Tuesday, September 25, 2012

The difference between Narcissistic Personality Disorder and Pathological/Malignant Narcissm

Narcissism is a spectrum disorder. There are different degrees of severity.  NPD is a cluster personality disorder loosely associated within the same cluster as Borderline Personality Disorder, Antisocial Personality Disorder and Histrionic Personality Disorder. All of these are highly charged, filled with dramatic, emotional and extremely inconsistent behavior. Narcissistic Personality Disorder characterized by The DSM-IV-TR, a manual that psychologists use to diagnose NPD and other mental disorders, defines NPD is a type of psychological personality disorder primarily characterized by:
grandiosity
need for admiration
lack of empathy
Additional characteristics the DSM associates with the pathologically narcissistic include:
extreme self-absorption
intolerance of others’ perspectives
insensitivity to others’ needs
indifference to the effect of their own egocentric behavior
"Otto Kernberg MD, a legendary thought leader in the study of personality disorders, originated the term “malignant narcissism” to describe a syndrome of narcissism that went beyond Narcissistic Personality Disorder (NPD).
Malignant narcissism is like NPD on pathological steroids, manifesting additional antisocial features, paranoid traits, and ego-syntonic aggression. Kernberg believed that malignant narcissism was part of a spectrum of narcissistic behavior; ranging from NPD, at the low end, to malignant narcissism, and with psychopathy representing the high end of narcissistic severity." (http://www.commentsonnationalamnesia.com/2011/05/19/traits-of-narcissistic-personality-disorders-npd-and-malignant-narcissism-personality-disorders-mnpd/)
So, if people with NPD are not necessarily malignant narcissists, what are malignant narcissists? Are they sociopaths? Do they have both disorders?The definition for malignant narcissism and anti social personality disorder can be interchangeable.  It is extremely possible for a sociopath to be a malignant narcissist, or even narcissistic but, it is not usually the case that someone that is narcissistic also has sociopathy.  What is for sure is that both disorders are marked with people that lack conscience, or empathy and  have flagrant disregards for the rights and boundaries of others. They violate the rights and needs of others and put their needs paramount. They take what they want, give back very little, and use and abuse those that get close to them. Does this make them evil? To discern that we need a  working definition of evil. The definition of "evil"  from Merriam Webster Dictionary is such
1
a : morally reprehensible : sinful, wicked <an evil impulse>
b : arising from actual or imputed bad character or conduct <a person of evil reputation>
2
a archaic : inferior
b : causing discomfort or repulsion : offensive <an evil odor>
c : disagreeable <woke late and in an evil temper>
3
a : causing harm : pernicious <the evil institution of slavery>
b : marked by misfortune : unlucky
— evil adverb, archaic
So while some people at the lower or middle end of the spectrum  of NPD grapple with their infliction, they are willing to accept responsibility for their actions and seek help to better themselves, most malignant narcissists do not share that same insight or need to "fix" something they don't believe is broken.  The malignant or pathological narcissists are at the very end of the spectrum of Narcissistic Personality Disorder. By population pathological narcissists are mostly men and about 25% women. They are your neighbors, your friends, your coworkers and by no means just the serial killers you read or hear about with dismay. You may never even see the "real" malignant narcissist because they wear "a mask of sanity". John Wayne Gacy was a very successful business man, he had large groups of friends that he entertained, and in his free time dressed as a clown and performed for sick children at an area hospital.  Imagine his neighbor's chagrin when he was found to have raped and murdered 30 boys and buried them under the floor boards in his home. Was he a psychopath?  Surely. Was he a malignant narcissist? Or was he  both? There is a fine line between the definitions and I think that the basic concept is that psychopaths kill for satisfaction/gratification and to achieved their goals. Malignant narcissist, although often cruel and filled with contempt, do not.  Malignant narcissists do damage but, may not resort to violence and killing to achieve their goals. In fact most of them fly underneath the radar of law enforcement, proving they do know the distinction between right and wrong but, will not go so far as to break the law, or be so flamboyant as to get caught. They only lie, manipulate, cheat and deceive to get what they want and when they are finished simply discard the person they subjected to all of their abuse.  Are we to believe this is not evil, or just less evil?  The damage that pathological narcissist leave is tangible and  substantial. The lives of the victims that malignant narcissists  come across are never the same after being "involved" with one. The victims usually  suffer from complex post-traumatic syndrome, depression and a host of other emotional problems in addition to financial ruin, while the malignant narcissist, not to be confused with a psychopath is well on his way to repeat the cycle of abuse to his next willing, unsuspecting victim.  When victims/partners  are in a "relationship" (friend, lover, sibling, child) with a malignant narcissist they know something is wrong but,  not quite what. There are definitely oddities, or eccentricities in their behavior and personalities. Many have described odd gift giving and strange eating patterns of the malignant narcissist in addition to their narcissistic rages, tirades, silent treatment and overall abusive treatment. Are these the doings of someone evil?
My belief  is that everyone that suffers from Narcissistic Personality Disorder is evil, but malignant narcissists, who may never kill anyone, only rape the soul and shatter their sense of  identity for their victims,  are. They are aware what they are doing is wrong but, if it brings the narcissist gratification then the  means surely justify the end.- let the victim pick up the pieces of their broken life long after the malignant narcissist is gone, it's  just simply not their problem . You may see someone at work that is excessively vain, or convey that everything is about them and while they may be narcissistic, they are not malignant nor evil. You may not care to be around them or get a pit in your stomach when they keep needing constant admiration or adulation but, the are not necessarily doing it to hurt you or anyone else for that matter.  The evil comes into play when its intent is to hurt, defraud, cause or inflict psychological, emotional, or financial damage onto another with the sole intent of self gain. Malignant narcissists want power and control, the want to win, even if it means annihilating his victim. He needs to feed off the soul and destruction of his prey, because without it he feels irrelevant. They never accept responsibility for their own actions, blame and project all their faults and problems onto their significant other, or family members. There in lies the evil, to not accept anything as your fault so, that you can feel good about yourself, at the cost of debilitating someone else. They are in general negative, paranoid, parasitic and have an overall impending doom about life. They view others as extensions of themselves and tools to achieve their own goals. They know right from wrong, don't kid yourself. If they didn't they surely would be in jail. They are extremely manipulative and have honed their craft for many years, on many people and should be considered dangerous and evil. 

"‘Having looked the beast in the eye, having asked and received forgiveness and having made amends, let us shut the door on the past – not in order to forget it but in order not to allow it to imprison us." Desmond Tutu

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