Since the American Psychiatric Association is constantly discovering new mental ailments—and they occasionally recognize that previously unhealthy mindsets and behaviors have become so pervasive they can no longer be considered aberrations—the DSM requires periodic revision.
The current authoritative version is DSM-IV-TR, or DSM, fourth edition, text revision. That means that if you were diagnosed with a defect according to the third edition standards, you may now have a clean bill of health. And, for those of you whose diagnosis is still included in DSM IV, don’t despair; they are currently consulting about version five, and who knows what psychoses may soon become “normal.”
I had to study these things during my seminary training, for my counseling work as a chaplain and civilian pastor. I was thinking about the manual recently as I pondered the spirit of Narcissus that seems to hold sway in our age. Like C.S. Lewis, I understand there is value in studying Greek and Roman myths, as many contain seeds of Truth. (Lewis’ appreciation for myth is most evident in Till We Have Faces, which is a reworking of one ancient Greek tale.)
Narcissus, of course, is the mythological Greek who was so consumed by his own handsomeness that he perished because he was unable to tear himself away from gazing at his own likeness. (The image above was painted by Michelangelo Caravaggio in the sixteenth century.)
Narcissism, which echoes his name, describes the unbridled vanity and self-concern (i.e. selfishness) that motivates growing numbers in our individualistic and hedonistic world. Since narcissism has become so rampant, the DSM now concerns itself only with “pathological narcissism.” That distinction will probably remain, even if Narcissistic Personality Disorder (NPD) is eliminated from the fifth edition as a distinct illness, as many have recommended.
God Save Us from the Narcissists
Pathological narcissists are terrible indeed. Their characteristic arrogance, envy, sense of entitlement and lack of empathy make them unhealthy members of society. In fact, large numbers of sociopaths and psychopaths are also narcissists.
But here’s the problem. At the rotten core of the disorder we find a putrid seed that negatively affects many of us who appear otherwise to be so normal. The source of the corruption is, in part, sinful pride.
Let’s take a look at the “diagnostic criteria” for NPD which confronted me when I first studied DSM III. (Perhaps you may wish to skip this section, since modest hints of some of these traits may strike close to home.) I’ve added my own introspective comments in italics.
Diagnostic criteria for 301.81, Narcissistic Personality Disorder:
A pervasive pattern of grandiosity (in fantasy or behavior) hypersensitivity to the evaluation of others, beginning by early adulthood and present in a variety of contexts, as indicated by at least five of the following:
(1) Reacts to criticism with feelings of rage, shame, or humiliation (even if not expressed).
– I’ve never “raged,” but it’s embarrassing to be criticized in public
(2) Is interpersonally exploitive: takes advantage of others to achieve his or her own ends.
– Never. I won’t tolerate manipulation–either as the manipulator or the manipulatee.
(3) Has a grandiose sense of self-importance, e.g., exaggerates achievements and talents, expects to be noticed as “special” without appropriate achievement.
– Have I told you lately about being Thespian of the Year when I graduated from high school . . ?
(4) Believes that his or her problems are unique and can be understood only by other special people.
– Not this trait, I’m aware everyone in this fallen world is faced with challenges . . . many of them worse than my own.
(5) Is preoccupied with fantasies of unlimited success, power, beauty, or ideal love.
– I do daydream about accomplishing special goals, although I never lusted after power and I accepted the facts about “beauty” long ago. I have, however, found ideal love, and we’ve been married 37 years!
(6) Has a sense of entitlement: unreasonable expectations of especially favorable treatment, e.g., assumes that he or she does not have to wait in line when others must do so.
– I’m the opposite. I always pick the longest and slowest line to stand in.
(7) Requires constant attention and admiration, e.g., keeps fishing for compliments.
– If people weren’t so frugal with compliments, I wouldn’t need to.
(8) Lack of empathy: inability to recognize and experience how others feel, e.g., annoyance and surprise when a friend who is seriously ill cancels a date.
– Nope. I really do care about others. That’s the reason good clergy and caregivers often suffer compassion fatigue.
(9) Is preoccupied with feelings of envy.
– Well, what about those cases where the person doesn’t deserve the honors they’ve received . . ?
There, I feel much better, having made a public confession of my almost-narcissistic human self-centeredness.
In his essay “Christianity and Culture,” C.S. Lewis warns that “A man is never so proud as when striking an attitude of humility.”
When we admit, instead, that there remains much in our soul that is base and prideful, we’re on the proper path. The course that leads to a rejection of Narcissus-in-us, and the embracing of what is precious in our neighbors and our world, is the road that leads to contentment.