misdiagnosing narcissistic personality disorder (npd): asperger's disorder

7/23/2019 Misdiagnosing Narcissistic Personality Disorder (NPD): Asperger's Disorder

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Misdiagnosing Narcissism - Asperger's Disorder

By:Dr. Sam Vaknin

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(The use of gender pronouns in this article reflects the clinical facts: most narcissists and

most Asperger's patients are male.)

Asperger's Disorder is often misdiagnosed asNarcissistic Personality Disorder

(NPD), though evident as early as age 3 (while pathological narcissism cannot be

safely diagnosed prior to early adolescence).

In both cases, the patient is self-centered and engrossed in a narrow range of

interests and activities. Social and occupational interactions are severely hamperedand conversational skills (the give and take of verbal intercourse) are primitive.
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The Asperger's patient body language - eye to eye gaze, body posture, facial

expressions - is constricted and artificial, akin to thenarcissist's. Nonverbal cues

are virtually absent and their interpretation in others lacking.

Yet, the gulf between Asperger's and pathological narcissism is vast.

The narcissist switches between social agility and social impairment voluntarily.

His social dysfunctioning is the outcome of conscious haughtiness and the

reluctance to invest scarce mental energy in cultivating relationships with inferior

and unworthy others. When confronted with potential Sources of Narcissistic

Supply, however, the narcissist easily regains his social skills, his charm, and his

gregariousness.

Many narcissists reach the highest rungs of their community, church, firm, or

voluntary organization. Most of the time, they function flawlessly - though theinevitable blowups and the grating extortion of Narcissistic Supply usually put an

end to the narcissist's career and social liaisons.

The Asperger's patient often wants to be accepted socially, to have friends, to

marry, to be sexually active, and to sire offspring. He just doesn't have a clue how

to go about it. His affect is limited. His initiative - for instance, to share his

experiences with nearest and dearest or to engage in foreplay - is thwarted. His

ability to divulge his emotions stilted. He is incapable or reciprocating and is

largely unaware of the wishes, needs, and feelings of his interlocutors or

counterparties.

Inevitably, Asperger's patients are perceived by others to be cold, eccentric,

insensitive, indifferent, repulsive, exploitative or emotionally-absent. To avoid the

pain of rejection, they confine themselves to solitary activities - but, unlike the

schizoid, not by choice. They limit their world to a single topic, hobby, or person

and dive in with the greatest, all-consuming intensity, excluding all other matters

and everyone else. It is a form of hurt-control and pain regulation.

Thus, while the narcissist avoids pain by excluding, devaluing, and discarding

others - the Asperger's patient achieves the same result by withdrawing and bypassionately incorporating in his universe only one or two people and one or two

subjects of interest. Both narcissists and Asperger's patients are prone to react with

depression to perceived slights and injuries - but Asperger's patients are far more at

risk of self-harm and suicide.

The use of language is another differentiating factor.

The narcissist is a skilled communicator. He uses language as an instrument to

obtain Narcissistic Supply or as aweaponto obliterate his "enemies" and discarded
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sources with. Cerebral narcissists derive Narcissistic Supply from the consummate

use they make of their innate verbosity.

(continued below)

This article appears in my book, "Malignant Self Love - Narcissism Revisited"

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Not so the Asperger's patient. He is equally verbose at times (and taciturn on other

occasions) but his topics are few and, thus, tediously repetitive. He is unlikely to

obey conversational rules and etiquette (for instance, to let others speak in turn).

Nor is the Asperger's patient able to decipher nonverbal cues and gestures or to

monitor his own misbehavior on such occasions. Narcissists are similarly

inconsiderate - but only towards those who cannot possibly serve as Sources of

Narcissistic Supply.

More about Autism Spectrum Disorders here:

McDowell, Maxson J. (2002)The Image of the Mother's Eye: Autism and Early

Narcissistic Injury, Behavioral and Brain Sciences (Submitted)

Benis, Anthony - "Toward Self & Sanity: On the Genetic Origins of the Human

Character" -Narcissistic-Perfectionist Personality Type (NP) with special reference toinfantile autism

Stringer, Kathi (2003)An Object Relations Approach to Understanding Unusual Behaviors

and Disturbances

James Robert Brasic, MD, MPH(2003)Pervasive Developmental Disorder: Asperger

Syndrome

Vaknin, Sam Malignant Self LoveNarcissism Revisited, 8th revised impression

Skopje and Prague, Narcissus Publications, 2006
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