Sub-types of NPD.

I find this "sub types" to be completely useless. Yes, might help people identify MORE disordered people, but no one is 100% anything. But you can just keep describing overall behaviors of people who fit the diganosis, and maybe those will also show to repeat and therefore make another person eligible for a diagnosis.

I think people see psychiatric diagnosis for some sort of explicit, precise and absolute thing the diagnosed person fits completely. it's actually a very crude, yet refined to it's essence, map on what to spot that is considered POSSIBLY an specific disorder. Yet, these specific disorders aren't well defined biologically either. Considering the millions of possible biological variations (plus life circumstances + personality) within a single individual, it's pointless to try to fit someone to a diagnosis completely. All a person has, really, is an amalgam of symptoms, with a lot of variations exclusive to that person (albeit the specific symptoms will repeat accross different people, in essence).

And by the way, personality disorders (as they are on the DSM) are biological, it's NOT the thing we develop because of life experiences + biological make up. They're caused by biological changes and abnormalities in the individual. Schizo* PDs and dramatic PDs all show to have differences in the brain compared to individuals without those PDs. What's really hot, though, among researches, right now, is the hormonal changes and pre-natal stuff on most mental illnesses.

Sorry if I seem rude or confusing, i'm under the influence of a lot of Xanax right now.

twistednerve wrote:I find this "sub types" to be completely useless.

I've always foudn the same thing. If you make a list compaing Overt and Covert, I could put a check mark next to almost everything in both columns. I think it's just a difference in communication style and not a different type of disorder.

And by the way, personality disorders (as they are on the DSM) are biological, it's NOT the thing we develop because of life experiences + biological make up.

This is incorrect, though. It is always recognized, even in obviously-biological disorders like Bipolar, that environment has some percentage of effect. It was earlier presumed that PDs were 100% environment, but we know that isn't true or else everyone with abuse would be BPD (for example). Now it's sort of considered that PDs have a greater origin in childhood abuse than "more biological" ones, but it's acknowledged that there needs to be a preexisting propensity towards the development. The percentage is unknown (and irrelevant really, except to people who feel "biology" is "proof" of something).

undenied wrote:

twistednerve wrote:I find this "sub types" to be completely useless.

I've always foudn the same thing. If you make a list compaing Overt and Covert, I could put a check mark next to almost everything in both columns. I think it's just a difference in communication style and not a different type of disorder.

And by the way, personality disorders (as they are on the DSM) are biological, it's NOT the thing we develop because of life experiences + biological make up.

This is incorrect, though. It is always recognized, even in obviously-biological disorders like Bipolar, that environment has some percentage of effect. It was earlier presumed that PDs were 100% environment, but we know that isn't true or else everyone with abuse would be BPD (for example). Now it's sort of considered that PDs have a greater origin in childhood abuse than "more biological" ones, but it's acknowledged that there needs to be a preexisting propensity towards the development. The percentage is unknown (and irrelevant really, except to people who feel "biology" is "proof" of something).

Though specific triggers and conditions may exist for PDs, I do believe at least cluster A and B ones require a strong biological basis. Actually, Cluster B PDs are more biological/physical than bipolar, schizophrenia or other axis 1 stuff.

Axis 1 disorders are usually small malfunctions here and there, or on a particular area of the brain or body. Cluster B disorders are pre-natally formed, usually, and no matter what the environment the individual lives, they are likely to show on some form or another. I think the environment molds the disorder somewhat, but it's still there.

Stress is really a trigger mostly on anxiety related disorders. Bipolars, for example, usually don't complain much of stress... They're likely "to flip" when feeling a lot of joy or miss a night of sleep.

The reason medication doesn't work for PDs aren't because they're in our memories, thought patterns, etc.... it's because they go deeper than what medications can do. Their bodies/brains tend to be VERY different, and their hormones are insanely dysregulated. Not many medications work on this, as of now.

Another thing that used to trick people into believing it was a matter of "learned behavior", was the age where cluster B disorders usually got better, between 45 and 65.
Turns out it's not maturity or any concept like that, it's actually the hormonal loss of old age. Less hormones = less Cluster B activation.

Cluster As usually remain the same, but pick up a thing or two here and there - it depends how bad their cognitive distortions and anhedonia is, usually.

Now, Cluster Cs, do look like it's untreated early childhood anxiety and environmental circumstances feeding it. I don't get Cluster C disorders very well, really. Looks like plain old anxiety and obsessive compulsive stuff influencing behavior. Nothing that standard medication plus habit breaking and disentisation doesn't fix.

twistednerve wrote:Though specific triggers and conditions may exist for PDs, I do believe at least cluster A and B ones require a strong biological basis. Actually, Cluster B PDs are more biological/physical than bipolar, schizophrenia or other axis 1 stuff.

While I agree with the first sentence, the second is incorrect according to current research on both PDs and axis 1 disorders.

Bipolar and Schizophrenia in particular are primarily neurological disorders, genetic, hereditary, and . They're most certainly not "small malfunctions". I'm also confused about your description of "flipping" in Bipolar, as a mood episode can certainly be triggered by something, but often is not. The trigger is not at all the cause.

I agree that PD, specifically Cluster B, are probably pre-natal (that's what temperament is, anyway) but pre-natal is not synonymous with genetic nor hereditary. I do not see evidence that "cluster b shows up no matter the environment", because if a person was indeed born with a predisposition towards Cluster B, but then didn't experience the abuse-triggers, then it wouldn't show up and they woul be unaware of the predisposition.

I have not seed evidence of the other things you describe like "hormonal imbalance". Do you have citations? The last I read, not only "imbalance" an incorrect interpretation of maladjusted neurology, but that still wasn't the primary theory of PD development. Yes, a person is born with a neurobiological propensity to, say, being hypersensitive, but the reason that becomes disordered is due to years of negative reinforcement. If this is no longer the primary theory, I'd definitely love to read the work on it.

I could also argue that the "getting better" for Cluster B in older ages, while probably hormonal, does not necessarilly point to an original hormonal origin. Less activation, certainly, but that isn't the same thing.

I don't get Cluster C disorders very well, really. Looks like plain old anxiety and obsessive compulsive stuff influencing behavior. Nothing that standard medication plus habit breaking and disentisation doesn't fix.

Somewhat unrelated, but I think OCPD should be Cluster B anyway. But that's a long other story. (I've also never heard of meds working for OCPD, but, not as well-read there....)

Marg,
I have just been through the 'dumping' process with my family and it is interesting to read through your descriptive sentences of how the mnpd works. I have been on the receiving end of their generosity, whether it's been a grandiose gesture or 'advise' to live by. When accepting the grandiose gesture from my brother, it felt wrong, and I should have known that there'd be hell to pay as a month later came the 'dump' in the form of the 'silent treatment' followed by really nasty 'gaslighting' 7 months later. Multiply this by 2 as my father mirrored the above but with 'advice' (his rules to live by) which he felt were being ignored and another extreme form of nasty gaslighting occurred. The gaslighting came from a letter that I sent to my brother explaining to him that my problems with my dad were much deeper than me ' not living by his rules' and that it was to do with his tyrannical behaviour and sexual medelling of me as a child, that was affecting my relationship with my dad. My brother immediately took the letter to my parents, who immediately brought it to my inlaws. So far their behaviour has kept them at bay and I'm being left alone but have no idea how things will pan out?

VTheChaosTheoryV wrote:I think this is based on Sam Vaknin's website. He points out there can be two distinct personality types in narcissists.
-Somatic type: Obsessed based around beauty, ideal looks and so forth.
-Cerebral type: Values their knowledge to an extreme.

Both characteristics can be present within the narcissist, but one may be more dominant than the other.

OMG ok, I have a very homely mother but I recall her being completely obsessed with wrinkles and her weight etc....to the point of practicing smiling in the mirror so she knew what looked good and what didn't. I can remember her being sooo worried about wrinkles at the age of 25. The weird thing is, my mom is 4'11 and looks like a dwarf..her head is big, her thumbs are big, like something went wrong.

My purpose in understanding NPD is of a practical nature. I'm not sure all of the reasons for a consensus regarding sub-typing have been outlined. Maybe, this is why there is not yet a consensus.

I'm attempting to plan responses in a workplace with an NPD exec who has given employees the silent treatment over the years despite management training. This paper showed in a search, and seemed to be a good way for me to begin to create a behavior-response model:
levylab.psych.psu.edu/publications/2012/levy-k.-n.-2012-subtypes-dimensions-levels-and-mental-states-in-narcissism-and-narcissistic-personality-disorder/view

If there is - or can be - an accepted consensus on the value of sub-typing for modeling purposes, maybe there can be consensus on responses - for example, should workplace accommodation be common? Could NPD versions of this: http://beetlejuice.wikia.com/wiki/Handb ... y_Deceased
be helpful in the workplace?

I don't need to fix or judge. I just need to find ways to exploit theories and research in order to reduce turnover and increase teamwork/production in environments with NPD managers and employees.

Umm, I didn't read through all 7 pages of comments on this post, so I am not sure if this has been pointed out or not, but N's consider themselves all unique and different then the rest of the world. But all of them think they are unique in there own way. They think they are almost different to the point of being subhuman and extraordinary, but in a different way. So there could potentially be millions and millions of different types out there. Or, depending on how you look at it, there could be only one type. And that is the type who thinks they are better than everyone else and unique. I think you could go either way with it.

arraine wrote:N's consider themselves all unique and different then the rest of the world. But all of them think they are unique in there own way.

I know what you mean. I was recently reading Vaknin's 9-part free essay (World of the Narcissist). He referred to an N's aversion to sex and intimacy. On the one hand an N thrives on their uniqueness. Sex/intimacy is an act of making yourself unique. But, to an N, everyone makes themselves unique this way. The act merely makes them merely distinct.

I can identify with that because I always considered sex within a relationship to be a burden, something to use as a silent-treatment tool to get the kind of supply which made me unique (not merely distinct).

There are deeper, more significant reasons I avoid(ed?) intimacy. A fear of exposing who I really am is the obvious. Being vulnerable to who someone really is (not who I require them to be through my projection and what I expect to be mirrored back to me). But, I thought the subtle distinction he made between uniqueness and distinctiveness was interesting. Your post reminded me of that.

arraine wrote:They think they are almost different to the point of being subhuman and extraordinary, but in a different way. So there could potentially be millions and millions of different types out there. Or, depending on how you look at it, there could be only one type. And that is the type who thinks they are better than everyone else and unique. I think you could go either way with it.

That's an interesting way to see it. I think it depends on perspective. The way I saw myself (before being self-aware), the former doesn't make sense. I never felt extraordinary. However, nons would think "that person think's they are extraordinary and special." (I felt the opposite of extraordinary. I had no idea I projected what others would see as entitlement, etc. But, don't believe "subhuman" would describe what I felt before being self-aware. It was more like "bad luck," "unfortunate circumstance which I had to try harder to overcome," "isolation," and "not fitting in." But, those feelings were really a result of believing things should be better, I was capable of making them better, people would view me as less than I am because things aren't better. That's the "entitled" which I had some sense of being.).

I think the latter way you described it is good. But, I didn't think of myself as unique before being self-aware. I thought my form of uniqueness was like everyone else's. That goes back to the former way you described it: extraordinarily unique. I thought everyone saw themselves that way. That's the wall which is hard to break through with narcissism and begin to see how I'm not like others.

But, that point comes back to your latter description (one type of N). Ns are unique. There is no unique N (as if the textbook defines the person). So, I wouldn't go with the latter description either.

The one thing I'd be careful with is the subhuman description. When I became self-aware I saw myself as subhuman. Even now, I relate to the AIs in the movie Bladerunner. (A close facsimile, but completely lacking an vital human component if you know how to look for it. Lost in a world that created them but can't relate to them.).

I don't think unaware Ns won't relate to "subhuman," and will only focus more on their overcompensating coping systems (which make them more extraordinary, and appear less human).

I've seen two different categorization of NPD. Covert vs overt and vulnerable vs grandiose. I'm a little lazy to read all the 7 pages of this thread. I can identify myself with vulnerable NPD and also, to a lesser degree, with covert NPD. How much these categorizations overlap? Can someone depict a map of different categorizations of NPD? Thanks.