Saturday, January 17, 2009

Second date 4, Narcissus in the suburbs

Wednesday morning, the second day of working on the study, I got to D's motel as she was getting dressed and she told me she wanted to go out for coffee before we went back to the house. So we went down the block to the nearest Starbucks; and as we walked, D asked me:

"What is Wife's primary psychological diagnosis?"

"Primary diagnosis? Depression. Why?"

"Depression? Really? You know, I've been watching her closely the last couple of days, and that's not what it looks like to me at all. Of course, I'm not a licensed psychiatrist. But you remember I spent years as a court-appointed guardian ad litem, and I saw a lot of cases where families were pulled apart by psychlogical issues of one kind or another. And you know, the way I have seen Wife interacting with the rest of the family for the last couple of days just doesn't match the patterns I saw in cases of depression."

"OK, I won't argue. Sometimes her psychiatrists have reached for something more serious, like bipolar disorder. But that still comes down to some variant of depression as a key factor."

"No, I don't think that's the main issue for Wife at all. It might be a secondary diagnosis, but it's not the primary one."

"Well, what do you think it is, then?"

Pause.

"I think she suffers from Narcissistic Personality Disorder."

"What's that?"

Long silence, which I finally interrupted:

"Umm, ... D? What's that?"

"I'm sorry, but I'm trying to choose my words carefully. I'm not just talking about some case study here, I'm talking about your wife -- the woman you have committed your life to. So if you don't already know what this is, I have to be careful how I say it."

"Oh shit, just spit it out. I can take it."

Pause.

"Narcissists see everything and everyone else in the world only in terms of the impact on themselves. This means ...," she paused again, "... that they can never really love anybody else. Everyone that they say they love is really just seen as an extension of themselves. The other person's triumphs are their triumphs. The other person's defeats are their defeats."

"You mean, like the way that Wife gets so enthusiastic over the boys' triumphs in sports, when she hates sports."

"I mean like the way she has responded to this whole cleaning project. Hosea, when I started cleaning up all that useless sewing crap in the study -- crap that she is never going to use for the rest of her life! -- did you see how she reacted? When I tried to make a space where the boys could work, all she could think about was how it displaced her stuff. Hosea, if you truly love somebody else, then you are happy when he is happy. Did you see how thrilled Son 2 was, that he finally had a desk of his own, decorated with his own medals and memorabilia? He was delighted! He was dancing! Wife says she loves him and would move heaven and earth for him -- but all she could think to say was how much she resented having her stuff moved. She never even noticed how happy Son 2 was! And if she had noticed, she would just have punished him for it."

"You have known Wife for twenty years. How is it that you are just thinking this now?"

"Hosea, narcissists use other people as tools to prop up their own self-esteem. As a result, they are usually very charming, because that lets them manipulate others more successfully. And so I think I was led astray because Wife isn't charming. I mean, she's not! So until I had a chance to see the four of you interacting as a family, it never occurred to me as a possibility."

"I see. Although, to be fair, when I first met Wife she had a kind of rough charm about her ... a charm with sharp edges, you might say. And she has to have had some kind of charm to attract all her various affairs."

"Fine. I won't argue that. But after watching how she has reacted to every bit of cleaning I've done, I really have no further doubts."

"So if you are right, what are the treatment options? Is this disorder treated with any of the same kinds of chemicals that are used to treat depression? Or are you going to tell me that Murphy's Law applies here, and the treatments for depression and NPD are exactly opposite?"

Again, D was silent for a minute. Then she said, in a low voice, ...

"Hosea, NPD is what's called an Axis-2 disorder. That means it is untreatable. Hosea, if Wife has what I think she has, she's never going to get better. I'm sorry."
.

5 comments:

  1. Actually, axis II disorders are treatable (not necessarily curable), they're just very difficult to treat. More specifically, narcissistic personlity disorder is a "cluster b" disorder and they tend to be hard to treat because of the fact they are ingrained in our personalities, as opposed to , say something a little more bio-chemical. Narcissistic personality disorder is especially problematic because individuals are reticent to seek treatment because they fear their inadequacies will be exposed. The "b" personality disorders share a number of commonalities, so one has to be careful when postulating a diagnosis (I know you said "D" was very careful about how put forth her opinion). And, the symptoms described can in fact be associated with depression. Sometimes the affected person displays hostility or irritability toward those whom they see as impinging on their happiness or potential to be happy. Doesn't make them a narcissist.

    ReplyDelete
  2. Oh and apologies for the grammatical errors.

    ReplyDelete
  3. I think it's difficult to diagnose Wife in such a situation. After all, D. is essentially coming into Wife's space and tearing down all that wife has built (no matter how helpfully). Of course Wife is going to take it personally.

    As for NPD, agree with Sara, too. Could be symptomatic of depression, even Lupus. And, not to be flip, but we've ALL got a bit of NPD in us.

    Plus, the empathy you once spoke of in your 8 things. That's not NPD.

    Anyway, tread carefully here.

    ReplyDelete
  4. Hmmmm. I am afraid I don't think D is am impartial observer anymore, if indeed she ever was!
    But anyway, I'm not sure it matters. You didn't really think wife was ever going to change, did you? It seems very unlikely at this stage that she would or could.

    ReplyDelete
  5. I was re-reading this post with a shuddering sense of hindsight. God, I even commented back then. Yeah. This is what MY lover has. So many of the same traits. The hoarding! He did it too. I've read an awful lot on NPD lately and I'm convinced. I don't know if there are degrees of NPD but maybe Wife is a lesser version?

    (And I take back what I said about everyone having a little NPD. Healthy narcissism is a sense of self. NPD is sociopathic)

    ReplyDelete