The removal of NPD from the DSM would be a disaster


Apparently, the removal of Narcissistic Personality Disorder (DSM-V code 301.81; ICD-10 code F60.81) from the Diagnostic and Statistical Manual of Mental Disorders is still being considered.   Sam Vaknin talks about it in this video.

I think its removal would be disastrous. It already scares me that narcissism seems to be increasingly regarded as an advantage in today’s winner-take-all society and that we even have a potential US President who is a poster boy for malignant NPD. Trump has even been given the NPD label by many mental health professionals. Yet he still remains popular and is a serious contender for our next President.

But narcissism (not the healthy, but the pathological type) is definitely not a positive thing. Narcissists are actually miserable people even if they become successful (and many of them do not). These are people without a real sense of self, who have constructed a false one to compensate and must feed off others like vampires to keep their false self intact. They do others a lot of damage, even if they think they don’t have a problem. Under the facade, these are people who have a vast well of emptiness inside and if the false self is removed through loss of narcissistic supply, will become deeply depressed, possibly psychotic, and even suicidal. NPD is a serious mental illness, but I think people tend to forget that, because on the surface, people with this disorder can seem so functional. SEEM is the operating word here.

Many self-help books, especially those that tell you how to be successful, encourage you to develop narcissistic traits. I think these books are dangerous, not only because they encourage people to become narcissists, but also because they have caused a shift in thinking about NPD to the point that many no longer consider it a mental illness and in fact think of it as something to strive for. We need to stop pretending narcissism isn’t a problem. More attention needs to be paid not only to the damage narcissists cause others, but also to the internal world of the NPD, which is a painful and bleak one. NPD is a serious mental illness, not a “personality type.” Its removal from the DSM would cause untold damage to the world.

We also need more mental health specialists who are actually trained to treat people with NPD. I think part of the reason why it’s under consideration for removal is because most therapists don’t want to treat people with NPD. If you have the diagnosis, you are shown the door. They don’t want to deal with you and assume you are incurable. Hence, there are more narcissists walking around doing damage to themselves and others than ever before. I don’t think the non-malignant type of narcissist is as incurable as people think; it’s just because it isn’t an easy disorder to treat and therapists don’t want to be bothered working with people who have it. Old-school psychiatrists and psychologists such as Kohut, Kernberg, Masterson, and Lowen treated people with NPD successfully in their practices, but we seem to have forgotten that and just assume it’s incurable and worse, that it’s not even a mental illness but a personality type. This needs to change!


5 thoughts on “The removal of NPD from the DSM would be a disaster

  1. I nearly spat out my coffee reading the fact that NPD removal was still being considered. My god, after all this time it still isn’t as well understood and it should be; not to mention the fact that it took so damn long to get it into the DSM in the first place…the last thing Narcs needs is more leniency!

    Liked by 1 person

  2. Thank you for this proclamation NOT to disarm the DSM-V code for NPD/BPD and alike, Luckyotter. For in my infancy of discovering why I am/was repeatedly magnetized to intriguing, brilliant and extremely charming high functioning yet moderate NPD/BPD ladies, I was able to validate my initial observations through the DSM-V code 301.81; ICD-10 code F60.81 found online. I was desperately seeking WHY my 32yr marriage was ultimately a train wreck and the first 52yrs of life was so dysfunctional and in repeated emotional ruin. If it were not for the reading and understanding of the DSM IV-V evaluations; in the beginning, I would still be wondering what is wrong with me as well as the ones I am drawn to. That was 7yrs ago and from that first “official” stepping stone of the DSM validation I am a recovering “fixer/rescuer,” completely understanding both sides now of this dysfunctional equation and why we are what we are; that of myself and that of the NPD/BPD’s. I wholeheartedly support NOT eliminating the DSM-V code 301.81; ICD-10 code F60.81 for this very reason. I am confident that others may find their new beginnings with this official clinical validation of those of us who are drawn emotionally and those of us who are emotionally predatory without maybe evening knowing it. Congratulations and many blessings to you on the discovery of the NEW YOU, your therapeutic blogs and reaching out to those of us learning to/or living with recovery of the same. Wishing you all the best, thank you.

    Liked by 1 person

    1. Thank you so much for sharing your story and your feelings about this possible travesty in psychiatry. The more people speak up about this, the more we can fight it and keep NPD in the DSM. It may seem like a small thing, but being that the DSM is the “bible” of both clinical psychologists and psychiatrists, its removal would have very negative effects. Not to mention, that it could no longer be used in courts of law for prosecution purposes (although, admittedly, the stigma is very bad and that needs to change too).


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