No, Your Partner is Not a Narcissist, Just a Jerk: A Refresher

A few years ago, gaslighting was all the rage. Then gaslighting faded and the newest fad is that everyone we live with or disagree with is suddenly a narcissist or a psychopath. As a mental health professional, I really worry. What all of these terms have in common in social media is that they are not understood or used correctly. Such is a major problem in social media because there is no firewall against authors that print misleading or inaccurate information. For most of us, almost all the information we get is incorrect or simply fake.

Platforms like Medium note that it wants quality work, but very few articles would pass any vetting at all. For example, one so-called expert in psychology notes how children get diagnosed with Narcissistic Personality Disorder. Such is extremely rare and raises ethical questions. Kids don’t often get diagnosed with personality disorders, and there is a reason for that. As a psychiatrist once told me, “We do not cure the disease called adolescence.”  Many middle school kids, for example, exhibit behavior that may look like a personality disorder, but we can be assured it’s only adolescence. Clinicians need to tread carefully because once you give such a diagnosis, it changes that child’s or teen’s life.

Media also wants to make money and will violate ethics in chasing piles of cash. As one that studied paraphilia and other disorders in great detail, we must encourage people to find vetted information, not the public’s regurgitation of its opinion presented as fact. We must hold the bar high despite what the public thinks. Your disagreement with me or mine with you should not end our lives or careers or families’, but we should be responsible. The goal should be good information, not how many likes and follows we get.

These diagnoses require expert knowledge or at least some pretty in-depth knowledge that keeps our prejudices, judgments and emotions at bay. That is the only way we can help ourselves or others.

It is not ethical to diagnose your partner or friend, even if the author is a psychologist or social worker. If I were to diagnose my child or ex-wife, such is unethical and could lead to disciplinary action from my Board. There is a reason people go to graduate school, study the Diagnostic and Statistical Manual of Disorders (DSM) cover to cover, and sit for a national exam, like the bar exam in law school. During this process, they work with supervisors making preliminary diagnoses so that they get practice.

What I am offering here is not simply trying to tell those of you what to do. You will do whatever you want. Social media allows that, but as a therapist and longtime teacher, creditability matters, and so does the harm one can cause by spreading misinformation because, in social media, we all are suddenly experts.

For the record, my words here are based on the DSM-5-TR and my years of providing diagnoses under supervision. I, too, can make mistakes and get a diagnosis wrong, just like a medical doctor can mess up, but I rely on more experienced experts to help me and rely on my clinical supervisor because many diagnoses, like ADHD or other spectrum disorders as well as personality disorders are very complex and have overlapping characteristics. People can often have comorbid factors, dual diagnoses, that also influence behavior. Yes, your boyfriend may be saying he is great and perfect, but that may be a pep talk, not narcissism per say.

It is also important for the individual writing the narcissist piece to ask what role they are playing in the relationship that may or may not be influencing or enabling unwanted behaviors. Relationships are not based on one person’s behavior. Both are involved. That is why a boyfriend, girlfriend, husband, or wife — -a friend — cannot diagnose. They have clouded vision.

Let me start by using my hypothetical self. I have some characteristics of PTSD and Adjustment Disorder, but I do not meet the criteria of either one. I can say that because that is what a therapist tells me, so I don’t have these.  So, if you drop your purse and I jump, you may say, “Earl has PTSD.” That is not correct. If I had PTSD, you just supplied the public with my protected health information which is a violation of the law. If you are a professional, you will lose your license. If you are a friend, such makes you liable for civil damages, including the legal process of divorce, where such could have a significant impact on your right to see your kids, or get any support. This is all to say that when throwing around clinical terms that refer to mental disorders, one has to use caution and should be ethical. Faking your expertise could cost another person their job or even life.

As annoying as that egotistical guy or gal or person is, if they are a narcissist, such is a mental disorder, so they cannot help the way they are. Personality disorders don’t easily fix. In fact, they really don’t fix at all. One cannot make a person with Anti-Social Personality Disorder have empathy because they just don’t get it. I saw this over and over again in prison. Just like you cannot change someone’s attraction or sexual interest. You cannot make a person like someone you think they should like anymore than you can change their personality. They are attracted to who they are attracted to. But they can be managed depending on the severity, and there are some cases where such a disorder can give a person an advantage in a society.

Many brilliant artists suffer from mental disorders. Bipolar Disorder is a major one. They can create phenomenal art when manic. A manic army general can go and go and go when everyone else breaks down. An anti-social or what many call a psychopathic individual can often lead well because they are unaffected by emotions like empathy. Narcissistic folks often run major companies or lead in politics because they pass themselves off as great and perfect, people that can do no wrong, so voters vote for them. They can do very well in interviews as well even if they are totally unqualified for the position. But these are still disorders and many such individuals have tragic endings.

In a society that values money and popularity, status over anything else, one could argue that the society itself has many disorders. I firmly believe that the society causes the disorder in many cases. We  all love psychopaths and narcissists, or at least those that show some of these characteristics. Most of our heroes are anti-social loners that commit violent acts in the name of justice, but so does just about every person sitting in prison for a violent act. They did what they did for their moral reasons.

So, the writer writes about their “narcissist” girlfriend, “psychopathic” boyfriend or “pedophile” brother for their moral reasons, but that does not mean they should do it. Think of the harm the author can cause in such cases, especially if they don’t know what they are writing about. Given the popularity of articles on narcissism, you’d think every other person is a narcissist. It’s not that common. Maybe you live with a jerk. We can all be jerks sometimes.

In differential diagnoses, mental health professionals try to distinguish the differences between disorders that can seem alike. So, for example, Narcissistic Personality Disorder can be coupled with Borderline Personality Disorder, what we call dual diagnosis and both a narcissistic person or one with BPD can seem egotistical. Both can struggle with relationships, though one distinction is that those with BPD tend to sabotage their relationships. In other words, they are so afraid of losing someone that they do everything to lose that someone.

Still, each of these have several criteria that need to be met, not just one. So, if you know a gal that is struggling with relationships, she may not have Borderline Personality Disorder at all. Maybe she has ADHD because some people with ADHD have difficulty with communication and struggle with relationships, and ADHD is not a personality disorder.

You may be convinced that your girlfriend is dressing sexy at the pool, wearing that forbidden G-string, because she is a narcissist, but actually her need for attention falls under Histrionic Personality Disorder because she is seeking attention. However, a woman or man dressing sexy does not mean that they have HPD because they would need to meet at least 4 other criteria to have the diagnosis. With Narcissistic Personality Disorder, one would have to meet 5 of the nine criteria noted to have the diagnosis.

All the while, people can have more than one diagnosis or have no diagnosis but several criteria of several disorders yet be totally functional. Often in paraphilia, the sexual realm, there is the non-disordered version and the disordered one. You can have a thing for socks and function just fine, or your thing for socks gets you in trouble at work, so you’d likely get a non-specified paraphilic disorder diagnosis (there are well over 650 of them). Our sexual strangeness is really not a problem unless we break the law or hurt others or ourselves. Yet our culture refuses to address or educate people about human sexuality, only focusing on what’s vanilla or acceptable.

What does this tell us? People are messy and we are dirty-minded while having very “good” moral intentions. So, when we write about people, let’s stay within our knowledge base. I would never diagnose my friend with cancer even if I am certain he has it. And the dude’s worry that his girlfriend is in a G-string because she is a narcissist may not be addressing his need to control her because he is jealous and suffering with his own anxiety issues and childhood feelings of abandonment. It’s always easier to fault the other person. We can do that, but we should write about what we know or write what we don’t know in a humorous way.