@villainatheart
Hello there, 💙
I hear you, it is disheartening that compassionate support for pw/NPD is so difficult to find. It really is sad that untreated NPD can result in hurting others.
I have been diagnosed with NPD and there's still a lot I need to learn about the disorder, its treatment, and about myself. I have also been diagnosed with BPD (borderline personality disorder), so the way my BPD and NPD coexist may not be typical for someone who has the individual disorders.
I was made aware that I had narcissistic traits during my first few appointments with my psychiatrist. In the beginning, the doctor told me something along the lines of
"I can see that there are borderline traits. Narcissistic traits are also present, but this works in your favour because the narcissistic traits can maintain the balance. Your prognosis is better than if only one disorder manifested purely." Hence, I thought the borderline traits were what was causing my main problems, and I took it that the narcissistic traits were helpful.
Although, at that time I didn't fully understand what my psychiatrist meant. I thought, "What on earth does it mean? That doesn't sound like me ...."
I did a lot of reflection and I looked for resources to understand better. Apparently, that did sound like me. "Borderline" and "narcissistic" explained many of the problems I've had since childhood that I didn't even think were that significant.
At some point during a later appointment, I asked the doctor, "Do I only have borderline traits or is it the full disorder?"
I did have the full BPD because when I first visited her for an appointment, I came looking for help with depression and anxiety symptoms. They were causing significant distress and dysfunction in my life, and that was one of the ways the disorder manifested for me.
She also explained how my narcissism could balance it out—how it actually protected me. Since I was so concerned about how others perceived me, I would put effort into the quality of my work to the point of obsessing over perfection. If I didn't have NPD, I would be okay with abandoning my work when I just didn't feel like it. Moreover, it could be a reason why I never actively considered self-harm or suicide—I was too preoccupied with worrying about what others would think.
After that, I sought resources and did a lot of self-work to understand BPD and how to heal myself. I've come a long way and it wasn't always easy, but I've felt significant improvements since then. I've found that the source of my problems were identity issues, rooted in my distorted core beliefs about my self (more on that in this post here).
I talked with my psychiatrist about that discovery I had. I asked her, "What can I do to build a stable identity and sense of self?" The doctor said I could start with the things that I like, and focus on my strengths. At that time, I didn't understand how focusing on my strengths and interests would lead to a stable sense of self. I just tried to believe it and see how things go.
Surely then, I realised that through my interests, I've found things I'm passionate about—through my strengths, areas where I can dedicate myself towards bringing something good. That may not be every single piece of the puzzle that makes up my identity, but this is a huge step.
At one point during a much later appointment, I asked my psychiatrist again, "From my first visit, what are my diagnoses?", to which she said NPD and BPD. She mentioned that the narcissistic is more dominant, even more so since my first appointment. After that, I reflected and educated myself more on NPD. "What is NPD? What does it mean for me? What can I do from here? ...."
Now that's where my journey of figuring out NPD truly began. I couldn't make progress with my NPD as rapidly as I did with my BPD, simply because it was so difficult to find resources for pw/NPD. Most of the resources that come up are aimed at people who have experienced abuse from someone with NPD. Articles like that can be discouraging and hurtful for pw/NPD, and I understand that, since the experience of the person who was abused was really painful. Sadly, it's too easy to forget that everyone's experience with a disorder is different, and not every person with NPD is doomed to be abusive and untreatable. Even the term "narcissistic abuse" became a thing—why not just call it abuse?—having narcissistic traits is not an excuse to be abusive. Unfortunately, NPD is still strongly stigmatised and misunderstood, even within the professional field.
When I think "Am I narcissistic?" and look for the answers, I come across people saying "If you are asking if you are a narcissist, you are not a narcissist". It sounds as if people with narcissistic traits are absolutely not capable of enough self-awareness, nor do they possess the desire to get better. They make it seem like if you have narcissism, you are an inherently evil villain—forever cursed to be difficult, incapable of getting better, and best to be avoided at all costs.
At some point during my journey to figuring out my diagnoses, I came across this video from BorderlinerNotes on Youtube: The Difference Between Borderline and Narcissism (NPD) - FRANK YEOMANS. (They also have a whole playlist with Frank Yeomans here, a lot of the videos cover narcissism)
I was so touched by Yeomans's compassion and empathy.
The interviewer mentioned how now it's not as bad to be a borderline—or at least having NPD is considered worse. Frank Yeomans said,
"Our knowledge has advanced. We understand better how to treat a borderline patient, so they're not as much of a threat to our capacity to help.
I think the field has been slower to advance in treating narcissistic personality disorder, so that negative reaction you described is because a lot of therapists say 'I don't know what to do with this, I mean, I feel disarmed by this problem' as we're trying to develop more effective techniques. So, the problem isn't with the pathology, it's with the lack of expertise in dealing with it."
In another video, Popular Misconceptions of Narcissism - FRANK YEOMANS, he said,
"First of all, I think what you're talking about, is the understandable stereotype that the narcissist is grandiose, arrogant, and that's that. And in fact, that's been an unfortunate limitation of the DSM diagnostic system. If you look at the DSM criteria, they're all about grandiosity, arrogance, entitlement, and so on and so forth.
What we find is that there's the flip side, the defended-against side, 'Why is that grandiosity there, what purpose does it serve?'
You put a narcissist in treatment, and you find an emptiness, a sense of nothingness behind the grandiosity.
I think what most people are missing when they talk about the popular conception of narcissism, is that narcissism is a compensatory psychological stance—it's to make up for something that's missing within the self. Narcissists do not have a core sense of self—they have a core sense of emptiness. So, to not be horrified and depressed and distressed by their own emptiness, they build what we call a pathological grandiose self—a narrative of the self that looks impressive and that they believe in—but that covers over an emptiness."
Hearing him mention the limitation of the DSM diagnostic system is really interesting to me. As a medical student, I've seen this in the environment around me. The way we're taught about mental and physical pathologies often focuses on the symptoms and how to make the diagnosis. The rest of the experience of the patient—"What do they think and feel? Why do they present with those symptoms?"—comes second (or third? not even?). This is worsened by study methods that overly condense these patient experiences as surface-level symptoms that are easier to memorise (and understandably so, since we have so much material to absorb and so little time). Patients aren't unique people with experiences worth listening to anymore, they are reduced to a list of symptoms—with checkboxes to tick in order to diagnose. When you study like that, it's too easy to stereotype people with certain diagnoses, especially mental disorders. It is easy to regard invisible mental disorders as a character flaw or something that someone has a choice on. That's not to say the entire medical field is like that, I'm sure there are plenty of people further down the line who takes a more holistic approach in their treatment—people who genuinely care.
One of the criteria for NPD in the DSM is "lacks empathy and is unwilling to identify with the needs of others" and I think our lack of empathy is another big part of others' impression of NPD.
I think I'm good with cognitive empathy, but I have low affective/emotional empathy. That means I can understand what someone might be thinking/feeling, but I don't physically mirror what they feel. When I don't relate to the other person's situation, this makes it difficult for me to express to them that I care. I want to seem good to them, so I try to compensate by saying or doing things I think they would appreciate—to help them feel better—but sometimes this feels awkward or makes me feel inauthentic, it gets me questioning if I'm being fake and manipulative. Speaking of that, I think I'm also really good with manipulation. When I want to persuade someone, I can be meticulous with every single word I choose and every single thing I let them see, so that everything is purposefully meant to subconsciously influence them. I constantly want to be perceived as the perfect version of myself, because behind all the façade, I believe that I am inherently meaningless. As Yeomans said, I also build a narrative of my self that looks impressive—an ideal version of me that I believe in, that only exists in my imaginary ideal world. That's where I am (as the DSM puts it) "preoccupied with fantasies of success, power, brilliance, beauty, or perfect love"—something I had thought of as mere daydreams with nothing significant underlying it.
My journey with NPD and BPD is still far from over and I'm afraid this post is getting offensively long. 😆 I hope what I've shared here isn't all nonsense and that something can be helpful. 💙
In the end, I believe healing is absolutely possible, even if the journey there has to be painful sometimes. This is not a life sentence. We can reverse our distorted core beliefs, unlearn behaviour patterns that are no longer effective, and replace them with effective ones. There is a difference between being capable of manipulation and choosing to be manipulative at the cost of others. Empathy can be improved with practise, and I believe empathy is not an absolute prerequisite for compassion. I understand empathy makes things a lot easier, but we are capable of choosing to be kind, even when we struggle with empathising. Whatever caused the development of our NPD may not always make sense, it's terrible and it's unfair. However, it is our power and responsibility to grow beyond our diagnosis.
We are here, you're not alone. 💙
