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hauntedselves · 5 months

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Clinical Formulations of Narcissistic PD

Clinical formulations and case conceptualisations are introduced in this post.

These are all generalisations and theories of how NPD develops, not something that is supposed to be true for everyone with NPD.

Psychodynamic model

Freud suggests parents either overvaluing or neglecting (or both) a child can lead to NPD & especially inability to form healthy, lasting relationships and regulate self-esteem

"In other words, [NPD] is the outcome of insufficient gratification of the normal narcissistic needs of infancy and childhood."

Kohut theorises that narcissists' ability to form a cohesive sense of self and others was developmentally arrested in childhood, resulting in grandiosity & idealising others

"Narcissistic injury" = fragmentation of the self

Kernberg suggests grandiosity & exploitation result from maternal emotional abuse

Grandiosity is an "emotional escape valve"

Grandiosity & entitlement mask the "real self" that is "split off"

The real self unconsciously holds rage, fear, envy, deprivation

Defensive structure is same as BPD but difference is grandiosity

Biosocial model

NPD is primarily the result of environment, especially "parental indulgence and overvaluation, learned exploitive behavior, and only-child status"

Special treatment from caregivers leads children to believe that the "world revolves around them", and therefore they expect the same outside the home

When special treatment outside the home doesn't happen, they "experiment with demanding and exploitive tactics and subsequently develop considerable skill in manipulating others"

"At the same time they come to believe that most others are inferior, weak, and exploitable."

NPD is self-perpetuating through sense of superiority, lack of self control, sense of entitlement, and dismissing of those who reject their world / self-view

Cognitive-Behavioural model

Key feature of NPD is self-aggrandisement

Core beliefs:

> Deserving of special treatment

> Not bound by social norms and rules

Conditional beliefs:

> Others should be punished for not recognising their specialness

> To maintain that special status others should be subservient to them

Instrumental belief:

> Always strive to demonstrate their superiority

> See themselves as special, superior, entitled to special favors and treatment, and vulnerable to loss of status

> View others as inferior but potential admirers

Main pattern of behaviour is "seeking prestige, power, position, and wealth as a way of reinforcing their image of superiority", using "manipulation and guile" if necessary

The primary schema is superior & special (/ entitlement & grandiosity)

> Superior schema "shaped by flattery, indulgence, and favoritism"

> Special schema shaped by "rejection, limitations, exclusion, or deficits"

> Common denominator is the belief that the individual is different in some way

Three subtypes:

> Self-centered impulsive type

> Ruthless impression-management type

> Acceptance-oriented impression-management type

> Each type is centred around an impulse control deficit developed in childhood

> "Specifically, these individuals learned to seek reinforcers without having to work for them. This resulted in their development as self-indulgent, egocentric, and impulsive individuals."

> Ruthless & Acceptance-oriented types focus on creating favourable impressions with others, but struggle with long-lasting healthy relationships because of their empathy deficits

Interpersonal model

People with NPD were raised in an environment of "selfless not contingent" love, leading to insensitivity to others' needs

The caregiver was over-adoring, but there was also a constant threat of a "fall from grace", with pressure to be the perfect child

The constant overbearing love means that any criticism or disappointment hits very hard

"In short, there is extreme vulnerability to criticism or being ignored, together with a strong wish for love, support, and admiration from others. Noncontingent love and presumptive control of others is expected and even demanded. If support is withdrawn, or lack of perfection is evident, the self-concept degrades into severe self-criticism."

Integrative model

People with NPD are hypersensitive

Seen as exceptional children, leading to pressure to perform

As children likely had highly developed speech and interpersonal skills

Life purpose: "I’m special and unique, and I am entitled to extraordinary rights and privileges whether I have earned them or not."

World-view: "Life is a banquet table to be sampled at will. People owe me admiration and privilege."

Goal: "Therefore, I’ll expect and demand this specialness."

Defense mechanisms: rationalisation and projective identification

Parental injunction: "Grow up and be wonderful—for me."

"The illusion of specialness, disdain for others’ views, and a sense of entitlement lead to an underdeveloped sense of social interest and responsibility. This, in turn, leads to increased self-absorption and confirmation of narcissistic beliefs."

- From Sperry, Handbook of Diagnosis and Treatment of DSM-5 Personality Disorders (2016)

#len sperry #handbook of diagnosis and treatment of dsm 5 personality disorders #personality disorder concepts #case conceptualisations #clinical formulations #pd info #npd #npd info #dogpost

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caffeinatedopossum · 4 months

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I actually find it really bizarre and counter intuitive that clinically speaking, you cannot legally be diagnosed with a personality disorder until you're at least 18. The reason given for this is because "the personality has not fully developed before this age" like ???

Ah yes, my favorite strategy. Not diagnosing the problem until it's already been virtually cemented into your brain for life! Wouldn't it be easier (and more painless) to address the problem before it's fully developed?

#im also certain that the age that personality fully forms at is not a universally agreed upon number #like idk. maybe this raises less questions about age and more about the potential consequences of pathologizing personalities #it feels a little fucked up to me that some mental illness are 'just' mental illnesses while others are deemed a thing synonymous with you #and i can understand if some people with personality disorders do really heavily identify with their disorders #thats fine!#i also think the average person has a concept of personality which is relatively stagnant and thats just not realistic tbh #i mean if you think personality is stagnant then yours probably is so in rhat sense youre not wrong #but personality can absolutely change and i dont think it makes you a 'different person'#i think its a natural progression #anyways. got a little derailed but the point im trying to make is #lets find a way to give people with personality disorders a more realistic hope for recovery without invalidating them #and also lets maybe try to treat personality disorders preemptively so they don't get worse

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aleclightofmylifewoodbane · 10 days

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have yall seen vax on twitter. tbh i love that freak

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lesbian-disaster-academic · 6 months

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Confessions of a Burnt-Out Gifted Kid (part 1/?)

[VIDEO ID: A sketched figure, labelled “me now” looks to the side with a worried expression on their face. They say, “You don’t have to be perfect or exceptionally great. You don’t even have to be GOOD”. The scene changes and it shows a slightly younger-looking figure labelled “teenage me”. They look angrily off to the side and say, “But I do.” They point to themselves. “I have to be all of those things all of the time”. END ID]

(Inspired by this video)

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starryluminary · 30 days

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Do I have enough concrete evidence to claim Lindsay has prosopagnosia. All I’ve got right now is it’s the only reason that makes sense to me why Lindsay can’t remember Tyler’s Tyler in world tour. What if she literally can’t remember his face

#prosopagnosia is a disorder that makes it near impossible for someone to remember faces #I don’t remember island or action well enough to say she has it for sure #(obviously the real reason she doesn’t remember Tyler is because she’s a ditzy blonde joke and the show writers thought it would be funny)#but listen to me for a second!!#what if she knows heathers Heather cause her bossy voice is stuck in her head #what if she knows Beth’s Beth because she never takes off her side pony #what if she only remembers Tyler’s Tyler because she recognized the little T patch on his tracksuit #and I KNOW in island she likes him cause he’s cute or whatever but I don’t think that’s enough to disuade me from the concept #what if she found his hair cute?? his headband?? the way he walks and runs?? the hit on her when Duncan killed the roach in the first-#-episode??#and if she did find his face cute I don’t think that’s enough to just cure your prosopagnosia for a person #she thinks he’s cute looks away looks back and remembers all over again #I’m no expert on prosopagnosia I’ve just read a couple articles so I don’t know if that’s accurate but. do you get me do you see what I see #food for thought #total drama #total drama lindsay #td lindsay #Starry speaks

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violentviolette · 1 year

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i need more people to understand that unmasking is not sysnomous with being symptomatic

masking is the act of performing nuerotypicality in order to hide ur actual needs, it is about hiding natural behaviors and feelings. but this is not the same as being actively symptomatic. symptoms are not natural behaviors because they are by definition disordered

for example, ur friends want to hang out but u are out of spoons and social battery. masking would be lying and saying u have work or a prior obligation when really ur just going to stay at home. unmasking would be being able to safetly say "sorry but im out of spoons and cant socialize anymore today." while in contrast, being actively symptomatic would be getting angry and annoyed at people for asking u and being rude or telling them u dont wanna hang out because they're annoying.

unmasking is about open and honest communication of ur self and ur needs. saying things like "i dont have the executive function to do that right now" "i need to be alone in a quiet space to calm down" "i dont like the sound of other ppl eating so i'd prefer if we ate seperately" "i get sensory overload when the tv is too loud, can we turn it down when im cooking?" "it helps me concentrate to stim so im gonna flap while i read this" that is unmasking, it's being able to be authentic and honest in ways that don't hide the fact that u have different needs than nuerotypical people

these things are not the same as openly exhibiting negative symptoms that harm urself and the people around u. yelling at people, having suicidal breakdowns infront of others, becoming violent, treating other people poorly, weaponizing ur insecurities against others, expecting unreasonable things from them, allowing ur symptoms and disordered/dysfunctional thoughts to guide ur actions and treating them as fact, ect. are not the same as unmasking

if u find that when u "unmask" around ur friends, especially if those friends are also nuerodivergent, they almost always get upset at ur behavior and dont like being around u or criticize ur behavior and how it affects them, then its probably a good idea to very seriously consider if ur actually unmasking or instead being actively symptomatic

#jack.speaks #aspd #npd #bpd #hpd #cluster b #cluster b pd #cluster b personality disorder #this is why we really need to stop coopting autistic and adhd language for cluster b pds #they are not the same and u can not just uncritically apply those same concepts just because theyre all nuerodivergent #autistic traits are not symptoms and u cannot speak about cluster b symptoms the way u talk about autistic traits #nuance is very much needed #u have to understand the differences here

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goldpilot22 · 7 months

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hi, does anyone have links to posts with advice on respectfully writing characters with NPD? (or just, have any advice on doing such?) I'm working on planning out a story and I want one of the characters to have NPD, but I want to portray them respectfully and without stigmatizing the disorder, and there's not much (useful, non-stigmatizing) resources out there about NPD in general. (I've done some research already by reading NPD resources from the community on tumblr, so I think I have a basic understanding of how the disorder affects people who have it and how the stigmatized portrayal of it is inaccurate, but I'm looking for advice specifically for writing a character.)

more specifically, what I'm looking for advice on is what the character's point of view and internal monologue could be like, and how to portray a character with NPD who is in a position where they're accepted for who they are and their emotional needs are being met, and info on how Autism and NPD might interact in a person who has both. (I might add on to this post later with more details on what I've got for the character so far.)

[don't make ableist / stigma-perpetuating comments on this post or I'll block you. be respectful.]

#npd #actually npd #(<- I don't have npd myself but I'm using the tag because I'd prefer advice from folks who do)#narcissistic personality disorder #writing advice #psii.txt #this post is brought to you by: Spite. and me getting really fuckin fed up with all the stigmatized portrayals of npd in media and online #do not mention 'narc abuse' on this post or I'll block you instantly. my position on the concept is that it's not a thing.#no disorder or neurotype makes someone capable of any special kind of harm. end of discussion.#anyways #yeah #btw if this post gets too much reblogged I might turn off rbs just in case. I think I have replies allowed from anyone though

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hauntedselves · 1 year

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Clinical Formulations of Histrionic PD

Clinical formulations and case conceptualisations are introduced in this post.

These are all generalisations and theories of how HPD develops, not something that is supposed to be true for everyone with HPD.

Psychodynamic model

Histrionics lack relationships with maternal caregivers so turn to paternal caregivers for love and attention

Learn that they can get attention through sexualised behaviours

Men with HPD may be hypomasculine (effeminate) or hypermasculine if their paternal caregiver is emotionally unavailable

Biosocial model

Mood swings, very emotional

Biggest influences are environmental: caregivers’ reinforcement of attention-seeking & manipulative behaviours and histrionic role models

Children learn they can use cuteness, charm, attractiveness & seductive behaviours to get what they want/need (attention from caregivers)

Histrionics are externally focused and largely ignore their internal worlds

Histrionic behaviours are self-perpetuating

Cognitive-Behavioural model

Two main underlying assumptions: “I am inadequate and unable to handle life by myself” and “I must be loved by everyone to be worthwhile.”

Need attention and approval from others, and in a similar way to DPD feel they are inadequate to look after themselves and need others

Hypersensitive to rejection & criticism (similar to DPD, NPD and AvPD)

Feel they must perform for others to gain approval and self-esteem

Thinking is “impressionistic, global, and unfocused” and leads to over-generalisation, emotional dysregulation, and splitting

Two subtypes:

The controlling type, who tries to gain control through dramatics and manipulation; they struggle with reading others’ emotions and are shallow, self-centred, and uncomfortable without immediate assurance; lack empathy.

The reactive type tries to gain approval and reassurance.

Interpersonal model

People with HPD learnt that their entertainment value and appearance was more important to others than their worth as a person

Learnt that physical appearance and charm can be used to manipulate others

Their childhood homes were unpredictable and probably involved substance abuse

The unpredictability was dramatic and interesting (unlike the “primitive” and life-threatening chaos associated with BPD)

Histrionics were likely rewarded (i.e. had their physical and emotional needs met) for their disabilities, illnesses and complaints

Histrionics “exhibit a strange fear of being ignored, together with a wish to be loved and taken care of by important others, who can be controlled through charm or guile.”

Integrative model

Histrionics experience reactive mood swings and have high levels of energy

They are hyper-responsive and externally oriented

“The self-view of the histrionic will be some variant of the theme “I am sensitive and everyone should admire and approve of me.” The world-view will be some variant of “Life makes me nervous so I am entitled to special care and consideration.” Life goal is some variant of the theme “Therefore, play to the audience, and live in the moment.””

Cargivers’ style based in reciprocity, i.e. “I’ll give you attention if you do what I want”, with minimal or inconsistent discipline and probable neglect

Internal experiences of HPD are “denial of one’s real or inner self; a preoccupation with externals; the need for excitement and attention-seeking, which leads to a superficial charm and interpersonal presence; and the need for external approval. This, in turn, further reinforces the dissociation and denial of the real or inner self from the public self, and the cycle continues.”

- From Sperry, Handbook of Diagnosis and Treatment of DSM-5 Personality Disorders (2016)

#clinical formulations #case conceptualisations #case conceptualisation #hpd #hpd info #pd info #dogpost #len sperry #handbook of diagnosis and treatment of dsm-5 personality disorders #this has been in my drafts for 10 months LOL #also re reading this its like 'people w hpd were neglected and so they try to get their needs met thru trying to get ppl to love them #which is OBVIOUSLY manipulative and selfish right?? /sarcasm #personality disorder concepts

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astrum-aetherium · 10 months

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Omg thoughts on the “best friends to lovers” trope with Henry

bittersweet. being best friends with him would pose such a great challenge in the first place. for it to be more or less sturdy, you would have to have known him for a long time. i'm talking pages upon pages of history — rooting as far as back as his childhood or early adolescence, i'd say. that may be the only way to find oneself in the role of his best friend. but even then — scarcely. barely. minimally.

he doesn't exactly associate himself much with people who aren't versed in his area of expertise, those who don't understand him — he rarely ever acknowledges someone like that, even. therefore, you'd need to know and comprehend his interests very well, concerningly well. in short, you would need to check many boxes. were that to be achieved, however, i don't exclude the possibility of further development taking place in regard to your relationship.

despite his being so intensely focused on aesthetics, i feel like the engrained and conditioned little inkling of finding someone for oneself would nevertheless linger in some obscure, hidden part of his mind. thus, if you were right there — someone he has known for the longest time and can therefore trust completely, someone who understands and reproduces his affectations, someone who's clearly devoted to his attentions — he would, at some point, indulge in the possibility of winning you over. he wouldn't see it as a challenge per se, but it would certainly pose a thrill — and the triumph he would perceive at the end, upon having managed to secure your affection, would be vast.

i believe he may be able to develop a feeling similar to love under the right circumstances, and when it'd come to you, i'm sure it wouldn't be all too difficult. admittedly, it would be a slinking, slow process — and yet, it'd pay off in the end. your affinity would be one to admire. romantically involved with someone already so committedly devoted and entrusted to you — a great marvel, and an outspoken rarity.

#henry winter imagine #henry winter x reader #henry winter thirst #astrum asks #indulgent thoughts #very interesting concept #although i do believe it is nearly impossible to be friends with that man #i mean does he even know what that word means #i don't know #antisocial personality disorder core #but only a tiny bit #or not that tiny #you know

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avpdvoidspace · 1 year

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I'm not even afraid of abandonment. The thing that scares me the most about losing a close friends is that they'll criticize me or tell me bad things about myself that I will internalize, and I'll fall into such a deep pit of shame that I'll never be able to get out.

#avpd #avoidant personality disorder #like obviously I don't want to lose my friends #but the concept of being abandoned isn't one that haunts me

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its-just-mads · 2 years

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life lately for me

#not mine #avogado6 #avogado6 art #depression #social anxiety #anxiety #major depressive disorder #vent art #dissociation #derealization #depersonalization #gender dysphoria #mentally tired #mentally ill #concept art #borderline personality disorder #bpd vent #actually borderline #quiet borderline

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pubbykid · 4 months

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getting so fed up with mental illness allies who pretend to be fully inclusive until someone has a "scary mental illness" bc like yeah i know i can be shitty because of my disorders. im working on it, but when someone has a disorder that cant be cured or it can only go into remission after years and years of work then being made to feel bad because you cant fix yourself fast enough or be palatable enough that shit sucks.

#i know its not their intention but i swear i can give every warning to how difficult i am to love and deal with #and as soon as they do in fact have to deal with me they cant seem to grasp the concept that recovery and working on yourself isnt linear #because yeah i regress a lot #and i know that shits hard to deal with but if you want to support people with mental illness that means the ones that are hard to be aroun #i just always feel like im being told im not doing enough and im not far enough in healing and not doing enough to be loved #im so tired of needing to be paletable to others and never feeling like im worthy of love because of my mental health #bpd #borderline personality disorder #actually cptsd #bpd vent #mentalheathawareness

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aspd-culture · 9 months

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ASPD + DID culture is getting stuck as the therapist friend because that one people pleasing high masking alter will NOT STOP letting this person trauma dump even though the rest of us are ready to block.

aspd-culture is

#I do not personally agree with the concept of trauma dumping in most contexts tbh #but I do get that it can step on boundaries #I just think that should be communicated if that bothers you vs creating a culture where ppl can't talk about their trauma #maybe that's just me tho?#aspd-culture-is #aspd culture is #aspd culture #actually aspd #aspd #aspd awareness #actually antisocial #antisocial personality disorder #aspd traits #anons welcome

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girlwhocriedsupernova · 4 months

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OK pet peeve time but I hate when people say that it's inappropriate to call someone a narcissist without diagnosis. Narcissist may be a term of art in clinical psychology, but like, it's also just an english word. If I call someone a narcissist and the conversation isn't happening in a clinical context then I'm not saying they have NPD. Psychology doesn't get to own normal English words.

#i am choosing not to comment on how seriously I take the concept of personality disorders in this post

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violentviolette · 1 year

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Could what you've said about HPD not just as easily apply to ASPD being based on pathologising criminal behaviour? There's even talks about ASPD dxs being separated into subtypes of have and have not committed crimes (awful idea imo), research being done on criminal populations that do not even have ASPD and such makes it pretty evident in it's not moving away from its roots in modern day either. So do you think ASPD isn't a real diagnosis in the same way HPD isn't then and if not what do you feel the difference is?

in my opinion no, which just to bring things back into perspective i am just some idiot with a blog and while my opinions on these things is very much based on years of research and a degree and my own experience in the mental health field as a patient for 20+ years, the stuff i say should still be taken as things to consider and not like, hard immutable fact but my thoughts essentially boil down to, i think aspd and bpd are the two cluster b pd's that have merit to warrent their own disorders because they have a unique set of symptoms that is not covered under or explained by other diagnoses.i think they're the product of a unique neurotype (the biological component) + trauma during early childhood and development (the environmental component) and thus are both nuerodivergent and mental illnessness i think npd and hpd are different as both of their symptoms could be absorbed by combinations of other existing diagnosis and thus would be better served by being either gotten rid of, or given their own catagories within things like cptsd. i think hpd and npd are both the result of prolonged abuse and trauma and are abuse responses, and i do think they have merit to be their own unique subtypes of cptsd but i dont think they have the nuerological components that make aspd and bpd lifelong npd and hpd both respond much better to treatment, especially trauma recovery treatment, and are more likely to be fully manageable with proper treatment in ways that aspd and bpd are less likely to, at least in my annecdotal experience but again, people are very free to disagree with that or to think thats horseshit im not lobbying the dsm or anything im just giving my current thoughts. i could feel very differently in 2 or 5 years, especially since more research is being done and we gain better perspective and understanding of things

#jack.speaks #anon #aspd #npd #bpd #hpd #cluster b pd #cluster b #cluster b personality disorder #before u get too angry pls remember #i am stupid and my opinion doesnt matter #u can just disagree and let me be wrong #but also im very down to have conversations about this if ppl find it interesting and want to discuss it further #i think this stuff is really evolving a lot and im very open to other peoples thoughts on them as concepts

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