Me, myself and I

Son of the water god, Narcissus was legendary for his beauty. When Echo, the nymph, fell in love with him, he rejected her. Heartbroken, she disappeared, leaving her voice behind. Angered by this, the gods made Narcissus come across a pool while hunting. Having never seen himself before, the dude fell in love with his reflection. He was thirsty, but didn’t want to disturb the image. He died by the pool side, pining for himself.

This Greek myth first featured in Homeric hymns in the seventh or eighth century. A thousand years later, in 1898, the story was resurrected by English sexologist Havelock Ellis. He used the term “Narcissus-like” in reference to excessive masturbation — where the person becomes his or her own sex object. Later, Sigmund Freud used the Greek legend to explain a psychological trait in humans, and it was defined as a ‘personality disorder’.

In 1980, it was included in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), published by the American Psychiatric Association and used as a guide by psychiatrists and psychologists the world over. But, now, the Narcissistic Personality Disorder (NPD) is being eliminated from the fifth edition of the DSM (due out in 2013).

So, what’s going on? Have we suddenly stopped being self-absorbed, and are there fewer narcissists amongst us? On the contrary, studies suggest that the social media age has spawned a more self-absorbed culture than ever before, as we constantly seek validation of ourselves on sites like Facebook and Twitter.

But that’s actually part of the problem that the DSM committee wants to resolve by removing NPD from the manual. Narcissism has become a part of our everyday lingo to describe anybody who is a little too full of himself. This can make a person selfish, egotistic and difficult to get along with, but not necessarily a candidate for the psychiatrist’s couch.

The Narcissistic Personality Disorder is a serious condition, with symptoms similar to those we loosely associate with narcissism but far more persistent and obsessive. The DSM committee of psychiatrists believes that the symptoms of this disorder, which requires treatment, often appear along with symptoms of other personality disorders and it would be more useful to club it under a broader head. This would also leave alone people with quirky or idiosyncratic behaviour which may be narcissistic without being a personality disorder.

Who, me, narcissistic?
The counter-view is that removing the NPD category would make it even harder to identify people with a narcissistic disorder who do need psychological help. That’s because, typically, the narcissist (in the clinical sense of the term) will be the last one to admit that he has a disorder, even when it causes great harm to himself and those around him. Take the case of Vishal Rathe*, 28-year-old manager at a consulting firm, who first sought help because he was depressed. Smart, good-looking and hard-working, Rathe quickly progressed professionally and was popular when he first joined the firm two years back. But, over time, his incessant need for appreciation from superiors as well as subordinates began to push his colleagues and friends away. He was no longer the star of every party, and he stopped attending parties altogether.

Eventually, a friend convinced him to see a psychologist for his depression and loneliness. But, when he was diagnosed with a narcissistic personality disorder, Rathe rejected the counsellor. It was only after two more counsellors made the same diagnosis, that he finally accepted he had a problem. After a year of counselling, Rathe’s relationships have improved marginally.

People suffering from NPD generally try to hide what they really feel about themselves, says psychiatrist Shefali Batra, who runs Mindframes, a counselling centre in Mumbai. “The pride is their façade, a defence mechanism for low self-esteem. Like most personality disorders, NPD too is triggered by one’s childhood environment. If a child is not given positive regard, his/her self-esteem is affected in later years,” she says.

Driving others up the wall
Psychiatrist Rhea Tembhekar of the Coffee Counselling Centre in Mumbai feels the removal of NPD from DSM-V will affect the identification and treatment of the disorder. “If we come across someone who has a narcissistic streak, we need to make a mention of NPD in his diagnosis so that the psychotherapist can counsel the person accordingly,” she says.

While all of us are self-centred to some extent, and we often refer to ourselves or others as narcissists in jest, the disorder itself can be quite a serious problem because it affects not only the person affected but others who interact with him as well. “Like the term ‘psycho’, ‘narcissist’ too found its way into colloquial vocabulary, but there is a fine line between being self-centred and excessive self-absorption which is a clinical problem affecting one’s relationships at work and home,” says Tembhekar.

Praveen Acharya*, a 33-year-old businessman, for instance, was so critical of everything people did that his family became scared of him and his employees would quickly seek jobs elsewhere. His wife felt inadequate because nothing she did was ever good enough. On the verge of a split, the couple approached a psychologist for marriage counselling. The counsellor soon realised it was Acharya who needed therapy, but he would not accept this.

“People with NPD find it very difficult to accept that they need therapy. Even those who do accept it sometimes use their disorder as a ‘weapon’ against friends and relatives, making excuses for their behaviour,” says psychiatrist Veena Chakravarthy. This too is a defence mechanism, say experts.

Narcissists typically look for others ‘like them’, who, they believe, have higher intelligence or are better-looking than others, much like the Greek legend Narcissus, who turned down Echo because he thought she was beneath him.

(*Names changed on request)