Stop press! the DSM 6 has included a new disorder, which is so widespread that it has missed inclusion in previous editions of this much revised manual.
Neurotypicality Personality Disorder is a pervasive, lifelong, limiting psychosocial disorder which has been under or misrecognised for decades.
Symptoms include but are not limited to:
An obsession with social status, being liked and seen as successful is more important to these people than being authentic;
The adoption of attitudes and behaviours that conform to prevailing opinion, a terror of being different;
The fixed idea that getting and having is more important than experiencing, wisdom or being;
The mistaken belief that ambition and competition is the same thing as having personal values anchored in character;
Hostility toward others who do not replicate their own opinions and attitudes, which may be overt or hidden;
The delusion that being normocentric is the only way to be live a fully human, meaningful life;
An inability to discuss ideas in a deep and meaningful way, a marked inability to converse beyond small and inconsequential talk;
A need for the display of conspicuous consumption: "I am what I have, and what I look like, appearances are everything";
A marked tendency toward holding double standards: expressing verbal respect for other cultures or minorities etc that is never matched by action or which stands against discriminatory behavior;
A love of hierarchy and ambition to climb ladders so that power can be exercised over others to embellish ego;
A marked difficulty on stating what they really mean/believe/feel and a disconnect between what they say and what they do;
A marked hostility to people who think outside the square, to reactively rubbish any new conceptualisations as suspect, weird, crazy prior to or instead of any consideration of the possibilities;
An addiction to the status quo unless change would increase their own opportunity to climb the social or status ladder;
A failure in being able to exercise creative thought and brainstorm innovative ideas spontaneously, without a lot of groupthink;
A tendency to claim the credit for someone else's work, especially in their careers; to backstab and be obsessed with office games;
An acceptance of office politics as a game of winners and losers, with no regard to the damage this attitude does to others;
A tendency to choose careers based on material and ego benefits, rather than intrinsic interests;
A sense of entitlement and failure to recognise the underlying narcissism that sees themselves as superior to others;
A belief that what others think is more important than thinking for oneself.
A tendency to bully or diminish people who are not as normative as themselves.
Prognosis:
These patients are extremely difficult to treat in terms of any lasting change as they see nothing wrong with their behaviour,
and often regard themselves as model citizens and paragons of virtue. Like psychopaths, they rarely seek treatment, despite the enormous damage they do. They lack insight and typically use denial, blame, manipulation and projection to avoid taking responsibility for their behaviour and delusionary beliefs. They recruit friends like themselves so that a cross-validation process occurs, perpetuating and reinforcing the main delusions.
Treatment:
They heavily self-medicate with alcohol, which is their favourite drug of choice. They usually come into treatment via behaviour resulting from alcohol abuse - violence, murder, domestic abuse, road rage, etc, where they are typically misdiagnosed as stressed rather than with the personality disorder of Neurotypathic Personality Disorder.. Typically they blame their lapses on alcohol, as if it were causal rather than the NPD.
Isolation makes some much more amenable to treatment, so seclusion theory (solitary confinement) is often useful in the first instance to improve their willingness to engage meaningful with therapy.
Goals of therapy:
To make them less obnoxious, judgmental, aggressive, domineering and unimaginative, to broaden their outlook as human beings, to uncover their true underlying personal potential (sometimes there is some).
Diagnostic Integrity Note:
Behavioural symptoms are to be regarded as competely reliable, (even if they are not) as there is no need to consider what these patients think, feel, or what prior life experiences they have had. The DSM prefers scientific clarity and the exclusive emphasis on "objective" behavioural symptoms strips away any other variable which might get in the way.
Some therapists have reported the usefulness of ABA with these patients, delivering aversive treatment (punches, electric shocks) for instances of pathological statements of normality, entitlement, superiority statements, backstabbing ego-trips etc.
22 Jan 2015, 4:18 pm
