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Narcissistic Personality Disorder Won’t be in the DSM-V…Oh Heaven Forfend!

Posted Jan 17 2011 2:21pm

There will be no Narcissistic Personality Disorder (NPD) in the DSM-V. I know, horrifying. But before we take to our torches and maces and 2 x 4′s with nails in them to destroy the committee chairman’s house, let’s consider what this really means. Here’s a preview: nothing.

The people who really care about this deletion in the newest text of mental disorders are:

1) Freudians (who get off on diagnosing the “non-symptom” disorder)

2) Academicians (who will have trouble conducting research studies without a definitive set of criteria to measure their subjects)

3) Perhaps some drug companies who are seeking the “cure” to a personality disorder that most people simply describe as “being an asshole.”

That’s basically it. No one else.

Make no mistake: I’m of the belief that someone so grandiose, self-absorbed and completely out of touch with a realistic sense of his abilities should be characterized as having a psychological pathology. But consider the following:

A clinician is in his office. The patient presents with all of the symptoms formally known as NPD. The shrink strokes his chin and says, “hmmm…this patient seems to have an inflated sense of self that doesn’t coincide with his actual potential. He also believes he is special and hyper-focused on fantasies of success and power. He also lacks empathy, is quite arrogant and takes advantage of others. I think this might be a problem for…wait! That’s not in the DSM-V! Good thing I remembered that. Let’s just drop this whole line of thinking altogether.”

How likely is that to happen? What therapist worth his salt is going to disregard pathological personality structure and behavior, simply because it’s not written in the manual? Clinicians will still be attuned to this issue and address it according to appropriate treatment protocol, whether it has shone its face or not in the false bible that is DSM-V. That is the critical difference between the voices you hear coming out of institutions of higher learning and what the rest call “real world” psychology.

So some may believe apologies are in order to the mental masturbating scholars out there who really have no clue how to actually help a person with his/her life and are instead confined to diagnosing and overanalyzing with no end in sight, simply because the manual has been altered. But to those who are wailing bloody disappointment about the edits for this version’s DSM: until you really grasp with what the manual is really all about , you’re just screaming into a void.

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