Narcissism Isn’t A Choice – It’s A Mental Disorder

When healing from narcissistic abuse, the aftermath of confusion and pain are often the focus of conversation.

Of course, it’s healthy to discuss and understand your relationship with a narcissist, but I’ve noticed an important aspect missing in that conversation.

Narcissism is a mental illness. In the DSM-5: The Diagnostic and Statistical Manuel of Mental Disorders, (also my version of google) refers to this illness as Narcissist Personality Disorder.

For an individual to meet criteria for diagnosis, five of the following nine symptoms must be present:

• 1. Grandiose sense of self- importance
• 2. Preoccupation with fantasies of success, brilliance, power, ideal love, and beauty.
• 3. A belief that he or she is special or unique and can only be understood by likeminded individuals.
• 4. A need for excessive admiration
• 5. A sense of entitlement
• 6. Exploitative behaviors
• 7. A lack of empathy ***
• 8. Envy of others or belief others are envious of them
• 9. Arrogant or haughty attitude and behaviors

A disclaimer is paramount: behavior ranges on a spectrum. Not all individuals who display a few of these symptoms meet criteria for diagnosis. The average person will experience moments of self-importance, arrogance, entitlement, or a need for admiration, etc.

During an evaluation, presence of symptoms is not enough- duration and frequency are essential components when considering diagnosis. A person who exhibits such symptoms for a short period of time, on a less frequent basis, will not qualify for narcissistic personality disorder.

An individual must present with five out of nine symptoms, beginning in early childhood and also occurring in multiple situations. A desire for admiration, sense of entitlement, arrogance, in romantic relations alone- isn’t enough.

An individual fitting criteria for diagnosis would frequently meet five symptoms with an early onset, causing impairment in several domains of life- social, vocational, educational, and relationships.

Being aware of this is important for healing to take place. You were dealing with a mentally ill individual that operates under a skewed and irrational perception of reality. If he doesn’t acknowledge or seek intensive therapy, he’ll continue to suffer from NPD.

Nothing was your fault. Take it with a grain of salt and never take his actions personally. There’s nothing you could have done differently to change him. It’s a decision he must make. If forced upon him, it would only lead to resentment and under such circumstance, improvement is rarely effective.

All that confusion, frustration, and mental exhaustion wears you down, to the degree of questioning your own sanity. You were in love with an individual who currently lacks capability to think and behave rationally, using manipulation and exploitation as means of communication.

You’re not crazy, dramatic, or asked for too much. You were a vicim responding to a confusing and abusive situation.

This weight is not yours to carry.

It’s time to put it down.

-Jessica Bruno LMHC