This is the wrong moment to get rid of Narcissistic Personality Disorder (N.P.D.). To obliterate the line between pathological self-absorption and its healthier, more transient counterpart self-expression at a time when our identities have gone digital abandons the cultural moment and paints psychiatrists and psychotherapists as unwilling to come into the 21st century. In the days of social networks, multiplayer video games and online worlds never has there been a more important time for the mental health community to be deeply engaged in describing the continuum of narcissism.
In a world where self-promotion and has gone mainstream, healthy narcissism is hard to figure out. For example: Is the person who posts frequently to Facebook or Twitter in need of constant gratification? Or are they onto something about human connection in the 21st century? Does grandiosity describe the person who longs to create a video that will go viral? Or have they figured out that technology breaks down boundaries between our dreams and what is actually possible? What about the person who comes off as nasty, snarky or rude in an email? Do they have difficulty imagining themselves in another persons' shoes? Or is the technology too blunt an instrument to actually convey the subtlety of human interaction?
A recent New York Times article describes the debate that is going on about the possible removal of N.P.D. from the upcoming version of the Diagnostic and Statistical Manual of Mental Disorders (D.S.M. V). The current definition of N.P.D. describes a person who is in need of constant adulation, is often cruel to loved ones and co-workers and lacks empathy. The definition is criticized for being difficult to measure, but imagining the person who suffers from N.P.D. in a digital world of social interactions makes it clear that getting rid of the disorder is not the answer.
Digital communities are larger, move faster, they often remove face-to-face interaction and they leave permanent data trails. This is the perfect environment for pathological narcissism to thrive and also where it can do the most damage. To successfully live in communities that are increasingly digital we need kindness and empathy in large doses. Someone who lacks empathy tips the balance towards meanness and incites the bullies and trolls. An updated diagnostic picture of pathological narcissism not only offers the opportunity for the narcissist to get help, but it also protects all of us who live just down stream in the digital village.
Ultimately, one of the biggest losses that will come with doing away with N.P.D. will be to mental health community who gives the impression that they are not up to the challenge of defining human behavior in a new age. A cultural shift as big as this one requires a diversity of voices and a spirit of cooperation, but first the mental health community needs to show up at the table with something to add to the discussion. An updated definition of N.P.D. for the digital age would be a great place to begin.