Personality disorders are a class of mental disorders characterized by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating markedly from those accepted by the individual’s culture. These patterns develop early, are inflexible, and are associated with significant distress or disability. Wikipedia on Personality Disorders, quoting the DSM V.
Personality traits differ, in my opinion, from personality disorders not in their characteristics but in their effect. They become disorders when they impede the development of an individual’s sense of worth and satisfaction; cause conflict with society; and become situationally independent. What might seem to be maladaptive at first glance might be quite reasonable given a deeper perspective on the matter.
A man being chased by a tiger looks crazy, if you don’t see the tiger. [Wisdom learned in medical school.]
I’d always de-identified with Cluster B patterns of behavior – despised them, really.
- Antisocial personality disorder (DSM-IV code 301.7): a pervasive disregard for the law and the rights of others.
- Borderline personality disorder (DSM-IV code 301.83): extreme “black and white” thinking, instability in relationships, self-image, identity and behavior often leading to self-harm and impulsivity.
- Histrionic personality disorder (DSM-IV code 301.50): pervasive attention-seeking behavior including inappropriately seductive behavior and shallow or exaggerated emotions.
- Narcissistic personality disorder (DSM-IV code 301.81): a pervasive pattern of grandiosity, need for admiration, and a lack of empathy.
That, to me, has always seemed ignoble and dickish behavior. So I was surprised to run across some thought on different manifestations of NPD. I’d been reading UpToDate, which offered, in the section on NPD:
Subtypes — There is strong empirical and clinical support for two distinct presentations, or subtypes, of NPD, the grandiose or “overt” subtype and the vulnerable or “covert” subtype. The distinction between subtypes depends on whether core narcissistic grandiosity is openly expressed or masked, and whether stability is maintained by outward arrogance and evoked praise, or by hiding grandiose self-states behind feelings of inadequacy and inferiority. There is growing empirical and clinical support for a third, high-functioning subtype of NPD. Though with dramatically different presentations and levels of functioning, individuals in all three subtypes suffer from a grandiose and superficial sense of self, poverty of interpersonal relations and intimacy, and deficiencies in empathy described above.
This intrigues the hell out of me. It’s hard to look in the mirror to find personality disorders -they’re warty. I can see a lot of the “covert” subtype in myself, and a lot of the “high functioning” subtype in politicians, and with those I dis-identify with.
The stereotypes of the narcissist – grandiose and comic – are the fodder for network television. There is such intense ambivalence in America to the expression of certain types of ability, that provokes hostility towards people with talent in these areas. Certainly, superiority in physical sports is unabashedly admired by the public. The public response to the athletes is every bit as narcissistic as the athletes and other exceptional persons may be. We wear the jerseys. We go to the games. We support the industry. We watch millionaires competing on the teams of billionaires. When they win, we are exuberant. When they lose, they are traitors – bums, losers.
I am surprised how in professional sports, there is a liberal use of the indictment of a team that “they weren’t trying,” “They didn’t want to win,” “They had no heart.” A team may travel to the national championship, and there suffer the accusation that they weren’t into the game. Imagine that – a once-in-a-lifetime opportunity to be at the championships! I have seen botched plays from anxiety, but not from any sense of indifference. I watched a Super Bowl in which My Team was generally outplayed, but was fortunate enough to win. I was shocked to see the thunderous denunciation of the other team – what bums they are! That should show how invested many fans are in the narcissistic gratification of the sport. I enjoy my teams, have done so for a long time – but haven’t spent thousands of dollars on their symbols for sale.
.In intellectual and academic matters, though, we Americans are intensely ambivalent. from bullying the geeks to stereotyping the professions, we tend towards liking the professions which favor combat and victory, at least from the outside. The law, for instance, is sketched out in terms of Victory in a struggle of will, not the prevailing in matters of argument. Just win, baby!
The non-combat professions, though, are taken with a fair amount of dislike and condescension. I particularly dislike the show, Big Bang Theory, because of the dullness of characters who are asserted to be brilliant; and the triumph of the honest home-town girl over the eggheads. The comic foibles of the eggheads are so – so contemptible! Really, they don’t get what life is all about! They just go to the comic book store, and talk about getting laid. It’s early adolescence, arrested.
Sheldon, OMG, WTF, Sheldon? The series makes millions on this character’s quirkiness, and the actor makes millions in ads for chip manufacturers, adding the myth of rocket sciencry to the sales pitch.