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=== Self stigma ===
=== Self stigma ===
Self stigma is the process in which a person internalizes the stigma and stereotypes around them by applying them to the self<ref>{{cite book |last1=Bathje |first1=Geoff |title=Encyclopedia of Critical Psychology |chapter=Self-Stigmatization |year=2014 |pages=1713–1716 |doi=10.1007/978-1-4614-5583-7_395 |isbn=978-1-4614-5582-0 }}</ref>. This can lead to problems with self-esteem, depression and identity<ref>{{cite journal |last1=Sheehan |first1=Lindsay |last2=Nieweglowski |first2=Katherine |last3=Corrigan |first3=Patrick |title=The Stigma of Personality Disorders |journal=Current Psychiatry Reports |date=2016 |volume=18 |issue=1 |page=10|doi=10.1007/s11920-015-0654-1 |pmid=26780206 |s2cid=23014378 }}</ref>. Research has shown that the public is less likely to think individuals with personality disorders need professional help<ref>{{cite journal |last1=Furnham |first1=A |title=Mental health literacy and borderline personality disorder (BPD): What do the public "make" of those with BPD? |date=2015}}</ref> and instead hold the belief that those with personality disorders should be able to exhibit control over behaviours caused by said disorders<ref>{{cite journal |last1=Aviram |first1=RB |title=Borderline personality disorder, stigma and treatment implications. |journal=Harvard Review of Psychiatry |date=2006|volume=14 |issue=5 |pages=249–56 |doi=10.1080/10673220600975121 |pmid=16990170 |s2cid=23923078 }}</ref>, combined with the clinical belief that people with Narcissistic Personality Disorder are untreatable.<ref>{{cite journal |last1=Lewis |first1=B |last2=Appleby |first2=L |title=Personality disorder: The patients psychiatrists dislike |journal=The British Journal of Psychiatry : The Journal of Mental Science |date=1988 |volume=153 |pages=44–9 |doi=10.1192/bjp.153.1.44 |pmid=3224249 }}</ref> Low public mental health literacy has been linked to low treatment-seeking from those suffering from disorders the sufferers themselves stigmatize<ref>{{cite journal |last1=Corrigan |first1=PW |title=The impact of mental illness stigma on seeking and participating in mental health care |journal=Psychological Science in the Public Interest : A Journal of the American Psychological Society |date=2014 |volume=15 |issue=2 |pages=37–70 |doi=10.1177/1529100614531398 |pmid=26171956 |s2cid=2942361 }}</ref>. Narcissistic personality disorder has notably low treatment-seeking behaviour, most often seeking treatment for less stigmatized [[comorbid]] issues.<ref>{{cite journal |last1=Dhawan |first1=Nikhil |last2=Kunik |first2=Mark E |last3=Oldham |first3=John |last4=Coverdale |first4=John |title=Prevalence and Treatment of Narcissistic Personality Disorder in the Community: A Systematic Review" |journal=Comprehensive Psychiatry |date=2010 |volume=51 |issue=4 |pages=333–9 |doi=10.1016/j.comppsych.2009.09.003 |pmid=20579503 }}</ref>
Self stigma is the process in which a person internalizes the stigma and stereotypes around them by applying them to the self<ref>{{cite book |last1=Bathje |first1=Geoff |title=Encyclopedia of Critical Psychology |chapter=Self-Stigmatization |year=2014 |pages=1713–1716 |doi=10.1007/978-1-4614-5583-7_395 |isbn=978-1-4614-5582-0 }}</ref>. This can lead to problems with self-esteem, depression and identity<ref>{{cite journal |last1=Sheehan |first1=Lindsay |last2=Nieweglowski |first2=Katherine |last3=Corrigan |first3=Patrick |title=The Stigma of Personality Disorders |journal=Current Psychiatry Reports |date=2016 |volume=18 |issue=1 |page=10|doi=10.1007/s11920-015-0654-1 |pmid=26780206 |s2cid=23014378 }}</ref>. Research has shown that the public is less likely to think individuals with personality disorders need professional help<ref>{{cite journal |last1=Furnham |first1=A |title=Mental health literacy and borderline personality disorder (BPD): What do the public "make" of those with BPD? |date=2015}}</ref> and instead hold the belief that those with personality disorders should be able to exhibit control over behaviours caused by said disorders<ref>{{cite journal |last1=Aviram |first1=RB |title=Borderline personality disorder, stigma and treatment implications. |journal=Harvard Review of Psychiatry |date=2006|volume=14 |issue=5 |pages=249–56 |doi=10.1080/10673220600975121 |pmid=16990170 |s2cid=23923078 }}</ref>, combined with the clinical belief that people with Narcissistic Personality Disorder are untreatable.<ref>{{cite journal |last1=Lewis |first1=B |last2=Appleby |first2=L |title=Personality disorder: The patients psychiatrists dislike |journal=The British Journal of Psychiatry : The Journal of Mental Science |date=1988 |volume=153 |pages=44–9 |doi=10.1192/bjp.153.1.44 |pmid=3224249 }}</ref> Low public mental health literacy has been linked to low treatment-seeking from those suffering from disorders the sufferers themselves stigmatize<ref>{{cite journal |last1=Corrigan |first1=PW |title=The impact of mental illness stigma on seeking and participating in mental health care |journal=Psychological Science in the Public Interest : A Journal of the American Psychological Society |date=2014 |volume=15 |issue=2 |pages=37–70 |doi=10.1177/1529100614531398 |pmid=26171956 |s2cid=2942361 }}</ref>. Narcissistic personality disorder has notably low treatment-seeking behaviour, most often seeking treatment for less stigmatized [[comorbid]] issues.<ref>{{cite journal |last1=Dhawan |first1=Nikhil |last2=Kunik |first2=Mark E |last3=Oldham |first3=John |last4=Coverdale |first4=John |title=Prevalence and Treatment of Narcissistic Personality Disorder in the Community: A Systematic Review" |journal=Comprehensive Psychiatry |date=2010 |volume=51 |issue=4 |pages=333–9 |doi=10.1016/j.comppsych.2009.09.003 |pmid=20579503 }}</ref>

== Viewpoints ==
* 21st century [[transactional analysis]] has highlighted clients who suffered some narcissistic abuse as children (that is, an injury to their developing selves), examining for instance the boy in an all-female household who only survived by developing powerful [[emotional antennae]]{{Disambiguation needed|date=February 2020}} in order to respond to the emotional needs of his mother and sister.<ref>H. Hargaden/C. Sills, ''Transactional Analysis'' (2002) p. 131</ref>
*[[Jung|Post-Jungians]] have explored the after-effects of an intense narcissistic wound resulting from an oppressively unempathetic parent.<ref>Andrew Samuels, ''Jung and the Post-Jungians'' (London 1986) p. 228</ref> In particular, [[Polly Young-Eisendrath]] emphasises how the narcissistic longings of parents to amass reflected glory through their children can bring disastrous results for parent and child if both lose their capacity for autonomous development.<ref>Polly Young-Eisendrath, ''Women and Desire'' (London 2000) p. 198</ref>
*[[Object relations theory]] for its part stresses both that the most [[Psychological trauma|traumatizing]] experience of all is the absence of emotional giving from a parent, and that, in an intergenerational pattern, people who have been brought up by tyrannical authoritarian parents will often parent their children in the same way.<ref>Neville Symmington, ''Narcissism: A New Theory'' (London 1993) pp. 75, 79</ref> [[Adam Phillips (psychologist)|Adam Phillips]] adds that the parent who colonizes their child and stifles gestures of autonomy and difference breeds in them an often unconscious craving for the dead-end justice of revenge.<ref>Adam Phillips, ''On Flirtation'' (London 1994) p. 106</ref>
* In another tradition, [[Julia Kristeva]] points out how a pairing of mothers and fathers, overprotective and uneasy, who have chosen the child as a narcissistic artificial limb and keep incorporating that child as a restoring element for the adult psyche intensifies the infant's tendency toward [[omnipotence]].<ref>Julia Kristeva, ''Black Sun'' (New York 1989) pp. 61–62</ref>
*[[M. Scott Peck]] looked at milder but nonetheless destructive common forms of parental narcissism, as well as the depth of confusion produced by his mother's narcissism in a more serious instance.<ref>M. Scott Peck, ''The Road Less Travelled By'' (1990) pp. 175–77</ref>


==See also==
==See also==

Revision as of 11:52, 10 October 2020

Narcissistic abuse is a hypernym for the psychological, financial, sexual, and physical abuse of others by someone with narcissistic traits or suffering from narcissistic personality disorder (NPD)[citation needed]. Narcissistic Personality Disorder has been referred to as a mental health condition by several medical research and journal organisations, such as, for example, the United States National Library of Medicine, Mayo Clinic, and Cochrane medical journals.[1] [2] [3][relevant?]

Types of abuse

The concept of narcissistic abuse, based on Alice Miller’s observations in The Drama of the Gifted Child based on a mother-son relationship, has grown to be used in reference to all kinds of relationships. There is little evidence to show psychological, financial, sexual or physical abuse manifests itself differently or more often in people with narcissistic traits or narcissistic personality disorder.[4]

Psychological abuse

Main article: Psychological abuse

Financial abuse

Main article: Economic abuse

Sexual abuse

Main article: Sexual abuse

Physical abuse

Main article: Physical abuse

Controversy

Historically, narcissistic abuse is based on Alice Miller’s model of the narcissistic parent, laid out in The Drama of the Gifted Child, and taken to apply to relationships beyond parent-child. [5]

Stigma of NPD (narcissistic personality disorder)

People suffering from personality disorders, including, but not limited to, narcissistic personality disorder, face stigma in everyday life, including from themselves, society, and even clinical situations.[6]

Clinical stigma

Clinical or provider stigma is the disapproval of, or discrimination against a person based on perceivable patient characteristics that serve to distinguish them from other patients. In an opinion piece by psychologist Erika Penney, Brittany McGill and Chelsea Witham titled "Therapist Stigma towards Narcissistic Personality Disorder: Lessons Learnt from Borderline Personality Disorder", they propose the link to the stigma of BPD and NPD. Extensive research on the stigma against borderline personality disorder has been done but the same has not been done for narcissistic personality disorder.[7] This is significant given that clinical stigma impacts the treatment outcome of patients.[8] It is a common response for therapists to use countertransference such as retaliation or devaluation against common narcissistic symptoms and behaviours.[9] Such responses are likely to reenact familiar behavioural patterns and reinforce unhealthy coping mechanisms in patients.

Common countertransference to narcissistic behaviour shown in table below.

Patient Experience Observable Behaviour Common Therapist Countertransference
Overcompensation to avoid a sense of vulnerability. Idealisation of the self or expression of superiority. Admiring, disengaged, bored, resentful,inadequate, or frustrated.
Avoidance of uncomfortable emotions. Avoidance of emotions with

self-stimulating or self-soothing activities (e.g., gambling, alcohol, risk-taking, grandiose fantasising, binge eating, or excessive dedication to work).

Anxious, critical, disengaged, frustrated, helpless, overwhelmed, or feeling stuck.
Activation of rage when vulnerability threatens to surface Rage and uncontrolled aggression. Anxious, afraid, overwhelmed, ‘walking on egg-shells,’ confused, mistreated, angry, resentful, urge to retaliate, or urge to withdraw.

The de-stigmatization of mental health disorders is important discourse for clinical psychologists and the widespread use of highly stigmatizing language may promote avoidance of further research and discrimination against people with NPD.[7]

Self stigma

Self stigma is the process in which a person internalizes the stigma and stereotypes around them by applying them to the self[10]. This can lead to problems with self-esteem, depression and identity[11]. Research has shown that the public is less likely to think individuals with personality disorders need professional help[12] and instead hold the belief that those with personality disorders should be able to exhibit control over behaviours caused by said disorders[13], combined with the clinical belief that people with Narcissistic Personality Disorder are untreatable.[14] Low public mental health literacy has been linked to low treatment-seeking from those suffering from disorders the sufferers themselves stigmatize[15]. Narcissistic personality disorder has notably low treatment-seeking behaviour, most often seeking treatment for less stigmatized comorbid issues.[16]

See also

References

  1. ^ Ennis, N.; Pereira, D. B. (2017). "Narcissistic Personality Disorder in Clinical Health Psychology Practice: Case Studies of Comorbid Psychological Distress and Life-Limiting Illness". Behavioral Medicine (Washington, D.c.). 43 (3). United States National Library of Medicine: 156–164. doi:10.1080/08964289.2017.1301875. PMC 5819598. PMID 28767013. {{cite journal}}: |first1= missing |last1= (help)
  2. ^ "Narcissistic Personality Disorder". Mayo Clinic. Retrieved 1 September 2020.{{cite web}}: CS1 maint: url-status (link)
  3. ^ "Condition - Narcissistic Personality Disorder". Cochrane. Retrieved 1 September 2020.{{cite web}}: CS1 maint: url-status (link)
  4. ^ McMurran, Mary; Howard, Richard (2009). Personality, personality disorder and violence: An evidence based approach.
  5. ^ Miller, Alice (1979). The Drama of the Gifted Child (The Search forthe True Self ed.). p. xvii.
  6. ^ Sheehan, Lindsay; Nieweglowski, Katherine; Corrigan, Patrick (2016). "The Stigma of Personality Disorders". The Stigma of Personality Disorders. 18 (1): 11. doi:10.1007/s11920-015-0654-1. PMID 26780206. S2CID 23014378.
  7. ^ a b Cite error: The named reference penney was invoked but never defined (see the help page).
  8. ^ Ferguson, A (2016). "Borderline personality disorder and access to services: A crucial social justice issue". {{cite journal}}: Cite journal requires |journal= (help)
  9. ^ Behery, W; Dieckmann, E (2013). "Understanding and treating pathological narcissism". Schema Therapy for Pathological Narcissism: The Art of Adaptive Re-parenting: 285.
  10. ^ Bathje, Geoff (2014). "Self-Stigmatization". Encyclopedia of Critical Psychology. pp. 1713–1716. doi:10.1007/978-1-4614-5583-7_395. ISBN 978-1-4614-5582-0.
  11. ^ Sheehan, Lindsay; Nieweglowski, Katherine; Corrigan, Patrick (2016). "The Stigma of Personality Disorders". Current Psychiatry Reports. 18 (1): 10. doi:10.1007/s11920-015-0654-1. PMID 26780206. S2CID 23014378.
  12. ^ Furnham, A (2015). "Mental health literacy and borderline personality disorder (BPD): What do the public "make" of those with BPD?". {{cite journal}}: Cite journal requires |journal= (help)
  13. ^ Aviram, RB (2006). "Borderline personality disorder, stigma and treatment implications". Harvard Review of Psychiatry. 14 (5): 249–56. doi:10.1080/10673220600975121. PMID 16990170. S2CID 23923078.
  14. ^ Lewis, B; Appleby, L (1988). "Personality disorder: The patients psychiatrists dislike". The British Journal of Psychiatry : The Journal of Mental Science. 153: 44–9. doi:10.1192/bjp.153.1.44. PMID 3224249.
  15. ^ Corrigan, PW (2014). "The impact of mental illness stigma on seeking and participating in mental health care". Psychological Science in the Public Interest : A Journal of the American Psychological Society. 15 (2): 37–70. doi:10.1177/1529100614531398. PMID 26171956. S2CID 2942361.
  16. ^ Dhawan, Nikhil; Kunik, Mark E; Oldham, John; Coverdale, John (2010). "Prevalence and Treatment of Narcissistic Personality Disorder in the Community: A Systematic Review"". Comprehensive Psychiatry. 51 (4): 333–9. doi:10.1016/j.comppsych.2009.09.003. PMID 20579503.

Further reading

  • Angela Atkinson, Jillian Tindall, Navigating No-Contact with a Narcissist: A Recovery Roadmap for Survivors of Narcissistic Abuse (2017)
  • Patricia Evans, Controlling People: How to Recognize, Understand, and Deal with People Who Try to Control You (2003)
  • Alice Little, No Contact - The Final Boundary: Surviving Parental Narcissistic Abuse (2016)
  • Alice Miller, The Drama of the Gifted Child (1979)
  • Steven Stosny, Treating Attachment Abuse (1995)
  • Estela Welldon, Mother, Madonna, Whore: The Idealization and Denigration of Motherhood (1988)
  • Shahida Arabi POWER: Surviving and Thriving After Narcissistic Abuse: A Collection of Essays on Malignant Narcissism and Recovery from Emotional Abuse Paperback (2017)
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