Descriptive criteria aside, what is the essence
of mental disorders? Are they merely physiological disorders
of the brain, or, more precisely of its chemistry? If so, can
they be cured by restoring the balance of substances and secretions
in that mysterious organ? And, once equilibrium is reinstated
ÃƒÂ± is the illness "gone" or is it still lurking
there, "under wraps", waiting to erupt? Are psychiatric
problems inherited, rooted in faulty genes (though amplified
by environmental factors) ÃƒÂ± or brought on by abusive or
These questions are the domain of the "medical" school
of mental health.
Others cling to the
spiritual view of the human psyche. They believe that mental
ailments amount to the metaphysical discomposure of an unknown
medium ÃƒÂ± the soul. Theirs is a holistic approach, taking
in the patient in his or her entirety, as well as his milieu.
The members of the
functional school regard mental health disorders as perturbations
in the proper, statistically "normal", behaviors and
manifestations of "healthy" individuals, or as dysfunctions.
The "sick" individual ÃƒÂ± ill at ease with himself
(ego-dystonic) or making others unhappy (deviant) ÃƒÂ± is
"mended" when rendered functional again by the prevailing
standards of his social and cultural frame of reference.
In a way, the three
schools are akin to the trio of blind men who render disparate
descriptions of the very same elephant. Still, they share not
only their subject matter ÃƒÂ± but, to a counter intuitively
large degree, a faulty methodology.
As the renowned anti-psychiatrist,
Thomas Szasz, of the State University of New York, notes in his
article "The Lying Truths of Psychiatry",
mental health scholars, regardless of academic predilection,
infer the etiology of mental disorders from the success or failure
of treatment modalities.
This form of "reverse
engineering" of scientific models is not unknown in other
fields of science, nor is it unacceptable if the experiments
meet the criteria of the scientific method. The theory must be
all-inclusive (anamnetic), consistent, falsifiable, logically
compatible, monovalent, and parsimonious. Psychological "theories"
ÃƒÂ± even the "medical" ones (the role of serotonin
and dopamine in mood disorders, for instance) ÃƒÂ± are usually
none of these things.
The outcome is a bewildering
array of ever-shifting mental health "diagnoses" expressly
centred around Western civilisation and its standards (example:
the ethical objection to suicide). Neurosis, a historically fundamental
"condition" vanished after 1980. Homosexuality, according
to the American Psychiatric Association, was a pathology prior
to 1973. Seven years later, narcissism was declared a "personality
disorder", almost seven decades after it was first described
Indeed, personality disorders are an excellent
example of the kaleidoscopic landscape of "objective"
The classification of Axis II personality
disorders ÃƒÂ± deeply ingrained, maladaptive, lifelong behavior
patterns ÃƒÂ± in the Diagnostic and Statistical Manual, fourth
edition, text revisionÃ‚Â [American Psychiatric Association.
DSM-IV-TR, Washington, 2000] ÃƒÂ± or the DSM-IV-TRÃ‚Â for short ÃƒÂ±Ã‚Â has
come under sustained and serious criticism from its inception
in 1952, in the first edition of the DSM.
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 ÃƒÂ± only a subset of the criteria isÃ‚Â adequate grounds
for a diagnosis ÃƒÂ± 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) ÃƒÂ± fromÃ‚Â personality
A dearth of documented clinical experience
regarding both the disorders themselves and the utility of various
Numerous personality disorders are "not
otherwise specified" ÃƒÂ± 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
alternative 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 anotherÃƒÂ®
The following issues ÃƒÂ± long
neglected in the DSM ÃƒÂ± are likely to be tackled in future editions as well
as in current research. But their omission from official discourse
hitherto is both startling and telling:
Certain mental health afflictions are either
correlated with a statistically abnormal biochemical activity
in the brain ÃƒÂ± or are ameliorated with medication. Yet the two facts
are not ineludibly facets of the same underlying
phenomenon. In other words, that a given medicine reduces or
abolishes certain symptoms does not necessarily mean they were
caused by the processes or substances affected
by the drug administered. Causation is only one of many possible
connections and chains of events.
To designate a pattern of behavior as a mental
health disorder is a value judgment, or at best a statistical
observation. Such designation is effected regardless of the facts
of brain science. Moreover, correlation is not causation. Deviant
brain or body biochemistry (once called "polluted animal
spirits") do exist ÃƒÂ± but are they truly the roots of mental perversion?
Nor is it clear which triggers what: do the aberrant neurochemistry
or biochemistry cause mental illness ÃƒÂ± or the other way around?
That psychoactive medication alters behavior
and mood is indisputable. So do illicit and legal drugs, certain
foods, and all interpersonal interactions. That the changes brought
about by prescription are desirable ÃƒÂ± is debatable and involves tautological thinking.
If a certain pattern of behavior is described as (socially) "dysfunctional"
or (psychologically) "sick" ÃƒÂ± clearly,
every change would be welcomed as "healing" and every
agent of transformation would be called a "cure".
The same applies to the alleged heredity of
mental illness. Single genes or gene complexes are frequently
"associated" with mental health diagnoses, personality
traits, or behavior patterns. But too little is known to establish
irrefutable sequences of causes-and-effects. Even less is proven
about the interaction of nature and nurture, genotype and phenotype,
the plasticity of the brain and the psychological impact of trauma,
abuse, upbringing, role models, peers, and other environmental
Nor is the distinction between psychotropic
substances and talk therapy that clear-cut. Words and the interaction
with the therapist also affect the brain, its processes and chemistry
- albeit more slowly and, perhaps, more profoundly and irreversibly.
Medicines ÃƒÂ± as David Kaiser reminds us in "Against
Biologic Psychiatry" (Psychiatric Times, Volume
XIII, Issue 12, December 1996) ÃƒÂ± treat symptoms, not the underlying processes that
If mental illnesses are bodily and empirical,
they should be invariant both temporally and spatially, across
cultures and societies. This, to some degree, is, indeed, the
case. Psychological diseases are not context dependent ÃƒÂ±
but the pathologizing of certain behaviors is. Suicide, substance
abuse, narcissism, eating disorders, antisocial ways, schizotypal
symptoms, depression, even psychosis are considered sick by some
cultures ÃƒÂ± and utterly normative or advantageous in others.
This was to be expected. The human mind and
its dysfunctions are alike around the world. But values differ
from time to time and from one place to another. Hence, disagreements
about the propriety and desirability of human actions and inaction
are bound to arise in a symptom-based diagnostic system.
As long as the pseudo-medical
definitions of mental health disorders continue to rely exclusively
on signs and symptoms ÃƒÂ± i.e., mostly on observed or reported behaviors ÃƒÂ±
they remain vulnerable to such discord and devoid of much-sought
universality and rigor.
The mentally sick receive the same treatment
as carriers of AIDS or SARS or the Ebola virus or smallpox. They
are sometimes quarantined against their will and coerced into
involuntary treatment by medication, psychosurgery, or electroconvulsive
therapy. This is done in the name of the greater good, largely
as a preventive policy.
Conspiracy theories notwithstanding, it is
impossible to ignore the enormous interests vested in psychiatry
and psychopharmacology. The multibillion dollar industries involving
drug companies, hospitals, managed healthcare, private clinics,
academic departments, and law enforcement agencies rely, for
their continued and exponential growth, on the propagation of
the concept of "mental illness" and its corollaries:
treatment and research.
Abstract concepts form the core of all branches
of human knowledge. No one has ever seen a quark, or untangled
a chemical bond, or surfed an electromagnetic wave, or visited
the unconscious. These are useful metaphors, theoretical entities
with explanatory or descriptive power.
"Mental health disorders" are no
different. They are shorthand for capturing the unsettling quiddity
of "the Other". Useful as taxonomies, they are also
tools of social coercion and conformity, as Michel Foucault and
observed. Relegating both the dangerous and the idiosyncratic
to the collective fringes is a vital technique of social engineering.
The aim is progress through social cohesion
and the regulation of innovation and creative destruction. Psychiatry,
therefore, is reifies society's preference of evolution to revolution,
or, worse still, to mayhem. As is often the case with human Endeavour,
it is a noble cause, unscrupulously and dogmatically pursued.
is an ill thing to knock against a deaf-mute, an imbecile, or
a minor. He that wounds them is culpable, but if they wound him
they are not culpable." (Mishna, Babylonian Talmud)
If mental illness is culture-dependent and
mostly serves as an organizing social principle - what should
we make of the insanity defense (NGRI- Not Guilty by Reason of
A person is held not responsible for his criminal
actions if s/he cannot tell right from wrong ("lacks substantial capacity either
to appreciate the criminality (wrongfulness) of his conduct"
- diminished capacity), did not intend to act the way he did
(absent "mens rea") and/or could
not control his behavior ("irresistible impulse").
These handicaps are often associated with "mental disease
or defect" or "mental retardation".
Mental health professionals prefer to talk
about an impairment of a "person's
perception or understanding of reality". They hold a
"guilty but mentally ill" verdict to be contradiction
in terms. All "mentally-ill" people operate within
a (usually coherent) worldview, with consistent internal logic,
and rules of right and wrong (ethics). Yet, these rarely conform
to the way most people perceive the world. The mentally-ill,
therefore, cannot be guilty because s/he has a tenuous grasp
Yet, experience teaches us that a criminal
maybe mentally ill even as s/he maintains a perfect reality test
and thus is held criminally responsible (Jeffrey Dahmer comes
to mind). The "perception and understanding of reality",
in other words, can and does co-exist even with the severest
forms of mental illness.
This makes it even more difficult to comprehend
what is meant by "mental disease". If some mentally
ill maintain a grasp on reality, know right from wrong, can anticipate
the outcomes of their actions, are not subject to irresistible
impulses (the official position of the American Psychiatric Association)
- in what way do they differ from us, "normal" folks?
This is why the insanity defense often sits
ill with mental health pathologies deemed socially "acceptable"
and "normal"Ã‚Â - such as religion or love.
Consider the following case:
A mother bashes the skulls of her three sons.
Two of them die. She claims to have acted on instructions she
had received from God. She is found not guilty by reason of insanity.
The jury determined that she "did
not know right from wrong during the killings."
But why exactly was she judged insane?
Her belief in the existence of God -
a being with inordinate and inhuman attributes - may be irrational.
But it does not constitute insanity in the
strictest sense because it conforms to social and cultural creeds
and codes of conduct in her milieu. Billions of people faithfully
subscribe to the same ideas, adhere to the same transcendental
rules, observe the same mystical rituals, and claim to go through
the same experiences. This shared psychosis is so widespread
that it can no longer be deemed pathological, statistically speaking.
She claimed that God has spoken to her.
As do numerous other people. Behavior that
is considered psychotic (paranoid-schizophrenic) in other contexts
is lauded and admired in religious circles. Hearing voices and
seeing visions - auditory and visual delusions - are considered
rank manifestations of righteousness and sanctity.
Perhaps it was the content of her hallucinations
that proved her insane?
She claimed that God had instructed
her to kill her boys. Surely, God would not ordain such evil?
Alas, the Old and New Testaments both contain
examples of God's appetite for human sacrifice. Abraham was ordered
by God to sacrifice Isaac, his beloved son (though this savage
command was rescinded at the last moment). Jesus, the son of
God himself, was crucified to atone for the sins of humanity.
A divine injunction to slay one's offspring
would sit well with the Holy Scriptures and the Apocrypha as
well as with millennia-old Judeo-Christian traditions of martyrdom
Her actions were wrong and incommensurate
with both human and divine (or natural) laws.
Yes, but they were perfectly in accord with
a literal interpretation of certain divinely-inspired texts,
millennial scriptures, apocalyptic thought systems, and fundamentalist
religious ideologies (such as the ones espousing the imminence
of "rupture"). Unless one declares these doctrines
and writings insane, her actions are not.
we are forced to the conclusion that the murderous
mother is perfectly sane. Her frame of reference is different
to ours. Hence, her definitions of right and wrong are idiosyncratic.
To her, killing her babies was the right thing to do and in conformity
with valued teachings and her own epiphany. Her grasp of reality
- the immediate and later consequences of her actions - was never
It would seem that sanity and insanity are
relative terms, dependent on frames of cultural and social reference,
and statistically defined. There isn't - and, in principle, can
never emerge - an "objective", medical, scientific
test to determine mental health or disease unequivocally.
"Normal" people adapt to their environment
- both human and natural.
"Abnormal" ones try to adapt their
environment - both human and natural - to their idiosyncratic
If they succeed, their environment, both human
(society) and natural is pathologized.
My own research on the Internet and in books
has produced no evidence of an organic or genetic cause for Narcissistic
Personality Disorder. It may yet be found. Schizophrenic was
once considered caused by 'bad mothering' - as postulated by
the early Freudians. Even now there is no definite definition
of the disease according to the psychiatrists I work with. The
discovery of a possible gene linked to schizophrenic in the genome
pool of Iceland and a mouse model d with the same gene may shed
more light onto this mental disease. Perhaps further research
will show that there is a true genetic link.
NPD may also have a genetic marker, yet I
am skeptical. I am skeptical because NPD involves the 'personality'
of someone, and I believe 'personality' is something that is
constructed over the years.
Being a narcissist, I often think:
Is pathological narcissism the outcome of
inherited traits - or the sad result of abusive and traumatizing
upbringing? Or, maybe it is the confluence of both? It is a common
occurrence, after all, that, in the same family, with the same
set of parents and an identical emotional environment - some
siblings grow to be malignant narcissists, while others are perfectly
"normal". Surely, this indicates a predisposition of
some people to developing narcissism, a part of one's genetic
This vigorous debate may be the offshoot of
When we are born, we are not much more than
the sum of our genes and their manifestations. Our brain - a
physical object - is the residence of mental health and its disorders.
Mental illness cannot be explained without resorting to the body
and, especially, to the brain. And our brain cannot be contemplated
without considering our genes. Thus, any explanation of our mental
life that leaves out our hereditary makeup and our neurophysiology
is lacking. Such lacking theories are nothing but literary narratives.
Psychoanalysis, for instance, is often accused of being divorced
from corporeal reality.
Our genetic baggage makes us resemble a personal
computer. We are an all-purpose, universal, machine. Subject
to the right programming (conditioning, socialization, education,
upbringing) - we can turn out to be anything and everything.
A computer can imitate any other kind of discrete machine, given
the right software. It can play music, screen movies, calculate,
print, paint. Compare this to a television set - it is constructed
and expected to do one, and only one, thing. It has a single
purpose and a unitary function. We, humans, are more like computers
than like television sets.
True, single genes rarely account for any
behavior or trait. An array of coordinated genes is required
to explain even the minutest human phenomenon. "Discoveries"
of a "gambling gene" here and an "aggression gene"
there are derided by the more serious and less publicity-prone
scholars. Yet, it would seem that even complex behaviors such
as risk taking, reckless driving, and compulsive shopping have
What about the Narcissistic Personality Disorder?
It would seem reasonable to assume - though,
at this stage, there is not a shred of proof - that the narcissist
is born with a propensity to develop narcissistic defenses. These
are triggered by abuse or trauma during the formative years in
infancy or during early adolescence (see http://samvak.tripod.com/faq64.html).
By "abuse" I am referring to a spectrum of behaviors
which objectifies the child and treats it as an extension of
the caregiver (parent) or an instrument. Dotting and smothering
are as much abuse as beating and starving. And abuse can be dished
out by peers as well as by adult role models.
Still, I would have to attribute the development
of NPD mostly to nurture. The Narcissistic Personality Disorder
is an extremely complex battery of phenomena: behavior patterns,
cognitions, emotions, conditioning, and so on. NPD is a PERSONALITY
disordered and even the most ardent proponents of the school
of genetics do not attribute the development of the whole personality
Narcissists often quote themselves, so allow
me to conform to form.
From "The Interrupted Self" (http://samvak.tripod.com/sacks.html):
"'Organic' and 'mental' disorders
(a dubious distinction at best) have many characteristics in
common (confabulation, antisocial behavior, emotional absence
or flatness, indifference, psychotic episodes and so on)."
From "On Dis-ease" (http://samvak.tripod.com/disease.html):
"Moreover, the distinction between the
psychic and the physical is hotly disputed, philosophically.
The psychophysical problem is as intractable today as it ever
was (if not more so). It is beyond doubt that the physical affects
the mental and the other way around. This is what disciplines
like psychiatry are all about. The ability to control "autonomous"
bodily functions (such as heartbeat) and mental reactions to
pathogens of the brain are proof of the artificialness of this
It is a result of the reductionist view of
nature as divisible and summable. The sum of the parts, alas,
is not always the whole and there is no such thing as an infinite
set of the rules of nature, only an asymptotic approximation
of it. The distinction between the patient and the outside world
is superfluous and wrong. The patient AND his environment are
ONE and the same. Disease is a perturbation in the operation
and management of the complex ecosystem known as patient-world.
Humans absorb their environment and feed it in equal measures.
This on-going interaction IS the patient. We cannot exist without
the intake of water, air, visual stimuli and food. Our environment
is defined by our actions and output, physical and mental.
Thus, one must question the classical differentiation
between "internal" and "external". Some illnesses
are considered "endogenic" (=generated from the inside).
Natural, "internal", causes - a heart defect, a biochemical
imbalance, a genetic mutation, a metabolic process gone awry
- cause disease. Aging and deformities also belong in this category.
In contrast, problems of nurturance and environment
- early childhood abuse, for instance, or malnutrition - are
"external" and so are the "classical" pathogens
(germs and viruses) and accidents.
But this, again, is a counter-productive approach.
Exogenic and Endogenic pathogenesis is inseparable. Mental states
increase or decrease the susceptibility to externally induced
disease. Talk therapy or abuse (external events) alter the biochemical
balance of the brain. The inside constantly interacts with the
outside and is so intertwined with it that all distinctions between
them are artificial and misleading. The best example is, of course,
medication: it is an external agent, it influences internal processes
and it has a very strong mental correlate (=its efficacy is influenced
by mental factors as in the placebo effect).
The very nature of dysfunction and sickness
is highly culture-dependent. Societal parameters dictate right
and wrong in health (especially mental health). It is all a matter
of statistics. Certain diseases are accepted in certain parts
of the world as a fact of life or even a sign of distinction
(e.g., the paranoid schizophrenic as chosen by the gods). If
there is no dis-ease there is no disease. That the physical or
mental state of a person CAN be different - does not imply that
it MUST be different or even that it is desirable that it should
be different. In an over-populated world, sterility might be
the desirable thing - or even the occasional epidemic. There
is no such thing as ABSOLUTE dysfunction. The body and the mind
ALWAYS function. They adapt themselves to their environment and
if the latter changes - they change. Personality disorders are
the best possible responses to abuse. Cancer may be the best
possible response to carcinogens. Aging and death are definitely
the best possible response to over-population. Perhaps the point
of view of the single patient is incommensurate with the point of view of
his species - but this should not serve to obscure the issues
and derail rational debate.
As a result, it is logical to introduce the
notion of "positive aberration". Certain hyper- or
hypo- functioning can yield positive results and prove to be
adaptive. The difference between positive and negative aberrations
can never be "objective". Nature is morally-neutral
and embodies no "values" or "preferences".
It simply exists. WE, humans, introduce our value systems, prejudices
and priorities into our activities, science included. It is better
to be healthy, we say, because we feel better when we are healthy.
Circularity aside - this is the only criterion that we can reasonably
employ. If the patient feels good - it is not a disease, even
if we all think it is. If the patient feels bad, ego-dystonic,
unable to function - it is a disease, even when we all think
it isn't. Needless to say that I am referring to that mythical
creature, the fully informed patient. If someone is sick and
knows no better (has never been healthy) - then his decision
should be respected only after he is given the chance to experience
All the attempts to introduce "objective"
yardsticks of health are plagued and philosophically contaminated
by the insertion of values, preferences and priorities into the
formula - or by subjecting the formula to them altogether. One
such attempt is to define health as "an increase in order
or efficiency of processes" as contrasted with illness which
is "a decrease in order (=increase of entropy) and in the
efficiency of processes". While being factually disputable,
this dyad also suffers from a series of implicit value-judgements.
For instance, why should we prefer life over death? Order to
entropy? Efficiency to inefficiency?"
I strongly recommend this paper, by the way:
Liveslye, W.J., Jank, K.L., Jackson,
B.N., Vernon, P.A.. 1993. Genetic and environmental contributions
to dimensions of personality disorders. Am. J. Psychiatry. 150(O12):1826-31.
Are there Social causes?
I believe personality is independent of intelligence
and of genetics. I agree with Freudians and post Freudians that
personality is a part of our natural development. The 'self'
that we call ourselves is based on this thing we call our personality.
Heinz Kohut did some amazing work on self and narcissism. As
I understand Kohut theories, our mothers (and to some degree
our fathers) give us 'selves' by mirroring back to us when we
are babies. In my natural understanding of babies, I see them
as pure narcissists much like aliens who see themselves as the
center of the universe and who consider everything outside themselves
as part of themselves.
As a parent I have seen narcissistic babies
grow and explore till they reach the terrible twos, the age where
they seem to wake up and discover, to their great discomfort,
that they are not the center of the universe. I remember going
to the local park where a mother asked me if my son would bite
her if she took away the toy my son had 'borrowed' from her own
child. Only then did I realize that this behavior was common
till a certain age. Children go from a stage of thinking everything
belongs to them to suddenly realizing that no, certain toys belong
to others; this is a rude shock. Witness the huge rages two and
three year olds go through! This awareness of boundaries is the
beginning of 'humanity', I believe. In other words, the child
suddenly realizes he or she is separate from others, and that
other children and adults are separate from them; in other words
the child no longer sees the world as his or her oyster. No doubt
Piaget has much to say on this, as he categorized the stages
of child learning. Somewhere and at some time in our natural
development arises the notion of 'empathy' or awareness of the
other. I believe this has also called 'theory of mind' in that
the child, and in some cases animals, understand what other people
are feeling and even thinking.
In a recent article in Psychological Science
by David R. Forman and collaborators, entitled 'Toddler's Responsive
Imitation Predicts Preschool-Age Conscience, he posits an interesting
theory based on research that babies who mimic their care givers
have a higher sense of moral values when tested at a more advanced
age. It seems that monkey see monkey do holds true for humans
in that the mirroring that naturally occurs between mother and
baby (and fathers) can predict how they will behave later; the
babies who failed to mimic or who were more self absorbed were
noted as being less empathetic and more prone to 'cheat' on the
simple tests they were given. No data was given as to how these
children faired later but my guess is that the more empathetic
children stayed that way and vice versa. If we view this study
under the filter of narcissism, we might conclude that narcissistic
parents may raise narcissistic babies, or that self-centered
babies may stay self-centered as they grow up. As most babies
are narcissistic (according to my own theory) then the process
of weaning them from this mind set to a more empathetic personality
may very be the result of 'good' parenting.
Again the slippery slope of blaming our parents
for our 'personality' and thus mental disorders may lead us to
believe that narcissism is learned at our mother's breast. Our
parents' ills and failings sometimes bypass us, despite all the
bad habits they have, and children do grow up 'normal'. I believe
Ann Landers 12 rules of raising children are still as valid now
as when she first published them in her nationally syndicated
column (they can be found on the internet, I am sure).
The second time that narcissistic behavior
develops in children is in adolescence when they pass into the
penumbra of not children not adulthood. Hormones play a role
in how girls and boys suddenly change both physically and mentally.
Girls are known to suddenly want to either become veterinarians
Boys try to choose between firemen and soldiers.
Of course this is a gross over exaggeration, but parents who
have teenagers may see my point. This indeterminate time in a
person life can bring out narcissistic tendencies; girls who
suddenly garner the attention of males may enjoy this new situation,
and it may go to their heads. Boys who are respond to testosterone
by testing themselves against their fellow males/rivals can also
feel their egos inflated or deflated. Fortunately for most of
us, but not all, the passage into adulthood finally ends and
the habits that were once condoned, are forgotten and left behind.
But there are still adult men and women who
never quite get over their adolescent years and try to prolong
them till they die. Are they NPDs, these eternal adolescents?
Sibling rivalry also plays a role in how we
develop as individuals as books on birth order try to justify.
Therefore I conclude that the development
of humans includes narcissistic tendencies that are useful and
natural. Only when the individual gets stuck into an endless
feed back loop, where they no longer change or develop, do we
see something that is called Narcissistic Personality Disorder.
Is Cultural to blame?
At the risk of offending many cultures, I
would say that many different peoples often encourage narcissistic
behavior. By this I mean the behaviors characterized by selfishness
and self-centered behavior. No doubt there are good reasons for
this behavior, historical, sexual or whatever, still it comes
from the need to survive. Cover your own back is a good piece
of advice. But as E. O.
Wilson has pointed out in such seminal works
as Consilience, altruism is a survival technique as well. Charity
and generosity are often seen as signs of weakness when they
are really the domains of the truly powerful. By powerful, I
do not mean the rich. On the contrary, I have seen more giving
amongst the poor than amongst the rich. A rich man or woman counts
every penny they give and receive, while the poor is happy to
be alive. True, there are Bill Gates and other philanthropic
millionaires but most do not become rich by sharing the wealth
despite Reagonomic theory of the 'trickle down' effect.
Personal development dependency on culture
is the basis for many theologies and political movements. Granted
we are all part of our culture, or our human environment, but
take someone from one culture and plop them into another and
most people will adapt, if not thrive. To say we are encased
or enslaved by what happens around us, how other people act,
is an easy out of personal responsibility. Children usually follow
the orders, spoken and unspoken, of their parents, but when they
are cut loose from parental administration; they go their own
way. If they have developed some good morals and decision making
ability they will not be swayed by others, or by their culture.
Of course this is impossible to do, as culture is an ever-present
force, like gravity, and those who ignore it are bound to fall.
To escape this gravity (an idea that I discovered in Dinosaur
Brains; Dealing with All those impossible People at Work by Dr.
Albert J. Bernstein and Sydney Craft) is difficult. It can be
To say that one has to drive badly because
everyone on the highway drives badly is childish and nonsensical;
even though it is tempting. On the other hand, to ignore how
other drivers drive is also dangerous. We have to adapt to survive.
Perhaps a narcissist will say he or she drives badly because
everyone else is, although most judges will throw this defense
out of a court of law. The blame other defense is an easy out,
one that children often take because they know no better. Dr
Stephen Covey's first habit of highly effective people says,
"We are responsible for our own choices and have the freedom
to choose, based on principles and values rather than moods and
conditions. Proactive people choose not to be victims or to blame
others." This could be applied to NPDs and their victims.
Is this why this disorder exists? Just because
the world has dealt you a bad hand of cards, you have to play
anyway, and we all loose in the end. If life gives you lemons,
make lemonade. No doubt you will say my homespun humor and sayings
are off the target, yet they contain a grain of the truth. Narcissist
was a legend in his own time - in ancient Greece - because this
disorder is probably as old as humankind. It is part of what
makes us human. To say we 'suddenly' are living in a narcissistic
culture is to belie all of human history that tells the stories
of narcissists who have struggled to do and bad. Great leaders
need a pinch of narcissism, but too much spoils the meal. In
fact all of us need a little narcissism in our psyches to balance
out our personality. But when we suddenly think we are the star
of the show, the only one in the world, then we begin to show
signs of NPD; as to the origin of this there are many as I have
detailed in the above text.
So to answer your question, I would
say yes to all of what you asked in your question.
Last updated September 25, 2006