Diagnosing narcissism is very difficult. When someone has narcissistic personality disorder, they will often not be diagnosed. They believe that everything is someone else’s fault and never take responsibility for their behavior. As a result, a diagnosis is unoften impossible to do be done by a competent professional, and “remote diagnosis” must be done. However, that’s a big taboo in psychiatry…
How to diagnose narcissism?
Diagnosing narcissism is done through the use of a long questionnaire coupled with consultation. This is done to determine if the patient meets at least five of the following nine criteria from the ‘Diagnostic and Statistical Manual of Mental Disorders’ (DSM)
Narcissistic personality disorder criteria
- Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).
- Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
- Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions).
- Requires excessive admiration.
- Has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations.
- Is interpersonally exploitative, i.e., takes advantage of others to achieve their own ends.
- Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.
- Is often envious of others or believes that others are envious of them.
- 9. Shows arrogant, haughty behaviors or attitudes.
Diagnosing narcissism by a psychiatrist
Diagnosing narcissism can only be done by an authorized person such as a psychiatrist, who has examined the person in question. The remote diagnosis of someone who is not their patient is against the professional code of conduct for psychiatrists. In some countries, this is even prohibited by law.
The consequences of the taboo on remote diagnosis
In my article “Narcissistic Mother” I described under “Dad goes to the mental hospital” that the doctors in the psychiatric hospital saw through my narcissistic mother. Note: My father was driven into this institution by her.
Well, I don’t think they were actually diagnosing narcissism. This took place in the early 1980s, when not as much was known about narcissistic personality disorder as it is today.
But their realization that she has a serious mental disorder is clear from their statements: “We have the wrong one here”, “Every human feeling is foreign to her” and “She only comes here to destroy you even more”.
Quote from “Narcissistic Mother“:
I still find it astonishing today that these doctors caught on but didn’t ring the alarm bell! Knowing that this monster had two children in her care, they should have reported this to child protection. But Dad was their patient and they had nothing to do with anyone else, so they did nothing. And our narcissistic mother was able to continue her devastating work…
The fact that my father’s treating physicians did not sound the alarm is probably due in part to the taboo on performing remote diagnosis. If someone came up with the idea to report this, there was a good chance that they would be blamed. And since everyone is very afraid of losing their own position, they did nothing, despite all the consequences for the victims…
Diagnosing narcissism by a layperson
Knowing that remote diagnosis by a psychiatrist is taboo, it should be clear that diagnosing narcissism as a layperson is completely unacknowledged. This makes it very difficult for victims to gain recognition.
The abuser will not voluntarily be diagnosed, and without diagnosing narcissism by a licensed physician, the person doesn’t formally have a narcissistic personality disorder.
When a victim of narcissistic abuse reports to a support agency, there is a good chance that they will be told that they are not allowed to diagnose someone as a layperson. The perpetrator, therefore, remains out of the picture and the real cause is not treated. This means that the victim becomes a victim again, which is called secondary victimization.
Secondary victimization means that a victim is confronted with incomprehension and dismissive social reactions, and thus becomes a victim of the same offense twice.
How I came to diagnose my mother with narcissism
I’m going to make the story personal again by analyzing how I diagnosed my mother with narcissism. I am not a doctor and I am not allowed to make any official diagnosis of narcissism. But I can judge a person I’ve lived closely with for 47 years.
What came before
During my childhood, I was mentally abused by my narcissistic mother. I describe some examples of this in the article “Narcissistic mother”. When I brought this up later, she always reacted hysterically, and counterattacked, but never took the blame.
After this happened again at the beginning of 2015, I had had enough. She had touched me in such a way that there was no turning back. It would either be talked out in a normal way or I would break contact with her, as my sister already did before.
Breaking that contact with her was not a conscious choice. It was more so out of pressure, out of desperation. In retrospect, this was the best choice I made in my life, just way too late!
Many features of NPD are mentioned without realizing
After the incident had haunted my mind for days, I decided to send my mother an email telling her the truth and giving her a choice. She would not open this email, so I printed it and brought it to them personally.
Below are some excerpts from that email. Also, note how many characteristics of narcissistic personality disorder I mention in it. And at that time I didn’t even know anything about NPD!
Mom,
You don’t seem to want to see it, but our family bond is hanging on a thread! For a moment I had the hope that it would finally lead to a conversation, but last Tuesday returned to your old habits. And again I fell for your manipulations and deleted the e-mail in question and promised to write a milder version. Well, I won’t do the latter. I no longer allow myself to be manipulated and blackmailed. Just read what I have to say to you.
“What’s wrong with me now?” you once asked *** after getting a letter from aunt ***. Well, I’ll give you the answer to that. What’s wrong with you is that you don’t have any empathy for others and no self-reflection at all. You absolutely cannot handle the smallest criticism and immediately react aggressively. You always find the smallest fault in others while ignoring the massive issues in yourself.
A few weeks ago, you once again hurt me deeply with your sarcastic remark after I called a particular incident a “traumatic experience”. I have been trying to discuss this incident with you for almost 30 years but every time I end up retreating while you react aggressively. You only want to hear what suits you and whoever doesn’t agree will gets it with both barrels.
I’m not looking for a fight. If I talk to you about something, I want to make it clear that you hurt me. I want some acknowledgment for the suffering that has been done to me. Instead, I get a sneering comment. With this, you indicate that you have no empathy, that you do not want to think about it, and that you want to put cast yourself as “more pathetic”.
In this introduction alone I already mention several symptoms of a narcissistic personality disorder. I counted no less than ten!
Overwrought or narcissist?
Later in the letter, I list incidents of mental abuse. I even show some understanding because at the time I thought she did all that in a tense situation…
I understand the fact that you are in an overstrained situation – and I know what it is to be overstrained – everyone has lashed out at the wrong person at some point. But every evening? And that against your own child? Any sane person could see in an instant that what you are doing is awful.
As a child, I thought I would have done something – though I didn’t know what – that I deserved such a thing. Unlike you, I always looked for the fault in myself. But in my twenties, I started to realize that your behavior was pure mental abuse! Since then I have tried several times to talk to you about this. But as soon as I broach the subject, you react hysterically and aggressively and there is an immediate counterattack. Then you drag up other situations and people, to divert attention from yourself, and you force me on the defensive.
You don’t even want to think for a second about what I’m saying, let alone take responsibility for your behavior. It’s always someone else’s fault. But you were the adult who should have known better. I was a child, a vulnerable child at the time. In a hostile environment, you expect to find some safety with your mother. And of all people, you, my mother, would scold me every evening! Nothing, absolutely nothing, justifies taking out your frustrations on a child in that way. And until this day you do not want to be held accountable for it!
After every attempt to discuss this with you, I was frustrated to conclude that this is not possible. What you’re doing is just rubbing more salt into the wounds. Apparently, you always want to win and since you can’t do that with arguments, you behave aggressively as described above. Then I keep silent about it for years, meanwhile, it kept playing on in my mind. You may feel like you win the confrontation, but you lose your child!
About the divorce
In the letter I continue to describe the period during and after the divorce, which can also be found in the aforementioned article. In what follows, I describe her reaction when I confront her with the events of this period.
If I start talking about that time, you’ll soon be whining that no one understands you. But have you ever made an effort to understand another? Have you ever wondered what those times have been like for me? At the time you chose to marry Dad. I didn’t pick my parents. Suddenly, as a 16-year-old, I was faced with a fait accompli and existed between my parent’s constant conflict.
As for Dad. Your marriage was a great tragedy of two people who did not understand each other at all but came together by fate. You probably never would have married, were it not for the stupid scheming of your parents trying to split you up, but instead driving you to each other. Besides the fact that there are already enough differences between men and women, your characters differed too much from each other. Your marriage was doomed from the start.
Dad also made mistakes, but he is certainly not a bad person! He is a pathetic person, a war victim, and, a patient. And that’s not something he chose himself as you always suggest. No one chooses that, any more than I chose to have a social phobia. The fact that other family members have not become like that does not mean anything. Everyone is different and if you have a predisposition for something and you grow up under the right circumstances, you get it. That’s how I developed a social phobia and Dad got depersonalization. I suspect that deep in your heart you also know that, but you don’t want to see it out of self-protection…
Still unknowing…
It appears from the above passage that I was still unaware of narcissistic personality disorder at the time. With the knowledge now possess I view this very differently. My parent’s marriage was indeed doomed from day one. But not because they didn’t understand each other, but because of my mother’s covert narcissism.
And regarding your numerous attempts to convince me that I am less than in the eyes of my father, stop. If that’s the case, I’ll arrange it myself with him in my own way. And yes I talk to him in a different way than I do to you. But you bring that on yourself by immediately acting aggressively when I speak to you about something.
I am used to being second. I was always blamed when I was bullied by my sister. I was the bad boy, she was the sweet girl… And you always told me I would be a selfish person with a bad character. And then those “funny” evenings when *** (my sister’s boyfriend at the time) was always with us. I was insulted by him all the time and you didn’t say anything about it. But God forbid if I insulted him back. Apparently, you had stronger maternal feelings for him than for me…
Maternal feelings?
Now I know that those “maternal feelings” were a bit different than I thought at the time of writing. Our narcissistic mother always seemed to want to hit on my sister’s boyfriends. For example, she had once stood in front of one of them with a bare chest and asked if he liked her breasts.
Over the past ten years, we have built up a good relationship. You already made the first cracks a few years ago. When I visited you and *** (Her new victim) and the conversation turned to fireworks you suddenly started talking about that time at school when some fireworks exploded in my jacket during the daily bullying. Do you have any idea how humiliating something like that is? And then you casually ask: “Didn’t they drag you across the floor?”.
I can forgive you for making a clumsy comment. But not for your reaction when I confronted you about it at my house a few days later. “I will put a clamp on my mouth from now on. I can’t say anything either” you responded. Once again you showed that you have zero empathy and that you do not want to take responsibility for your own mistakes. If you had said “sorry I wasn’t aware of that” then that would have been it. But because of your aggressive reaction, this incident has brought back very bad memories of you. For the sake of peace, I let it go (So don’t say I spare Dad and attack you!). But this time I CAN’T!
I strongly urge you to seek help because there is something profoundly wrong with you. It seems you have no conscience. You say the most horrible things and don’t want to be held accountable for it. Instead, you blamed others. I suspect this is your repression mechanism so as not to have a guilty conscience.
A narcissist has no conscience!
Here too I was heading in the right direction, but not quite. I assumed my mom has a conscience, now I know she doesn’t!
The bad comments you made recently were the straw that broke the camel’s back for me. You have no idea how much you hurt me with this. What I have put in this letter I have carried with me for decades. There’s no turning back now, either you face the facts or you’ve lost me too.
Herman
Looking for answers
It’s mind-boggling how many traits I list that correspond to the narcissistic personality disorder, which I had never heard of at the time. While writing this letter it became increasingly clear to me that there must be something very seriously wrong with my mother.
I started researching all kinds of mental disorders. As I have already described in other articles, I encountered various disorders with common ground, but too few to make a “diagnosis”.
When I simply typed some of her character traits into Google, I came across an article about narcissistic personality disorder. The recognition was instantaneous. Since then I have immersed myself in this phenomenon and read a lot about it.
Diagnosing narcissism
Again, I know I am not a licensed physician and I am also careful not to label anyone who crosses my path. But I now know so much about narcissistic personality disorder that I dare to diagnose narcissism in my mother’s case.
