Stop the Stigma

Stigma Is Bad… Except for Narcissistic Personality Disorder?

Mental illness stigma is bad – unless we're talking about narcissistic personality disorder? - image of Narcissus

Mental illness stigma is a very real problem. Those of us living with mental illness usually aren’t thrilled when people casually toss around mental illness diagnoses as adjectives, such as “she’s so bipolar” or “he’s so OCD” or “everyone’s a little ADHD.” Yet, when it comes to narcissistic personality disorder (NPD), all of a sudden there are boatloads of people all over the internet becoming armchair diagnosticians and talking about “narcissistic abuse.” The notion that any of that is really NPD stigma doesn’t seem to cross anyone’s mind.

Let’s call abuse, abuse

Here’s my issue. Emotional/psychological abuse is horrendously damaging, and it’s an issue that doesn’t get anywhere near the attention that it deserves. But when you drag in a diagnostic term in relation to the abuser, that can cause a number of problems. If it can be done so zealously with one diagnostic term, who’s to say that the next big pop culture fad isn’t going to be borderline abuse, or bipolar abuse? Can’t we just talk about the nature of the abuse itself without dragging the abuser’s mental health into it?

Within the broader mental illness world, armchair diagnosing is generally frowned upon as being unlikely to be either accurate or helpful. Yet armchair diagnosis seems to be enthusiastically embraced in pop culture when it comes to NPD. That raises the question, if someone with another presumed diagnosis is an abuser, should that abuse also be referred to by the abuser’s presumed diagnosis?

Fabricating statistics

Being a pop psychology phenomenon, there are a lot of people online claiming to be authoritative about the topic, but there isn’t a solid foundation to ground it all. As an example, there’s an article on Psych Central by a licensed clinical social worker with the title Narcissistic Abuse Affects Over 158 Million People in the U.S. Her definition of narcissistic abuse includes people (and apparently all people) with NPD or antisocial personality disorder (so narcissistic and friends abuse?). She makes some assumptions, makes up some numbers, and concludes that narcissistic abuse affects 3.4 billion people.

Those numbers sound high, don’t they? They’re also pure speculation, based more on NPD stigma and hand-waving than any kind of connection to reality. Numbers are not statistics when they’re based on assumptions rather than actual data.

The Psych Central author quotes a 2010 article from Psychology Today by Sandra L. Brown, titled 60 Million People in the U.S. Negatively Affected By Someone Else’s Pathology:

“There are 304 million persons in the U.S. One in 25 people will have the disorders associated with ‘no conscience’ which include anti-social personality disorder, sociopath, and psychopath. Three hundred and four million divided by 25 = 12.16 million people with no conscience. Each anti-social/psychopath will have approximately five partners who will be negatively affected by their pathology = 60.8 million people!”

The Psychology Today author goes on to say that if that many people were affected by a heart disorder, society would be doing something about it. Now, in case you wondered, she’s not talking about developing therapies that can help people with NPD function more adaptively in their social environment and have healthier interpersonal relationships, because in that sense, it’s not convenient to call it an illness.

“Pathologicals”

The author of the Psychology Today article lumped anyone with a cluster B personality disorder, including antisocial PD, NPD and borderline PD, into an umbrella label of “pathologicals.” She warns that “our future is highly dependent on what we provide as Public Pathology Education,” and goes on to make assorted generalizations from there. Perhaps she forgot to check the dictionary, because, aside from the labelling problem, I don’t think pathological means what she thinks it means. She seems to be assuming that it’s the same as psychopathy (as in being a psychopath), but psychopathology just refers to having a psychological disorder, which includes me and anyone else who has a mental illness.

It’s hard to know where to begin, but it’s about as nonsensical as throwing into a pot everyone with a mental illness that can cause psychosis, including depression, bipolar, schizophrenia, schizoaffective, etc., and concluding that all of those people experience command auditory hallucinations and are likely to kill one person and maim two more.

This is only a tiny sample of what’s out there online, but what I find concerning is that no one seems to be trying to apply the brakes to any of this. I can see how this kind of content is likely to resonate with survivors of emotional abuse, as it’s validating, it offers a “why” for the abuse they’ve experienced, and confirmation bias means that we’re more likely to seek out, believe, and perceive as authoritative, information that matches with our beliefs.

Again, emotional abuse is a very serious problem that should not be minimized. But when people start pulling numbers out of their asses (and these articles aren’t alone in that), it just starts to turn into a circus show. Maybe the next act in the circus will be to start spraying aerosolized antipsychotics to treat all of us who must be hallucinating and therefore getting ready to go on a shooting spree.

Stop the circus show

Why can’t we just talk about abuse without the NPD stigmas circus show?

Even the way terms like “the narcissist” and “the narc” are used would probably be considered cringeworthy if one were to substitute “the borderline,” “the schizo,” “the bipolar,” or “the psycho.” If it’s not okay with other conditions, why is it so enthusiastically embraced with another? Language use is a surface issue in terms of the greater pop culture phenomenon, but it does clearly illustrate the contrast.

I’m not trying to defend all people with NPD, nor am I suggesting that the disorder is an excuse for abuse. In fact, calling it narcissistic abuse, and suggesting that it’s inevitable that everyone with NPD will be an emotional abuser, seems to shift the responsibility away from the individual abuser and squarely onto their mental disorder, absolving them of responsibility for their abusive actions because the disorder made them do it. Of course, that’s absurd, but if we’re to hold individuals responsible for their abusive behaviours, it doesn’t work to say at the same time that it’s fundamentally inherent in the mental disorder. Individuals commit abuse, not personality or other mental disorders.

Some people with NPD are emotional abusers, and that’s a very serious problem. Other people without NPD are also emotional abusers, and that’s just as serious a problem. Should we start treating psychotic and violent as synonymous? Or should we be using “borderline” as synonymous with manipulative, as the popular stereotype suggests? Generalizing that everyone with a certain type of disorder is exactly the same and behaves in exactly the same way is stereotyping, which is a key pillar of mental illness stigma in general.

It’s a slippery slope. Maybe it’s best to back away from the armchair and focus on supporting the people we should be talking about in this situation (i.e. those who have been emotionally abused) without trying to weave the abuser’s mental health into the mix.

Note: My intent with this post is not to criticize individual people who talk about narcissism in this way. It’s become a massive cultural phenomenon, and this is its language. I just think it’s worth some critical evaluation because of that slippery slope.

Mental illness: Stop the stigma - graphic of face and megaphone with the words "speak up"

You can find more on mental illness stigma on the Stop the Stigma page.

Book cover: A Brief History of Stigma by Ashley L. Peterson

A Brief History of Stigma is the upcoming new release from Mental Health @ Home Books. It looks at the nature of stigma, the contexts in which it occurs, and how to challenge it most effectively.

Visit the book page for tips on how to be an effective advocate.

46 thoughts on “Stigma Is Bad… Except for Narcissistic Personality Disorder?”

  1. Thanks so much! I was at one point in Facebook groups for “narcissistic abuse” survivors, because indeed like you say the idea is validating. However, one major issue I have with the term is that abuse is a power dynamic that (at least in theory) anyone can be a perpetrator of and anyone can fall victim to, whereas NPD is a clinical disorder. Also, the term seeks to sort of excuse abuse by deeming its perpetrators mentally ill.

  2. I think people leap from a personality trait (narcissistic, obsessive, etc.) to using the medical term. I guess I do it with “OCD” for myself, though it has somewhat impacted my life, though not to the extent that I can’t work or leave the house. I’ve never been diagnosed, although I’ve read that an eating disorder (which I have) is another manifestation of OCD. Anyway, yeah. Everyone is a doctor now along with being a constitutional scholar and an expert on the economy. The wonders of a google search 🤣

  3. Very interesting read. I’m glad to know why I couldn’t find this post when I saw it yesterday. I’m also glad WP hasn’t messed up my ability to read your posts..I was a bit concerned. I had an Aunt with NPD and it sounds mean to say, but if she got stigma attached to her because of that, she was nasty enough to have deserved it. I have to wonder what occurred to make her like that, because none of her siblings were the same. Mental illness can be a fascinating subject, as long as one remembers to leave the categorizing to the professionals. Thanks for sharing your expertise!

  4. “Can’t we just talk about the nature of the abuse itself without dragging the abuser’s mental health, or lack thereof, into it?” < I feel the same a lot of the time. It's funny you wrote this because I've actually seen a heck of a lot of blogs popping up these days about narcissism and the perpetrators of abuse, like a cult following of individuals rising up against narcissists. I'm usually glad for raising awareness, but it does put me on edge a bit. As for the pop culture phenoms themselves and stereotyping, they'll persevere for all of time. When it comes to comments, 'research' or stats, I always look under the surface now to see who's writing it, why they're writing it, what credentials they really have (often none!), and so on. xx

  5. Being the victim gives people power. I see a lot of people broadcasting online that they have some kind of disability. For instance, one girl practically bragged that she was autistic solely for attention. Most genuine people with disabilities don’t go around actively broadcasting that they have a disability. I know this wasn’t related, but I needed to vent!

    Perhaps people use the “narcissistic survivor” as a way to give themselves power and validation. Going around broadcasting that stuff online tells me that they are seeking attention. People who have suffered some kind of trauma often keep to themselves. It’s good to have support groups, but when does it become too much?

    1. So in your view the only genuine people with disabilities are the ones who are ashamed of it? Plenty of people broadcast things about themselves just because they want to be known, or want to send a message that they’re not ashamed or encourage others who are going through something similar. Autistic people shouldn’t have to justify to neurotypicals why they’re talking about being autistic.

  6. This is a thought provoking piece. I never really thought of the stigma attached to personality disorders. You’re right though. If we frown on stigmas associated with other mental illnesses, then we should think critically about the stigmas of personality disorders too.

  7. When it comes to writing about mental illness I only write about what I know, myself! I leave all the rest to the qualified trained people.
    I do not try to understand the mental state of the ones who abused me. I just leave it where it belongs in the past, at least this works for me. I do not sit and brood over them.

  8. I agree on the stigma and misuse of the terms wholeheartedly, I am quite disheartened when people throw around diagnoses as any adjective. The root of all of this is evolutionary which gets parsed out and divided up into more categories and so on and so on. As a shaman, I can clearly see the levels people go to with this labeling and grouping are reactions to the human condition and are systematic trauma responses. As a person who has endured and survived abuse, I don’t like it when that word us thrown around. Great article my dear, indeed a very bright spotlight needs to be shone on this phenomenon or new epidemic.

  9. Today, I found out a friend had a nickname for me with her other friend. You wanna know what it was? Hypochondriac. 😒 Yeah, some people make me cringe. First, you are talking about me and two you are calling me outside of my name but then saying I didn’t come up with it to hurt you. Yeah, emmmkay.

  10. Apparently, I missed this one. I know, because of all the internal screaming I’m doing. I’d have remembered being that pissed off. Ms. Brown has made me very testy.

  11. I really like your critical view on the topic.

    Individuals commit abuse, not personality or other mental disorders.

    I couldn’t agree more. Great post Ashley.

  12. You have some good points, especially making up numbers is harmful.
    But it’s also important to realize that most people don’t mean a person with NPD diagnosis when they say a narcissist. and most people are not saying that everyone with NPD are abusers. Narcissist is a descriptor, not a clinical term(if someone uses it as a clinical term that’s just not accurate). it is not the same as saying ‘she’s a little ocd’ because ocd is not a descriptor in any setting. people are not saying ‘she’s a bit narcissistic personality disorder’ that doesn’t make any sense, they are saying ‘she’s a little narcissistic’, just as they would say ‘she’s a little introverted/extroverted/perfectionistic/pragmatist…’
    It would be a good idea to focus on finding ways to cure npd rather than make up numbers. Everyone will be better off if npd get easier to recover from. Also shaming people doesn’t help if we want them to get help.

    1. The thing is, though, I see a lot of the people online who are talking about the whole narcissistic abuse phenomenon talking about the diagnostic criteria for NPD and engaging in armchair diagnosis. And the people I’ve come across that are really vocal online about all of this are saying that everyone with NPD is an abuser. These people seem to have large audiences, so it would be hard for that not to trickle down to readers. It would certainly be a lot less of an issue if these folks were simply describing a trait, but if they’re pathologizing, which is what I’ve seen, that’s not describing a trait.

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