Friday, January 25, 2008

The Credibility of Authority

There are good clinicians and researchers out there, but academia is a dead weight hindering the progress of psychology.

They have political and social agendas: 'People are inherently good,' they say. 'Just give them a hug, a puppy dog, and a musical instrument and they're all going to be okay.' "

That isn't science. That's like a religious doctrine.

Therefore, no matter what, they just won't know the truth about psychopaths and other narcissists. And they won't let you know it, either.

The new clericalism of academia rivals that of the magisterium. Academics will try to tell you that, though you have lived with a narcissist for 20 years, observing his or her behavior every day, you know nothing about NPD.

That's absurd.

In fact, chances are that, if you have lived or worked with a malignant narcissist for a long time, you know more about NPD than many, if not most, of the so-called "authorities" do.

Why? Because your knowledge is based on facts, established by first-hand observation. Frequently repeated observations. A billion of them. But the so-called "authorities" have no respect for this kind of knowledge. Their inability to appropriately judge its value destroys their own credibility.

What's more, if you are a narcissist, chances are that you know more about NPD than most of the so-called "authorities" do. But they don't respect your knowledge of yourself, either. According to them, narcissists like Sam Vaknin know nothing about NPD? Give me a break. Insofar as he wishes to, Vaknin knows exactly what goes on in his head. And academia's failure to appreciate the true value of such knowledge again destroys its own credibility.

Of course, everyone's credibility must be assessed, but I'm beginning to wonder whether academia has any idea how to estimate credibility. They seem to think it equals the three little letters "P", "h" and "D." As though it is some power bestowed on one like a priestly mantle or surplice.

And where do they get all this superior information that makes them scoff at the experience of us lesser beings? From books. Book learning, almost all of which is pure thought, conjecture, not science. AND and from asking a handful of these pathological liars in treatment questions about themselves.

It ain't smart to pretend that they don't see what's wrong with that.

Since the 1980's they have been nailed for relying on the self-reports of psychopaths and other narcissists - pathological liars by definition - but they refuse to clean up their act.

Animal behaviorists and anthropologists have much more complete and reliable data to base their theories on than psychologists do. They study their subjects in the wild, but psychologists are too lazy to get out of the clinic. (See below.)

Plus, academia is notorious for slavery to groupthink, largely because academics are notoriously intolerant of free thinking. And so, for a long time the psychiatric "authorities" claimed with one voice that homosexuality is a mental illness. When the politically correct wind shifted, the weathervane minds all came about and decided that it is not a mental illness but that smoking cigarettes is.

That's credibility?

Is this credibility?

One issue in the diagnostic assessment bias literature is errors in applying the diagnostic criteria (Rabinowitz & Efron, 1997). In one demonstration of this bias, Morey and Ochoa (1989) asked 291 psychiatrists and psychologists to complete a symptom checklist for a client whom they had diagnosed with a personality disorder. When the checklists were later correlated with the DSM criteria, nearly three of four clinicians had made mistakes in applying the diagnostic criteria. Kappa coefficients of agreement between clinicians' checklists and the DSM criteria varied from 0.09 to .59, indicating a poor-to-modest level of agreement (Babbe, 1998). These results demonstrate the pervasiveness of errors in applying diagnostic criteria.

Errors in applying the DSM criteria were also reported by Davis, Blashfield, and McElroy (1993). They asked 42 psychologists and 17 psychiatrists to read and diagnose case reports containing different combinations of the DSM-III-R criteria for Narcissistic Personality Disorder (NPD; APA, 1987). They found that 94% of the clinicians made mistakes applying the diagnostic criteria, and nearly one out of four clinicians made a diagnosis of NPD even if fewer than half the DSM criteria were met.

Rubinson, Asnis, Harkavy, and Freidman (1988) found clinicians making more mistakes of omission than of commission in applying the DSM criteria. Researchers sent 113 questionnaires to a random sample of clinicians asking them what criteria they used to make a diagnosis of Major Depression. The 54 questionnaires returned indicated that clinicians' most often erred by failing to use all the diagnostic criteria in their diagnostic decision making.

— Jerry McLaughlin, "Reducing diagnostic bias," 01-07-02, Journal of Mental Health Counseling

In the 1970's a TV movie about a character with Multiple Personality Disorder was a big hit. Guess what happened? There was a dramatic increase in the diagnosis of MPD in the United States. Only in the United States. Is that credibility? Is any of this credibility?

As that article says, this is precisely why health insurance providers won't pay for mental health care, and I don't blame them. No court on the planet would force an insurance company to pay for that.

Confusing psychopathy with antisocial behavior is credibility?

Traditionally, affective and interpersonal traits such as egocentricity, deceit, shallow affect, manipulativeness, selfishness, and lack of empathy, guilt or remorse, have played a central role in the conceptualization and diagnosis of psychopathy (Cleckley; Hare 1993; in press); Widiger and Corbitt). In 1980 this tradition was broken with the publication of DSM-III. Psychopathy- renamed antisocial personality disorder- was now defined by persistent violations of social norms, including lying, stealing, truancy, inconsistent work behavior and traffic arrests.

Yeah, so Lee Harvey Oswald is just a narcissist until the day he assassinates President Kennedy: then he becomes a psychopath: psychopathy (a disease) = assassinating President Kennedy (an act). Absurd.

And, I'm sorry, but the average person knows the difference between your average street criminal and your sick-o, like the serial killer, rapist, child molester, or other psychopath. Why can't the so-called "authorities" tell the difference?

How can we take such "authorities" seriously?

Incredibly, not until 2004 was the first actual population survey conducted by one of the National Institutes of Health, giving us the first LEGITIMATE estimate of the prevalence of personality disorders in the United States.

That's credibility?

What kind of junk science estimates the prevalence of personality disorder in the GENERAL POPULATION without surveying the GENERAL POPULATION? These clowns just used the statistics they gathered from people who showed up in clinics for treatment. No wonder the 2004 survey showed that they were off by about 200%.

It doubled the DSM estimate of 6–9%, estimating that 15% of Americans meet the diagnostic criteria for at least one of seven personality disorders — not counting borderline, schizotypal, and narcissistic disorders.

Since Grant conducted the study among a randomly selected population-based sample, the prevalence rates from her study diverged from those presented in the DSM-IV-TR in some cases.

For instance, according to the DSM-IV-TR, dependent personality disorder is "among the most frequently reported personality disorders encountered in mental health clinics," the study report pointed out. However, Grant's study found it to be the least common in the population.

In addition, the DSM-IV-TR estimates that the prevalence of avoidant personality disorder in the general population is between 0.5 percent and 1 percent, yet Grant found it to be 2.36 percent.

Grant explained that prevalence estimates of various personality disorders in the DSM are based on relatively small, clinical studies of patients who are receiving mental health services on an inpatient or outpatient basis.

"You can run into problems if you rely solely on clinical samples," she said. "If you want to know the true prevalence of a certain disorder, you have to get out of the clinic."

Psychiatric News September 3, 2004
Volume 39 Number 17

Duh! Grant was putting it diplomatically. I won't: Real scientists would never have produced estimates from such shoddy "research" as that which her work corrected. Indeed, no college science major would dare hand in research based on such invalid statistics as that.

You find mediocrity everywhere, but it seems to me that this doesn't even measure up to that. Pyschopaths and other narcissists are predators who go through life hurting other people. It's time academia in this field stopped being so callous about that.

Not that they have no sympathy - but look where it all goes!!! Disgusting. Absolutely disgusting. And that doesn't help their patients any more than it helps their pateints' victims.

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6 Comments:

At 12:16 AM, Anonymous holywatersalt said...

Again great post.
Today I blogged on what Psychos say are their "behaviors" vs. what experts say.

One serial killer from Russia- stated he killed only those known to him and not for financial gain, an "expert" stated they killed strangers and are cons.

They do kill and steal, embezzel, but I think their motive is different. It's the thrill, the duping that drives them....as the killer said " he was almost God."

But I am no expert. I am sure they have different manifestations of their personality disorder, but to think folks who knew them best can't make a best guess- that's absurd.

I a STILL- to this day- realizing what he was actually doing. It floors me, no way a 50 min. hr specialist would catch this stuff---no way.

 
At 9:27 AM, Anonymous CZBZ said...

Thank you, Kathy! Exactly the kick-in-the-arse I needed today. Those of us who have 'lived' with a narcissistic partner for years, continue to doubt ourselves even POST-N.

Yea, it can be very confusing while we're trapped in the relatioNship. But even trying to assert ourselves afterwards can be an exercise in courage.

One of the most healing experiences in my life has been connecting with other people who have LIVED the N-experieNce, too. People without credentials or psychological groupthink telling them 'how' to interpret their experience.

Thanks for this message. Perfect timing! I sooooooo needed to read this today. Some of the best-hearted (and worn out) folks on our planet continue to be silenced even after leaving the relationship behind; because of course, they have no credentials to validate their educatioN.

CZBZ, M.O.M

 
At 11:09 AM, Anonymous Anonymous said...

Kathy, you are righter than right, if there is such a thing.

I have a Ph.D. myself. Not in the mental health area, though. I'm just a scientist.

When I started graduate school I looked forward to seminars and 'journal clubs' with my mouth watering - couldn't wait for a chance to really sit down and talk with people who were working on the Big Questions. Finally! Real Science!

Hah.

What I found was that nobody, or damn near nobody, worked on the Big Questions.

What they did instead was pick a Little Tiny Question, something they could get a paper published on in a year or less. And the less relevant it was to anything in the actual world, the better.

And believe me, they knew what they were doing. The scorn for those of us who wanted to work on Big Questions was unbelievable. Never mind the scheming, conniving, backstabbing, nepotism in vying for grant money, in having your buddies 'peer review' your submitted publications [by submitting them to places where you knew your buddies would get them for review]... not to mention picking your students and postdocs for their potential as bedmates... the game is so corrupt, so rigged and so irrelevant it's sickening.

So I took my newly minted Ph.D. and wandered off to try and do some actual good... as a result of which, I've been working in proximity to mental health professionals for about two decades now.

*** My. *** Freaking. *** God! ***

You haven't even scratched the surface, but you're right over the mother lode. Keep going, Kathy. You're righter than right.

 
At 4:36 PM, Anonymous Anonymous said...

yup

 
At 8:08 PM, Anonymous Anonymous said...

It makes me think that quite a number of academics happen to be narcissists, who don't want to be exposed...thus their lack of interest in further discussion.

 
At 2:26 PM, Anonymous Anonymous said...

This exposure thing took me awhile to understand. I was slimed by more than one principal who had a need to project all her feelings of inferiority and incompetence onto me. Interesting that in college one female professor told me that she was incompetent. She was kind to me, so when the other individuals slimed me, I really processed it as malignant. I gave up teaching---work places were never conductive for real learning. I just ended up seeing the shadow side. Some people can't change and see how low they have become.

 

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