Are NPD and Psychopathy the Same?
Lately I've become more interested in the debate about whether Narcissistic Personality Disorder and Antisocial Personality Disorder (psychopathy) are the same thing.
There's a new article on the main website about it.
7:14 PM permanent link
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7 Comments:
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Kudos!
I completely agree with your analysis on NPD and psychopathy being the same. Your logic on this is solid, as far as I can see. I do have a question though. You say, "There's quite a debate about whether Narcissistic Personality Disorder and Antisocial Personality Disorder (psychopathy) are the same thing." Where is this debate happening? Are the so-called professionals debating it? And if so, do you have any links to this discussion in the professional community? I am asking because I recently made the same type of assertion you have on this subject in an email group for adult children of narcissists and was challenged on it because people read the DSM IV like a Bible. It the DSM IV don't say it, then it taint so. *sigh* Logic be damned. Can you help on this?
That "DSM-IV-is-the-Gospel" attitude is the main part of the problem. It is the logical fallacy of "argument by appeal to authority figures." People do it to remain in denial of facts and logic. Because when they know facts or logic to present in their case, they use them. These folks are also disregarding European doctrine on the subject.
Since recent research blasted the notion that psychopaths are violent and narcissists not, people have struggled to maintain the artificial distinction with differences that truly seem to be nothing more than individual variation in how far a particluar person has pushed the envelope and how good he has gotten at repressing feelings.
For a long time, the only references I saw to the belief that APD and NPD are one was in websites. At first I was skeptical, considering this sloppy thinking and just focused on NPD.
But recently I began to learn more about psychopathy and was surprised to see the lack of distinction myself.
The work of Dr. Robert Hare mainly. He doesn't address this issue specifically, but he has developed a highly accurate "checklist" for identifying psychopaths. The resulting profile is a good deal different thatn the DMV IV. Very like a narcissist. In fact, narcisssism is part of it.
He also blasts the notion that psychopaths commit physically violent acts: the vast majority don't. So, there goes the principle traditional distinction.
He and collegues also criticize the DSM IV for making behaviors, instead of underlying character traits, the criteria for mental illness. That's what makes people think NPD and APD are actions, not personality traits that produce them.
For a direct attack on the question of whether APD and NPD are the same, see this page of quotes and links at MSN Groups that offers info and links on the subject.
You can also Google Scholar for articles in the professional literature, though they often are not free.
Fighter,
I've visited that site several times before. Thanks for mentioning it, which reminds me to link to it.
Not sure I agree with this. I've read some of Cleckley's profiles of psychopaths (www.cassiopaea.org/cass/sanity_1.PdF), and I get a distinctly different sense of these people than what I've experienced with the N's in my life. They (the psychopaths) seem more disconnected from anything the rest of us consider meaningful, whereas the N's I know do care about people and relationships (although in a mind-boggingly perverted way).
N's need other people for purposes of stroking their false image of themselves as a wonderful person (narcissistic supply), whereas P's, who get off on their ability to charm and manipulate their way out of trouble and accountability, seem to need people only for entertainment and for honing their skills.
The N's I know definitely care about and have moral boundaries; however, they are all too ready to make justifications for when they overstep them. (One might ask, what's the difference between this and not having moral boundaries to begin with? I would say the moral boundaries do keep them in line a lot of the time, which I don't get the sense of from the Cleckley profiles.) In particular, they attack when they feel threatened or put upon, unjustified as that feeling may be. In that case, anything goes in terms of verbally and emotionally eviscerating the cause of their insecurity--they feel attacked and they're defending themselves. In this state of mind, they truly don't care about you or your feelings, or the inappropriateness of what they're doing. Nor do they reflect on it once they're done, preferring denial or blame to admitting imperfection and making amends.
Clearly, this behavior demonstrates a lack of empathy, humility, and humanity, and, one could argue, a lack of conscience. It is certainly painful enough for the victim to want to label it with something more powerful than "just" narcissistic.
But, I see this more as a situational lack of conscience ("holes in the conscience") than an overall lack of conscience in all things. I agree with Martha Stout that "Narcissism is a failure not of conscience but of empathy, which is the capacity to perceive emotions in others and to react to them appropriately." I think P's might actually be more willing to admit that they had hurt someone ("so what?"), whereas N's cannot admit to having done anything wrong. So, cognitive distortions and magical thinking are the order of the day for N's, rather than lack of a conscience.
>N's need other people for purposes of stroking their false image of themselves as a wonderful person (narcissistic supply), whereas P's, who get off on their ability to charm and manipulate their way out of trouble and accountability, seem to need people only for entertainment and for honing their skills.<
What's the difference? Ns don't always try to get people to think they're wonderful. Sometimes they abuse. Ns prefer seclusion to a place where anyone else is getting attention. In a family, they can become loners. A psychopath needs people too. A violent psychopath's victims stoke his image.
I don't see how anyone who lashes out viciously at a little child to devastate him or her can have a conscience. He may claim he does, but I don't believe it.
I guess it boils down to whether your a "lumper" or a "splitter." I tend to see these differences as individual variations along a continuum, determined by the Ns environment, rank, ability to get away with stuff, desperation for attention, and how far he or she has already pushed the envelope. Others, like you, tend to see a dividing line somewhere along it.
More facts are needed for anyone to be sure.
An afterthought...
We can't conclude that Ns cannot empathize or that they have "difficulty" empathizing. We don't know whether they cannot empathize or will not empathize.
It is the same with feelings and conscience. We can't assume that they cannot feel and can have no conscience: these are things that all people can repress. So, it's most likely that both narcissists and psychopaths simply repress their feeling and conscience. Anything repressed can surface to consciousness when something happens to remind us of it. In fact, it's actually a struggle to keep such things buried in the subconscious.
So, it's likely that they do occassionally experience stirrings of conscience or feelings. Some get better at repressing than others.
Nonethless, there is a distinct difference from normal though. Normal people do not go around with conscience and feelings repressed as their default setting.
Also, as Dr. Sanity points out, narcissists confuse shame with guilt. I wonder if they have even have a concept of guilt. What they're repressing consciousness of is shame.
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