On a reality TV show, a girl planning her Sweet Sixteen wants a major road blocked off so a marching band can precede her grand entrance on a red carpet. Five times as many Americans undergo plastic surgery and cosmetic procedures as ten years ago, and ordinary people hire fake paparazzi to follow them around to make them look famous. High school students physically attack classmates and post YouTube videos of the beatings to get attention. And for the past several years, Americans have been buying McMansions and expensive cars on credit they can't afford.
Although these seem like a random collection of current trends, all are rooted in a single underlying shift in American culture: the relentless rise of narcissism, a very positive and inflated view of self. Narcissists believe they are better than others, lack emotionally warm and caring relationships, constantly seek attention, and treasure material wealth and physical appearance.
The other day a patient sent me an email with a link to a New York Times article that reported that the upcoming revision of the psychiatric diagnostic standards manual, the DSM-V, has removed the narcissistic personality disorder from its roster.
She asked me, "Are they crazy?"
I wrote back, "I think so." Then, I thought, maybe the lunatics really are running the asylum.
"Removed" in this case appears to mean two things: 1) that the syndrome as they have hitherto described it is not, in their opinions, clear enough to be described as a character pathology; and 2) that it will no longer be an acceptable diagnosis for reimbursement. Insurance companies, hospitals, treatment facilities and protocols will no longer recognize it or use it to direct treatment.
Should that give us hope or terrify us? Does that mean narcissism is slowly going the way of the Dodo, or does it mean that it has become so pervasive that it's no longer thought of as pathological?
My experience personally and professionally has me leaning in the direction of the latter, that it has become so much a part of our culture, particularly our parenting, that narcissistic traits are considered norma -- so much so that if we don't have a reality show named after us, we use our own phones or video up-links to transmit our private lives to anyone from Alaska to Antarctica who will watch.
Our culture, the media-infused air we breathe, has itself become both a breeding ground and a reflecting pool for narcissists.
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