
- or otherwise (for instance, colleagues or co-workers). They
are driven by their all-consuming loneliness and all-pervasive
Consequently, erotomaniacs react badly to any perceived rejection
by their victims. They turn on a dime and become dangerously
out to destroy the source of their mounting frustration - you.
When the "relationship" looks hopeless, many erotomaniacs
turn to violence in a spree of self-destruction. This hasn't
been the case here.
One comment on a message board about the character she
plays in the movie Fatal Attraction goes like this:
Jeez Alex why would you want a sleaze like him anyway?
Obviously she was suffering from some mental disorder because
there is no other way to explain such extreme behavior after
just a weekend fling. I mean, I could almost see how she could
become attached if she was sleeping with him for years and there
was some emotional involvement but after 2 days?
I do believe the character had borderline personality disorder
in that she displayed all the obvious characteristics like over
reaction to rejection and the "I hate you- don't leave me"
personality type. Even though she was a mess, I felt sorry for
her in that I don't think she could control her reaction to him
dumping her after the fling.
Myself personally, I could never pursue someone who didn't
want me. It's just so pathetic. I cringed every time she called
his house and stalked him because it was just making her look
worse and worse to him. She should have realized he was "happily"
married and didn't want to be with her and she should have walked
away- but hey- she was psychotic. It was not something she could
If I had a quarter for every married man that hit on me
in bar I'd be rich. LOL.
From L. (identity reserved)
My question to you is how can one differentiate between
say a NPD, a Borderline and an Inverted Narcissist? The Axis
II disorders, according to one of your web pages, are very much
alike? But how so, and to what degree? Should we put them all
into the same kettle of fish?
This is one case where discarding the fish together with the
kettle may be a great idea (laughing).
Seriously now: the classification of Axis II personality disorders
- deeply ingrained, maladaptive, lifelong behavior patterns -
in the Diagnostic and Statistical Manual, fourth edition, text
revisionÃ‚Â [American Psychiatric Association. DSM-IV-TR, Washington,
2000] - or the DSM-IV-TRÃ‚Â for short -Ã‚Â has come under
sustained and serious criticism from its inception in 1952.
The DSM IV-TRÃ‚Â adopts a categorical approach, postulating
that personality disorders are "qualitatively
distinct clinical syndromes" (p. 689). This
is widely doubted. Even the distinction made between "normal"
and "disordered" personalities is increasingly being
rejected. The "diagnostic thresholds" between normal
and abnormal are either absent or weakly supported.
The polythetic form of the DSM's Diagnostic Criteria - only
a subset of the criteria isÃ‚Â adequate grounds for a diagnosis
- generates unacceptable diagnostic heterogeneity. In other words,
people diagnosed with the same personality disorder may share
only one criterion or none.
The DSM fails to clarify the exact relationship between Axis
II and Axis I disorders and the way chronic childhood and developmental
problems interact with personality disorders.
The differential diagnoses are vague and theÃ‚Â personality
disorders are insufficiently demarcated. The result is excessive
co-morbidity (multiple Axis II diagnoses).
The DSM contains littleÃ‚Â discussion of what distinguishesÃ‚Â normal
character (personality), personality traits, or personality style
(Millon) - fromÃ‚Â personality disorders.
A dearth of documented clinical experience regarding both
the disorders themselves and the utility of various treatment
Numerous personality disorders are "not otherwise specified"
- a catchall, basket "category".
Cultural bias is evident in certain disorders (such as the
Antisocial and the Schizotypal).
The emergence of dimensional alternatives to the categorical
approach is acknowledged in the DSM-IV-TR itself:
to the categorical approach is the dimensional perspective that
Personality Disorders represent maladaptive variants of personality
traits that merge imperceptibly into normality and into one another' (p.689)
The following issues - long neglected in the DSM - are likely
to be tackled in future editions as well as in current research: