"Captain America" by David Hogue, CC BY-SA 2.0
Source: "Captain America" by David Hogue, CC BY-SA 2.0

People in relationships with others who suffer from Narcissistic Personality Disorder typically find it difficult to get along with them; but the reasons for such difficulty are not abundantly clear from psychological diagnosis alone, which is based on a cluster of symptoms that define the disorder. As such, this blog attempts to provide a deeper, philosophical understanding of the disorder, which can help to explain precisely why such individuals think exactly as they do. I maintain that NPD can usefully be understood as a breach in the ordinary manner in which human beings process and assess truth and falsity; and that it involves a deviation from basic epistemological norms that ground successful human interaction. By “epistemological” I mean the area of philosophy that studies theories of knowledge and truth.

The American Psychiatric Association Diagnostic and Statistical Manual (DSM 5) defines NPD as “a pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy". The patient with NPD has a grandiose sense of self-importance manifested in terms of unreasonable expectations such as being recognized as superior or special; receiving favorable treatment, and automatic compliance.  Fantasies, in turn, revolve around “unlimited success, power brilliance, beauty or ideal love” (pp. 669-670).

I submit that this cluster of symptoms for diagnosis of NPD is rooted in an epistemology that turns the ordinary conception of truth and falsity on its head.  For the majority of human beings, beliefs are true when they correspond to the facts; and false when they fail to correspond to the facts. According to this conception, facts are understood as having a status that can be verified by an average observer, and are therefore independent of any single human being’s subjectivity. Beliefs are conscious states that refer to objects outside themselves. For example, in believing that there are dogs barking, you are referring to the external state of affairs consisting of dogs barking. If there are dogs barking, then your belief is true; if not, then it is false. Aristotle long ago defined truth, and falsity, in this common sense manner when he stated, “To say of what is that it is not, or of what is not that it is, is false, while to say of what is that it is, and of what is not that it is not, is true.” 

In contrast, for the person with NPD, something is a fact when it corresponds to his or her belief and false when it fails to correspond to it. As such, the person with NPD emerges as the arbiter of what is true or false. “If I believe that p, then p must be true; and if I believe that p is false, then p must be false.” Herein lies  the NPD philosophy of truth. Facts are verified by whether or not they correspond to the beliefs of the person with NPD, not conversely. Assumed here is privileged access to reality enjoyed uniquely by the person with NPD; and all others are expected to build their worlds around the expectations and demands of this individual. “If I believe that I am gifted or special, then I am, and you must also believe the same.” 

Persons with NPD also process other referential states of consciousness in the same way. For example, some conscious states such as preferences refer to objects outside themselves that are not ordinarily considered verifiable (validated as true or false). Thus your preference for chocolate ice cream instead of strawberry cannot itself be shown to be true or false. This applies to other referential states such as desires, wants, hopes, and wishes. Your desire is neither true nor false; nor are your wants, hopes, or wishes. However, the epistemology of NPD breaches this ordinarily accepted epistemic rule. Thus, if the person with NPD desires chocolate ice cream instead of strawberry, then chocolate ice cream is, in fact, better than strawberry; and everyone else should confirm this fact. The tastes, values, and other preferences of the person with NPD are catapulted into veritable standards of reality to which others are expected to “automatically comply.” Here, there is no room for dissent, which is viewed with contempt by the person with NPD.

As such, there is no place for empathetic regard for others. This is because the person with NPD does not perceive any other perspective but his own as veridical.  Those who disagree with his perspective are “stupid” or otherwise misguided; whereas those who agree are praiseworthy—at least so long as they continue to agree.

In this topsy-turvy epistemological climate, it is not quite accurate to say that the person with NPD tells lies or is a liar; for the liar intentionally tries to deceive others by saying things he believes to be false. In contrast, a person with NPD has the grandiose idea that he is judge and jury of reality and that therefore, if he says something, then it must be true. The disorder, therefore, lies in an epistemological deformity—a breakdown of the ordinary constructs of truth and falsity that make satisfactory interpersonal relationships possible.  

Nor is it quite accurate to say that the person with NPD is delusional; for the latter implies that she does not recognize what others would consider to be real. Instead, what others consider to be real is perceived to be based on an inappropriate standard of reality, namely one that does not defer to his perspective. If there is “delusion” here, it is in adopting such an aberrant philosophy of truth; but this only gets us deeper into the muddy waters of epistemological theory, and may even dignify the NPD’s position as a source of “alternative facts.”

Indeed, there is a tendency among us all to perceive reality through our own belief systems. After all, we cannot escape our own subjectivity. Thus, you may think that a certain sort of food is good and find it difficult to understand how others may not also like it. The problem may therefore be one of degree where NPD lies at the extreme end of a continuum of subjective assessment of reality. At some point, most of us learn that the world does not necessarily conform to our demands and expectations, and we are prepared to draw a practicable line. In contrast, the person with NPD does not draw such a line, or draws it in a manner that leaves little room for the subjectivity of others. 

Given that recognition of objective truth and falsity independent of our own subjective beliefs and outlooks makes possible inter-subjective agreement and cooperation, it is difficult for persons with NPD to successfully relate to others in the workplace or in other social and familial contexts. As with all personality disorders, such a disorder is resistant to change. This is not to discount the possibility of constructive change through therapeutic interventions, at least in some cases. This blog suggests the possibility that such therapeutic interventions may best take the form of philosophical counseling in which the person with NPD works cognitively, behaviorally, and emotionally to sideline his radically ego-centric epistemology, and recognize, instead, that the world does not, nor must it, conform to his subjectivity.

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