The subjects of Lucy Knight's excellent article on narcissistic personality disorder (NPD) share a useful trait: insight (“They constantly tell you that you are evil”: from the life of diagnosed narcissists, October 15). They understand their problem and how it affects others, and they have the humanity and ability to solve it.
A tenet of psychiatry is that we all have personality traits, including narcissism, on a spectrum where they become disorders when they negatively affect us or those around us. The dangerous ones are found in extremes where there is little or no understanding and characteristics become bizarre and chaotic.
I have experience with this in the case of a once-beloved relative who tried for seven years through the courts to deprive his siblings of their father's inheritance, insisting that he was the only one who deserved it. He has no understanding and disdains formal diagnosis.
His behavior fits all the criteria for malignant NPD: self-centeredness and grandiosity, lack of empathy, lying and manipulative behavior (associated with great charm), paranoia, aggression, resentment, magical thinking, intimidation, loyalty to like-minded people (usually autocrats), etc. His campaign ultimately failed, but financially and emotionally the costs are irreparable.
Does this mean anything? This relative is American and fiercely loyal to Donald Trump.
Name and address provided
While narcissistic personality disorder is arguably one of the most stigmatized mental disorders, surely we should question the value of telling someone that they have a personality disorder? Given that stigma around personality disorders is higher among mental health workers than among the general public, there is questionable value in assigning a label that will cause those who are supposed to care for people to treat them worse.
Keir Harding
Occupational Therapist Consultant
