Narcissism in the DSM-5
The Diagnostic and Statistical Manual6 is an officially sanctioned reference work consulted widely in medicine and psychotherapy to identify (diagnose) what are broadly referred to as “mental” disorders.
Narcissism is one of the so-called “personality” disorders, which bears a striking resemblance to the vices of pride, taken as a syndrome of related attitudes. In the case of this disorder, at least, the word “personality” can be replaced with “character,” bringing out that the functional and experiential dysfunction that the disorder visits on human lives belongs as much or more to ethics than it does to medicine.7 The havoc and unhappiness wrought by narcissism center in social relationships. Narcissism tends to render these relationships (at least secretly) adversarial, and consequently to undermine and nullify them.This chapter assumes that harmonious, mutually satisfying interhuman relationships are central to proper human functioning and happiness, and that anything that undermines them as insidiously and systematically as narcissism assaults human well-being at its core. I will here offer a philosophical commentary on the criteria presented in the DSM-5 for narcissistic personality disorder (NPD), to draw out the systematic connections among them, and render them somewhat more precise. In the present section, the words in boldface are from the DSM-5 on pages 669—670; the other words are my commentary.Narcissism is
A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
(1) has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
If grandiosity (in fantasy or behavior) is “aiming at great things against right reason,”8 then grandiosity is not, as such, a mark of narcissism.
A young person might want to be a movie star, but unrealistically, because she doesn't have what it takes to become one.This unrealistic ambition might pervade her young life. But this by itself is no symptom of narcissism. The reason that the unrealistic ambition by itself doesn't amount to narcissism is that it doesn't have the target essential to narcissism. In this first criterion, the DSM notes that the target of narcissistic grandiosity is “self-importance.”What kind of importance of the self is self-importance? Not every desire to be important is narcissistic. I suppose that everybody wants to be important to somebody—to his mother, his family, his church, his God, perhaps even his nation. A person who feels utterly unimportant— unloved, unappreciated, worthless to all the world—has a severe life-deficit, and cannot be called happy. So people need to be important and to know themselves to be important. By contrast with this healthy kind of importance, self-importance is, from a deeply human perspective, a pseudo-value, not really importance at all: it is the kind of importance a person might feel as a result of being envied, admired as superior to others, having power over others, or having entitlements that others don't have. It's the kind of importance that the envious person is seeking when he feels frustrated and resentful of the rival who outshines him. It's the kind of importance that snobbish people feel they get from belonging to prestigious institutions and being accepted in the company of “important” people, a kind of importance that snobs take to be lacking in people who attend state universities and don't belong to any elite. Not all self-importance is individualistic. Snobbery, for example, has a “we—self” character, since it values belonging to an elite group. Racism can be seen as a kind of snobbery; other in-group “we—self” vices of pride are homophobia, sexism, and some forms of nationalism. If self-importance, the pseudo-value, is what persons with the vices of pride seek and value, then any concern for it whatsoever is vicious.There is no mean, no right amount or right way in which to love it.As Aristotle points out, there is no normative mean of vice.9
(2) is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
The comment on (1) suffices as comment on (2).
(3) 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)
As noted above, snobbery is one of the vices of pride.
(4) requires excessive admiration
The admiration in question here is the admiration sought by the passion (vice) of vanity. It is admiration that “satisfies” the desire for the pseudo-good of self-importance.This admiration is the kind that recognizes a person as “special,” that is, superior to others; it is the desire for this, in abstraction from any real excellence, that defines vanity. Whatever real excellence is admired is incidental or merely instrumental to the vain person's elevation above others. Note the basic meaning of “vain”: “a. Devoid of real value, worth, or significance; idle, unprofitable, useless, worthless; of no effect, force, or power; fruitless, futile, unavailing” (OED, first definition). I'm not saying that what occasions the admiration must actually be idle, unprofitable, useless, worthless, etc. A person might be vain of something that is genuinely admirable, such as beautifully performing a piece of music, or rescuing someone from poverty, or passing significant legislation; what makes for the character trait of vanity is that the individual’s chief reason or motivation for doing the admirable thing is to garner the admiration of important people and thus to be important (self-important) himself.The narcissistic passion for admiration devalues what it seeks admiration for by valuing it for a vain or empty reason.
It is healthy and good to enjoy admiration for genuinely admirable accomplishments. This enjoyment is a kind of fellowship with the admirer: something that you highly appreciate, something that you poured yourself into, is appreciated by another; and your common appreciation is a kind of joyful and grateful communion with a fellow human being. The narcissist, as such, is not interested in such communion, but just in the self-importance that the admiration of the admirer seems to him to project on himself.
So “excessive” is perhaps not quite the right word to identify what it is about admiration that is characteristically narcissistic. The narcissist is not defined by the amount of admiration he “requires,” but by the kind he seeks—namely, vain admiration, admiration as serving self-importance.(5) has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
The narcissistic concern for special entitlements goes by the name of “arrogance” or “presumption” in ordinary English (note DSM criterion (9)).As criterion (5) notes, some of the narcissist’s expectations of being treated as privileged are usually unreasonable.That is, some of them are not legitimate entitlements. The reason will be that he doesn’t seek entitlements just for their value as entitlements, but less discriminately, out of a narcissistic hunger for them—that is, to enhance, support, or express his self-importance.What is the legitimate value of special entitlements?
Entitlements are used to regulate social life in the interest ofjustice and the human good. For example, certain government officials are entitled to see classified documents that are not available to the public, because the information in them may be relevant to governing the nation. Doctors are entitled to order medicines for their patients that the patients are not entitled to buy without such prescription, because the doctor is presumed to be in a better position than the patient to know what the patient needs. And so forth for all socially legitimate special entitlements. The kind of entitlements that are designed to protect an elite, such as membership in an exclusive club, or racist entitlements that deny privileges to the non-members of a given race, are implicitly in the service of the narcissistic concern. In such manifestations, the selfimportance in arrogance has a “we—self” character.
So it is perfectly rational and consistent with humility to desire the special entitlements that facilitate one’s contribution to justice and the public good.The essential reason for wanting and enjoying such entitlements is to make one’s special contribution.
But this is not the narcissist’s characteristic reason. The narcissist, as narcissist, wants such privileges because they enhance or express his self-importance.Thus, it is not essential to narcissism merely to desire and enjoy entitlements, but rather to do so for the sake of one’s self-importance.The latter is what (5) expresses with “has a sense of entitlement.” If a person who has such a sense of entitlement suffers from arrogance, a person who, perhaps with frustration, seeks and longs for such entitlements is proto- arrogant. He has the concern that defines arrogance.I said above that, typically,“some” of the narcissist’s entitlement claims are illegitimate, implying that some of them may be legitimate. Illegitimacy of entitlement claims is only an indicator
of narcissism, not a necessary condition of it. A person can be narcissistic about entitlement claims that are legitimate for him. For example, a government official might experience narcissistic enjoyment of his legitimate privilege of viewing classified documents. The essential narcissistic feature is how he regards them; why entitlements interest him. To the extent that he desires and takes pleasure in having special entitlements as enhancing his self-importance, he is narcissistic, whether or not he has legitimate claim to them.
(6) is Interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
The narcissist’s “ends” are typically ones that enhance or maintain his sense of self-importance: prominence, power, privilege, and wealth, for example.To be exploitative of other persons is not just to gain advantage from what others do; in any division of labor and sharing of its fruits we gain advantage from others’ contributions, and we naturally and legitimately seek such advantage. The DSM uses “exploit” in this criterion to indicate that the “advantage” gained by the narcissist is unfair in some way. I mentioned domination as one of the vices of pride. It is the narcissist’s exercise of power over others for the sake of the self-importance he feels he garners from it.
It is a co-opting of another person’s agency. I suppose that domination is most paradigmatic where the unfairness is objective. For example, a professor co-authors scholarship with a graduate student. The work represents almost entirely the student’s creativity and labor, but the professor designates herself“first author” and in a footnote thanks the student for his “help.” But narcissism doesn’t require material unfairness. It is a matter of attitude, to wit, the attitude toward the “exploited” one. Narcissistic pleasure in exercising power over others, even where it is overlaid with a patina of solicitous concern for the other, will harbor an element of disrespect: the domineering agent in reality secretly sees the exploited one as little more than an instrument of his self-importance. This attitude is also unfair, though it is so only attitudinally.To see its moral shortcoming, think of how the “exploited” one would feel if she vividly perceived the exploiter’s attitude. Among possible responses, she feels hurt if she cares about his attitude; or she “writes him off ” in an effort not to care.(7) lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
Many of the vices of pride make the value of the self depend on the devaluation of the other. Examples are envy, invidious triumph, snobbery, conceit, hyper-autonomy, and self-righteousness. The vices of pride are vices, in large part, because they are self-serving while involving a false conception of the value of the self and its good; and they distort the value of the self, in large part, because of their exploitative conception of the value of the other. What makes the other good for me is his inferiority or failure relative to me—his value as an unsuccessful rival. Empathy, as it is understood in (7), is a benevolent feeling of the feelings of others. It is a rejoicing in the other’s joys, and a sympathy with the other’s sorrows; and these feelings are based on being concerned for what the other is concerned about, on behalf of the other. In empathy we track, in agreement, the other’s concerns, and when we communicate such feelings to the other, she tends to feel supported, respected, and even loved. It is really a bit of an understatement to say that the narcissist lacks empathy, and that “those who relate to individuals with narcissistic personality disorder typically find an emotional coldness and lack of reciprocal interest” (DSM V, 671).This is true, but it is an understatement because so often the narcissist is not just cold to the other, but implicitly malevolent insofar as his exploitative attitude positively opposes the other’s interest.
(8) is often envious of others or believes that others are envious of him or her
People are sometimes surprised that I include envy among the vices of pride. They should also be surprised that the narcissist, who supposedly has a grandiose view of his own importance, is characteristically envious.The envious person is not proud of himself, they think.To feel proud is to feel good about oneself, but to feel envy is to feel oneself to be a loser in relation to the rival and to feel bad about oneself. It is to feel frustratingly small.
It is true that envy is not a feeling of pride or of grandiosity. But the vices of pride are basically concerns and allied dispositions of thought, not feelings. Envy, thought of in this way, is a disposition to feel the emotion of envy, and this disposition is a concern to be important by besting certain others in some respect that is thought to be “enviable”—intelligence, strength, beauty, talents, skills, wealth, power, etc.When a person who has this concern and this way of thinking about his value as a person is bested by a rival, then he feels envy; but when the same individual bests the rival, he feels invidious triumph, which is a feeling of pride—vicious pride.Thus the disposition to envy and the disposition to invidious pride are the same concern, the same disposition, and it gives rise to one or the other emotion depending on the circumstances—or, more precisely, on the individual’s construal of the circumstances.10 (8) identifies both possibilities and suggests that they have the same root: to believe, with delight, that others envy you is just the flip side of believing, with pain, that others justifiably believe that you envy them.
(9) shows arrogant, haughty behaviors or attitudes
Essentially, (9) is a repetition of (5), so my comments on (5) will suffice.
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