The NYTimes recently carried an article about the debate about leaving or omitting narcissism in the forthcoming, updated version of the American Psychiatric Association’s influential Diagnostic and Statistical Manual of Mental Disorders. The DSM sets forth the authoritative criteria used by medical professionals to diagnose and treat mental disorders. Narcissism, the article points out, falls into the class of “so-called personality disorders.” People with this characteristic behavior are “severely” disabled.
Narcissism was always a natural. Its technical definition describes a devastatingly vulnerable person, compensating for a deeply imprinted inadequacy with a desperate need for admiration, and a grandiose self-image. “When you see extreme examples of this or other personality disorders, you sit back and say: ‘Wow. It’s just stunning,’ ” said Dr. Darrel Regier, research director at the psychiatric association and co-director of the team updating the DSM. “But all of these disorders are on a continuum with more normal behavior, and people will immediately pick up on some of more annoying traits in the definition and run with it.”
The DSM criteria rest on the delicate balance between “normal” and “abnormal” behavior. This form of behavior draws its name from the Greek myth of Narcissus, a handsome youth who, in escaping the seductive pursuit by the nymph Echo, came upon his reflection in a still pond. The goddess, Nemesis, responding to Echo’s anguish on being rebuffed earlier, had directed Narcissus to the pond. Not knowing it was his own face he saw, he fell madly in love with it. After realizing it was himself that he saw, he beat himself, rent his clothes, and ultimately died of what was inevitably to be unrequited love. The fate of Narcissus is extreme, but the disease can cause much suffering in those diagnosed with it.
It is not clear to me what criteria are being applied in the decision to retain this behavioral “abnormality” or leave it out. The work of the panel revising the DSM is still going on. In any case, my take on this has to do with what is deemed normal and what is not. It is easy to spot a few actors displaying distinctly different behaviors in the hoi polloi, and assess them as abnormal. But as the number of the crowd displaying that behavior grows, what is abnormal gets more and more difficult to single out and what is deemed “pathological” rests on a certain degree of relativity. R. D. Laing, who saw mental illness as culturally dependent, famously defined insanity as a “perfectly rational adjustment to an insane world.”
Cultural norms have been shifting for a while, driven by underlying beliefs and values, towards more autonomy, more independent actions, more selfishness, and other traits entirely consistent with what might be seen as narcissism by professionals. I wonder if the dilemma being faced by the redactors of the DSM is based on some set of “objective” factors, or, rather, on the fact that narcissism has become a culturally normal behavior? The political conversation in the US could easily be interpreted as a bunch of clones of Narcissus talking to one another.