I want to break down a common point of conflict when addressing NPD stigma.
A lot of hangups people have tend to be along the lines of "but I DO see a lot of people with actual NPD who are acting in toxic or abusive ways".
This will be kind of long, so bear with me.
Point #1: People are way more likely to be diagnosed if they exhibit "stereotypical" symptoms.
There's this image of NPD as a disorder that is only present in those with patterns of destructive behavior towards others. Many therapists have this conception. (Shockingly, the mental health field is not perfect & without stigma.)
Gonna copy-paste this here from my other blog (so forgive me if you've seen it before), because it's a good example.
Three people are criticized at work. Their boss yells at them for their performance in front of everyone.
Person A gets mad and defensive. They yell back, using cutting remarks as a way to try and ease the distress they feel.
Person B acts really mature and responsible the whole time, nodding along and agreeing and promising to do better, just desperate to maintain and improve their status. Desperate to be liked. Later they go home and handle their distress through self-destructive means, and spend the next few months overworking themself to the point of illness.
Person C doesn't seem to respond much at all. They go quiet and seem distant. They don't lash out or lash in, but for the next month or so, their productivity drops. They simply aren't able to focus on work or self-care, no matter how hard they try. The stress is overwhelming.
All three of these people have the same root issues, but only the first would be labeled a narcissist.
Outwards behaviors and presentations don't reflect the pain, distress, and difficulties with life that are underlying them.
So, three main things happen.
There ends up being a higher rate of people with destructive behaviors who are diagnosed with NPD
The people who don't particularly exhibit behaviors and are considered ""too nice to have it"" are overlooked entirely (and never get any sort of help for their underlying issues, yayyy)
People are more likely to be more honest about "ugly" symptoms / symptoms that are frowned down upon than they are in other mental health communities.
(Also some people decide to act super edgy about it, which is annoying but here we are. Some of them are trolls.)
(And while I'm at it, some people are misdiagnosed with NPD because a psych sees someone who committed a violent crime and is like "uhh slap them with the Evil Assholeā¢ disorders!! no further thought given.")
Point #2: People who have messed up are not inhuman monsters who deserve no help or support
While I do think it's important for people to understand that patterns of toxic behaviors aren't the ONLY way NPD can present, I'm not going to let the conversation stop at "some of us are nice though!!"
Human beings aren't RPG characters who can be sorted into "monster" or "ally". Every single person has done something hurtful, has messed up, exhibits some sort of behavior that puts strain on their relationships sometimes.
So I'll bullet point some aspects of this that need to be talked about.
People without NPD also commonly exhibit toxic behaviors, but people ignore that nowadays. Either they armchair diagnose anyone who's slightly rude, or they only focus on it in pwNPD and ignore it in themselves or others. NTs can be jerks too, and they're probably less likely to acknowledge it than pwNPD who are constantly watching and checking themselves and analyzing their behaviors and attempting to do better.
Assuming that NPD makes someone abusive doesn't help anyone. Can it impact behaviors, and make it more difficult for people to be self-aware? Of course. But an important step in healing from any mental health condition (especially personality disorders, ime) is realizing that you're not inherently ""bad"", and that you can take responsibility for your actions and learn to deal with things in constructive ways. Just going "NPD makes people bad, full stop"- other than being a mean shitty thing to say- absolves people of guilt and asserts that there's no reason for them to try and improve.
Yes, it's okay for people to hate their abusers. Their abuser. Not an entire community of people who happen to (maybe) share a trait with them.
Building on the above point, people tend to go in defense mode when they hear things like "pwNPD who have acted in toxic ways can learn to improve their behavior", "people shouldn't be saying awful things about folks with this condition", etc. because they automatically try to apply this to their abuser. Interpersonal situations are very different from society-wide mental health access. No, don't stay with your abuser expecting them to change, and don't hold onto the hope that they will. No, don't censor yourself or your hatred or anger towards them. Just don't make blanket statements about a disorder that they may or may not have- blame their abusive actions, not their mental health.
"I hate you for your abusive actions and the harm that you caused me." =/= "I hate a group of people because of an inherent unchangeable part of them that's tied directly to severe childhood trauma they suffered. Because of it, they're evil and unlovable and are incapable of change. They're inhuman and will never experience real connection with others." ..........See the difference??
Even if there were a disorder with a 100% rate of toxic douchey behaviors, I'd want the conversation around it to be changed. I'd want different words to be used to divide up the spaces and conversations and resources, so that survivors of abusive or toxic behavior can get help, but that the disorder still has space to be treated. Otherwise, there are zero resources for healing. Nothing is being done to help these people or solve the issue. They're just told they may as well not try. They're blocked from healthcare entirely, despite how the entire point of being diagnosed with a condition is supposed to be to treat it.
There's a wide range of people who have NPD- it presents in many different ways, a person who has it may or may not exhibit harmful behaviors- but no one deserves to be denied treatment or told they're unlovable because of a condition they have that was formed from trauma.
Speak out against abusive behavior. Don't destroy healthcare for a medical condition.
