Ameliorating narcissistic personality disorder (NPD)

If you do not know what narcissistic personality disorder (NPD) is, you may want to move on to a different article, because I am not going to explain NPD.

Practically speaking, I suspect that it can help people with NPD greatly to have a “business manager” who is very grounded and who can help people with NPD keep their feet on the ground and for example handle or help them make certain decisions. As many people with NPD are top artists and almost all artists benefit from having a hands-on manager, it seems to make sense from that perspective as well.

There may be more that we can and should do. We. Society. You and I and you there around the corner too. And the medical profession, as well.

Society allows situations that lead to the development of NPD in children, so society should also take responsibility for making the lives of people with NPD as pleasant as possible, enabling them to the best they can be, for everyone else’s sake too.

I’ve been thinking about that.

The nature of NPD — and the common response to it, namely scorn and rejection — is such that it reinforces itself in the brain of the people who have it. Learning comes from repetition. The noisiest neurons get most attention.

What if you could have a therapy that creates and strengthens other pathways in the brain?

Fear is strong in the brains of people with NPD (see this article). Shouldn’t we be able to create exercises that diminish that fear?

Why not? So many things are now possible that we used to consider impossible. We used to think that neurons don’t regenerate and lots of other things that turned out not to be true.

(If you want an example from my own professional background, we used to think that Mn3+ was unstable in solution until we discovered that it can be stabilized through complexation by enzymes such as manganese peroxidase, which is excreted by certain wood-degrading fungi because they want to use the Mn3+ to degrade lignin in wood.)

New technologies are developed all the time that can help stimulate the development or healing of certain (brain) cells.

So this might be possible too.

Not hampered by a thorough background in the fields of neurology and psychiatry, hence still relatively unbiased and open-minded albeit with plenty of experience, I did a few quick searches and I first ran into this:

Well, if even pregnancy can lead to long-lasting changes in the brain…

Then I found this, with more gems inside the paper:

“Elizabeth Phelps and her colleagues (Olsson & Phelps 2004) have shown that people can learn to fear an object (such as a blue square) simply by watching someone else being conditioned to fear that object, because each time the blue square is presented the person observed receives a painful shock. This learning by observation occurs even when the conditioned stimulus (the blue square) is masked and the observer is unable to report when this stimulus occurs.”

The opposite should also be possible, and might also work for people with NPD.

Fear-related learning apparently is much stronger than learning about positive things, I learned from this article, so maybe therapeutic exercises could redirect existing fear responses in people with NPD. (Away from social situations and toward the law, for example. Po-leese.)

The above-mentioned research also seems to explain a lot about how NPD comes about, but unless it is a topic you are already familiar with, this statement will likely be meaningless to you. Let’s say that maybe we really should have parenting licences in the future and really should make the world a much more compassionate place.

(Did you know that psychopathy may tend to develop particularly in babies who are conceived and develop in war situations? All sociopaths and psychopaths have NPD, but people can have NPD without being sociopaths or psychopaths. Psychopaths can be brilliant surgeons who accomplish miracles for you or scientists who for example study psychopathy and then get the shock of their life when one of the brain scans they are studying turns out to be their own.)

I read another paper some time ago that includes brain scans showing that people with NPD have less grey matter in a certain area of the brain. This is related to a lack of emotional empathy (as opposed to cognitive empathy). It makes me wonder if there is a way to do something about that, too. The brain is highly flexible. Could it be possible to create more neurons in that area?

Traditional “talk therapy” reinforces the idea that there is something wrong with the person with NPD and could potentially backfire for that reason. Instead, he or she may need to hear the opposite — that he or she is okay or, better, perfect — in an attempt to address the subconscious and rewire the brain.

The brain is miraculous, and we are nowhere near to using its full potential. Academic learning focuses only on a limited part of what our brains can do. Personality is a creation of the brain and we have less control over it than we would like. Consider personality changes after strokes, traumatic brain injuries or due to dementia.

There is so much we do not know yet.

But one thing is clear. NPD is not an imagined condition, not something to grow out of, not a “character flaw”, not the person’s fault. People with NPD are not horrible people who do unpleasant things on purpose. They have no choice. If anyone would love to cure himself or herself, it’s the person who has NPD.

NPD occurs along a spectrum from mild to severe. But it can be very hard for the rest of us to see the genuine human being in question separate from the condition. Underneath the condition.

Many of the “horrible” things people with NPD do essentially seem to express “This much is how I hurt inside, and I want you to feel that because I don’t know what else to do with it”.

NPD is a very challenging condition, both to have and to witness in people around you.

All in all, its existence and its apparent increase in incidence seem to point out that we need more compassion in the world, not less, and more common sense, and less of the crazy race for the accumulation of power over others, money, fame and material possessions.

Now watch this video and read this article next please, while keeping in mind that the Netherlands scores very low on Hofstede’s index of “masculine” cultures and high on egalitarianism and happiness (though that is slowly starting to change and I find that worrying: