November 27, 2004

• PD Soup

  I have been trying to learn more about personality disorders.  Scratch that — I have
  been learning, not only trying.  One of the things I’ve learned is
  that I have so much to learn because the definitions, not just the basic
  nomenclature but the official theoretical model, made one big shift in 1980, with the publication of DSMIII.  Most of what I had learned until recently about abnormal psychology, I had learned before then.

  After months of reading and studying, I’ve become convinced that most
  of what I’ve been learning lately has been simply a new vocabulary,
  many of whose words are nothing more than what Gregory Bateson called,
  “explanatory principles,”  words like, “gravity,” that only give
  us a means of talking about things we don’t understand without helping us
  understand them.  I encounter so much contradictory data, and so
  much that I simply cannot credit because it runs counter to my personal
  experience, that the more I read the less I think the established
  experts know.

  I think it is time for a new model.  I think the psych community
  should get together with the neurologists, neurochemists and
  orthomolecular physicians, with a few hi-tech shamans (not tribal
  medicine men or witch doctors, though I wouldn’t object to their being
  included too) thrown in to keep things
  real, and synthesize a new model of the mind that takes into account
  the electrochemistry involved and the role that nutrition plays in
  it.  The trend has been in that direction for the last quarter
  century, but not much progress has been made. 

  It appears to me
  that a major obstacle to that effort is the pharmaceutical companies
  who fund most research.  They are not going to fund research that
  doesn’t help them develop new pills to sell, and so some of the most
  vital research
  just doesn’t get done.  But even in the absence of new research of
  that type, many of us already know that such things as compulsive
  overeating and compulsive gambling involve the same sort of
  neurochemical cascade effects as drug addictions, and yield to the same
  orthomolecular nutritional supplements.

  The currently trendy system uses five dimensions or axes in diagnosing
  and prognosing psychopathology.  Axis III is concerned with
  physiological conditions, but I have seen scant attention paid to
  nutrition or basic neurotransmitter imbalances.  The emphasis
  there is rather on brain injury and disease states.

  Personality disorders are considered on Axis II along with
  developmental disorders, and there is a baffling amount of disagreement
  among authorities about both.  DSM divides personality disorders
  into three clusters.  
  Researchers, practitioners and other people vigorously dispute the validity
  and usefulness of such classifications because there is a tremendous
  amount of overlap and crossover among them.  NPD, in particular,
  often exists along with other diagnoses and comorbid states such as borderline personality, antisocial personality and various substance addictions.

  In the case of NPD, narcissistic personality disorder, which is what I
  first set out to learn about, those “other people” I referred to include both
  some of the “sufferers” who are diagnosed with the disorders and their
  “victims,” the people who have tried living with them.  I would
  contend that most of the victims are volunteers, and Greyfox frequently
  points out that he and others with NPD make other people around them suffer more than
  they do, but let’s not quibble over semantics right now.

  One of the web’s most prominent authorities on NPD is not a mental
  health professional.  Sam Vaknin has his own website, has
  published a book on NPD, runs a couple of Yahoo egroups on NPD and
  narcissistic abuse, and sends out periodic email newsletters to a list
  of subscribers that includes me.  A websearch today for
  “narcissistic personality disorder” returned 47,000 results.  When
  I added “-Vaknin” to my search terms to eliminate Sam’s sites and sites
  that cite Sam, it brought the number down to 36,000.  Looking
  through them, though, I soon found many traces of Sam Vaknin and his
  view of NPD, only not attributed to him.

  Sam is a pathological narcissist who has found his source of
  narcissistic supply in “helping” the “victims” of other
  narcissists.  The term he prefers is,
  “malignant narcissism,” and on one of the sites featuring his writings
  each page is headed, “Should we call them human?”  From reading
  what he writes about those who have the disorder, one might peg him as
  a victim, not a sufferer.   His bio sets us straight on
  that.  Sometimes Sam contradicts himself, and he is heavily
  emotionally invested in his own theories on the disorder, but what can
  we expect from a pathological narcissist?  Intrinsic to the
  definition of NPD is a heavy emotional investment in one’s own
  idiosyncratic reality.

  Don’t misunderstand me here.  I highly value what I’ve learned
  from Sam.  I quote him frequently, and I print out many of his
  newsletters for my own personal NPD non-sufferer, Greyfox.  I love
  Sam Vaknin.    Now that
  would really rile him!  I don’t suppose he reads my blogs, but if
  he did I’m fairly sure he’d get a little uptight about
  that.   Sam says that Ns feel threatened by love, that it
  brings up all the repressed memories of the abuse and neglect that
  precipitated their disorders.  Although there is widespread
  disagreement among authorities on exactly what causes NPD, Sam is sure
  that it is cruelty and trauma visited upon the Ns in their youth.

  I’m not saying that it isn’t, but I am fairly certain that there are a
  lot of people who have had similar trauma and abuse who have never
  developed malignant narcissism.  I think the reasons for that
  might be found in variations in brain chemistry.  We know that
  various people develop various other mental disorders and addictions
  while other people don’t even though they use the same substances and
  experience similar precipitating factors, because of differences in
  brain
  chemistry.  Why not NPD?  Sam himself has written, “Not
  enough is known about the biochemistry of NPD. There seems to be some
  vague link to Serotonin but no one knows for sure. There isn’t a
  reliable non-intrusive method to measure brain and central nervous
  system Serotonin levels anyhow, so it is mostly guesswork at this
  stage.”

  It may be true that such levels can’t be measured, but it is fairly
  easy, through supplements of certain amino acids, to increase or
  decrease the levels of various neurotransmitters and observe the
  behavioral results.

  In that same newsletter, Sam said,

  “The narcissist’s moods change abruptly
  in the wake of a narcissistic injury.  One can easily manipulate
  the moods of a narcissist by making a disparaging remark, by
  disagreeing with him, by criticizing him, by doubting his grandiosity
  or fantastic claims, etc.

  Such REACTIVE mood shifts have nothing to do with blood sugar levels, or with the presence or absence of any substance or chemical
  [my emphasis].  It is possible to reduce the narcissist to a state of
  rage and depression AT ANY MOMENT, simply by employing the above
  “technique”. He can be elated, even manic – and in a split second,
  following a narcissistic injury, depressed, sulking or raging.”

  What Sam appears to have overlooked here is that rage and depression
  are neurochemical states.  The relative freedom from narcissistic
  rage that Greyfox experienced after he started on orthomolecular
  therapy for his substance addictions seems to suggest that the
  supplements helped.  Also, one of the neurotransmitters
  specifically targeted by those supplements is serotonin.  In the
  fourteen years that Greyfox and I lived together, I noticed
  correlations among his stress levels, nutritional status (and therefore
  his blood sugar levels), drug use, and other pathological
  behaviors including narcissitic ones.  That, too, suggests some
  biochemical connections.

  Recently, Greyfox has begun noticing that some events and experiences
  sure to have triggered narcissistic injury and rage in the past, aren’t
  affecting him that way now.  Since we have been using a holistic
  approach in his therapy — body, mind and spirit — we’ve no clear idea
  how much influence any one aspect of the therapy has had.  In my
  view, they all work together and none would be so effective without the
  others.  I don’t foresee any large research grants forthcoming for
  holistic healing, so meanwhile we’ll just get by on
  self-experimentation and anecdotal reporting.
  

  • 8:36 pm
  • 10 Comments