The last week has seen a surge in two horrible phenomena that have been troubling me for the past two years. One is obvious and requires no further explanation. But part of the reaction to Trump has been ugly, and frankly has come from people who I expected better from.
All shapes and sizes of media outlet have taken to calling Trump a narcissist. Sympathetic right-wing outlets brush over it, while left-wing outlets – supposedly “woke” to mental health issues – base entire articles on it. The only real counter-narrative is that it’s wrong to diagnose people from afar.
While armchair diagnosis is difficult, the more problematic element of this whole affair is the idea that being a narcissist is somehow comparable to Trump’s politics, his divisive rhetoric, or his contempt for the rule of law. This adds to the immense stigma around a hugely stigmatised mental illness.
What is Narcissistic Personality Disorder?
The DSM-5 is America’s premier diagnostic manual; I’m using it ahead of the WHO’s ICD because it was updated more recently. The DSM gives the following symptoms of NPD:
- Having an exaggerated sense of self-importance
- Expecting to be recognized as superior even without achievements that warrant it
- Exaggerating your achievements and talents
- Being preoccupied with fantasies about success, power, brilliance, beauty or the perfect mate
- Believing that you are superior and can only be understood by or associate with equally special people
- Requiring constant admiration
- Having a sense of entitlement
- Expecting special favors and unquestioning compliance with your expectations
- Taking advantage of others to get what you want
- Having an inability or unwillingness to recognize the needs and feelings of others
- Being envious of others and believing others envy you
- Behaving in an arrogant or haughty manner
Yes, most of these traits are ways we describe people we don’t like. And yes, this could also be a description of Donald Trump’s public behaviour.
However, don’t most of those traits also sound like horrible symptoms to have? Narcissists tend to base their entire self-worth on the number of compliments that they get. Every criticism is an injury, every rejection is a humiliation. Failing to receive the admiration they feel they deserve, or meet the unrealistic achievements or beauty standards they set themselves, undermines their fragile self-esteem. And of course, because people generally don’t like manipulative, self-absorbed egotists who demand special treatment, compliance, and devotion. Most narcissists aren’t popular high-fliers who throw their loyal friends on the scrapheap, but outcasts desperate for any form of affection.
It bears repeating that this is a mental illness, not someone just being a cold sadist. Narcissists are hugely fragile individuals. Yes, they can be exploitative and self-centred, but to focus exclusively on how exploitative and self-centred they are – and indeed, to interpret their other symptoms through the lens of how horrible it is to know them – is profoundly ableist.
The NPD stigma
Woke people generally accept that it’s wrong to stigmatise mental illness. And yet, in practice there’s little accessible information about NPD that isn’t pure stigma. Searching the internet for “narcissism” returns the Wikipedia page, and then a string of articles about “spotting the warning signs” and “surviving” being around a narcissist. The more clinical “narcissistic personality disorder” is better, returning the usual suspects like WebMD and Medline high in the rankings, but spotted alongside the scaremongering popular articles.
Even phrases like “narcissism self-advocacy”, “narcissism neurodiversity” or “narcissism positivity” don’t return anything aimed at narcissists themselves or providing education: instead, they’re about standing up to narcissists and recovering from “narcissistic abuse”. While these are important subjects, they show how skewed the NPD discourse is.
For another measure, notice that the Reddit sub /r/RaisedByNarcissists, dedicated to blaming all parenting failures on narcissism, has over 130,000 subscribers. /r/NPD, seemingly the largest sub for people with NPD, currently has 555.
As an autistic person, this is all too familiar. For decades, autism was only understood through the perspective of the people “affected” by autism: our parents, lovers, and the professionals that surrounded them. Organisations that claim to help us focus their resources on creating mass panic about epidemics of child-theft. Parents who claim to care for us can be praised as heroes when they murder us. Works like Mark Haddon’s Conradian novel The Curious Incident of the Dog In The Night-Time get praised for “taking risks” by featuring autistic characters who are negative stereotypes rather than believable portrayals.
Since the birth of the autism rights movement in the early 90s, big steps have been taken towards learning more about autism and how to improve autistic people’s lives. This has incidentally done more to improve the lives of our families than fifty years of prescription bleach and electric shocks. Surely it must be worth trying the same approach with narcissists. There’s every chance that approaching narcissism from a non-judgemental neurodiversity paradigm will do more for those “affected” by narcissism than the stigma does. It certainly can’t be worse for the narcissists themselves.
Socially Acceptable Mental Illness
Away from the scary world of Trump, Le Pen, and Brexit, mental health is the issue of the day. There seems to be an ever-increasing willingness to talk about mental illness, politicians promise funding parity with physical treatments, and the stigma surrounding mental health is tumbling.
At least, that’s the narrative. I’m fairly sure it’s true for depression, anxiety, stress, and PTSD. We all know friendly, likeable people with these conditions, and charismatic celebrities speak about them openly. Bipolar disorder, too, seems more widely accepted than it used to be, probably largely thanks to the friendly face of Stephen Fry. It wasn’t so long ago that this was a “hard” mental illness, the meth to schizophrenia’s heroin. Now, we might not understand it, but we’re also not afraid of it.
But schizophrenia? Psychosis? Borderline? Narcissism? Not only is our understanding of these conditions even worse than for depression and anxiety, there’s a tendency to view people with these conditions as inherently “bad” or dangerous in a way that there simply isn’t for the more “socially acceptable” mental illnesses. Our fears about these sorts of conditions are just as irrational and disproportionate as they would be about depression. Regardless of the name of the illness, the mentally ill deserve to be supported, not feared.
It would be completely unacceptable to suggest that someone shouldn’t be a politician because they are depressed, so why is it acceptable to suggest that they shouldn’t be a politician because they have a “nasty” mental illness?
If your fight against the stigma of mental illness ends as soon as you get to a condition with any real stigma attached to it, then you are not fighting against the stigma of mental illness.
Attack Trump when he behaves like Andre Bikey. Attack Trump when he brings America’s name into ill repute. Most importantly, attack Trump whenever he turns a destructive idea into a destructive policy. But don’t drag narcissists into it.