An earlier version of this post appeared in December 2008.
A couple of years ago, I put up this post about overcoming my own mental illness. In particular, I wrote in response to this post by the Happy Feminist about her relationship with her narcissistic father.
In my years in and around the mental health system, I was consistently diagnosed not with depression but with a personality disorder. More precisely, I was regularly described (by several psychiatrists) as having “cluster b” personality disorders: Narcissistic, Antisocial, and everyone’s favorite, Borderline. Based on the traditional criteria, I hit each and every one of the criteria for the last of these, and many of the crucial ones for the first two. From late adolescence until the cusp of thirty, as I cycled in and out of doctors’ offices and hospitals, these diagnoses were offered again and again. And in my 2006 post, I talked in general terms about my recovery, conversion, and transformation. But I didn’t get much into specifics.
I’ve corresponded a bit with Jan at Planetjan, who has written quite a bit about dealing with folks with Narcissistic Personality Disorder. (See her first, second, and third excellent pieces.) She wrote something that stirred me up a bit, for understandable reasons:
How is a personality disorder different from mental illness? I had a hard time initially wrapping my head around this one. A mental illness (schizophrenia being the most widely known) can be treated, with varying degrees of success, with medications or cognitive therapy. Most mental illnesses are caused by brain cell synaptic disruptions, most of which are believed to be genetic in origin. I have friends who are bipolar and as long as they take their meds, any symptoms subside and they feel and act relatively “normal.” Mental illnesses typically present themselves in late adolescence or early adulthood. The onset of the mental illness is often sudden and profound. A mental illness descends over a person’s personality like a heavy wool blanket feels on an already warm summer night.
A personality disorder, on the other hand, is all pervasive. The DSM-IV describes a personality disorder as “an enduring pattern of inner experience and behavior that deviates markedly from the expectation of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.”
With mental illness, a person’s personality is blanketed, or suffocated, by the onset of the mental illness. But the personality of someone with a personality disorder is virtually interwoven into every fiber of that blanket. Unravel the blanket and you unravel their personality.
So someone doesn’t have a personality disorder; they ARE the personality disorder. These personality traits are so deeply ingrained that they defy change.
Bold emphasis mine.
I’ve heard this distinction between mental illness and personality disorders before, of course, though rarely so succinctly expressed. And of course, it brings me up short. Looking at my life narrative, three possibilities suggest themselves as a response to her position (widely but not universally held by the psychiatric profession) that personality disorders “defy change”:
1. Despite being diagnosed with cluster B disorders again and again over more than a decade by a number of doctors, perhaps I never really had a personality disorder — the shrinks were wrong. I just met a whole bunch of the diagnostic criteria, but not the disorders themselves.
2. The diagnoses were correct in the first place, and I’m fooling myself — and a lot of other people — when I claim that I have “overcome” the pernicious influence of these disorders on my psyche and my life. I may have gotten better at disguising the NPD and the Borderline characteristics of my identity, but they still dominate my identity at its very foundation.
3. Jan, and a great many doctors, are wrong. Personality disorders, as powerful as they are, can be overcome.
I want to believe #3, and most of the time, I do believe #3. I seldom give much credence to #1, largely because of the preponderance of evidence over a fairly significant period of time. I do worry, less and less as I grow older, about #2. The fear that I am broken, “maimed from the start” by an aspect of my identity that can be hidden but never erased, comes up occasionally. I know that I have aspects of my personality which continue to meet the diagnostic criteria for at least some of the named disorders, even if I do what I imagine is a very credible job of keeping them from becoming manifest and obvious to others.
I’ve known for a long time that my self-involvement, my preoccupation with Hugo, was stronger than the normal self-regard we see in other, well-adjusted folks. And particularly in the past decade, I’ve been very intentional about developing the ability to hear and connect with others and prioritize their concerns. The problem, of course, is that like many narcissists I was always very good at feigning empathy in order to get close to others so that I could win their approval. (Most folks who knew me in my teens and twenties would nod vigorously at this.) The dilemma, as I first began to contemplate my recovery seriously in the late ’90s, was a simple one: how do I make something real out of something I fake very well?
My Twelve-Step sponsor, Jack, told me to practice a new way of listening to people. Normally, my mind would wander in most conversations, even as my eyes and expressions continued to suggest interest. I spent a great deal of time not only wondering what it was that the other person was thinking about me, but also about what I needed to say or do in order to get him or her to do what I wanted (leave me alone, sleep with me, validate me, co-sign some bizarre or dangerous impulse.) Jack told me to repeat, in my head, everything that was said to me — so that I would hear the other person’s words in the voice I clearly paid the most attention to, my own. He told me to ask the universe (or God) to help me to see what the other person really needed from me. Jack told me that if I let their words rather than my own sink in, I would begin to be able to act in response to them with genuine rather than manufactured empathy. It seemed simple, perhaps too much so — but I tried it. And bless him, Jack’s direction worked.
What I came to understand was that while I might have a personality disorder (exacerbated by drug and alcohol addiction), I was not a sociopath. I was not incapable of empathy; indeed, I had a surprising capacity to connect with others. I was able to imagine, quite vividly, how others might feel — and indeed, the intensity of that realization (once the drugs and the alcohol were out of my system permanently) was almost incapacitating. What I realized was that narcissism, for me, functioned like a very loud radio station. As long as I was tuned into to “KHGO” at full volume, listening to a litany of my own needs and anxieties and desires, I couldn’t hear anyone else’s “station” very well. If I had genuinely lacked empathy, I would have lacked the ability to “hear their sounds” at all. But someone who is listening to loud music isn’t incapable of hearing other sounds — they’ve just chosen to drown out everything else. And so learning to lower the volume on my own broadcast was the first key step in learning to hear, really hear, what others were saying and what others needed.
It’s no accident that in the nearly fourteen years since I began what has proved (thank God) to be a lasting recovery, my primary volunteer work has been with teenagers, and with animals. I’ve been a youth minister with various churches and the Kabbalah Centre for nine years; my wife and I have run our chinchilla rescue charity for nearly five. Adolescents and domesticated chinchillas are, almost by definition, remarkably dependent upon loving, caring, responsible adults. Taking care of teens and other small creatures proved the great litmus test to determine the degree to which I had been able to overcome my staggering, clinically disordered self-centeredness. But of course, it’s tricky to use this sort of public volunteerism as evidence for having overcome narcissism. After all, I get at least a fair amount of approbation as a result of what I do. Something teenagers and other non-human animals definitely have in common is a tendency to respond to love and attention with a great deal of the same. I get a lot of love and validation and praise from this work, and that is of course pleasing to my ego as well as to my soul.
I’ve come to accept a basic truth, however: true service to others does involve a commitment to de-prioritize one’s own desires. But a willingness to serve doesn’t mean that one’s own pleasure and validation must be absent. In many areas of life, the greatest moments of delight often come at times of shared joys. (Cooking, sex, traveling, and so on and so on). Rubbing my chinchillas behind their ears feels good for them and it feels good for me. And while it doesn’t mean that there is anything deficient about solitary pleasures (from reading a good book in a hammock to masturbation to a nice long run in the mountains), there is a particularly fulfilling aspect to experiencing one’s own capacity to bring delight to another. The fact that I get deep satisfaction and validation from public service doesn’t mean that my narcissism has wormed its way into every aspect of my life. And it’s only been in the last couple of years that I’ve come to accept that commonsensical and happy truth.
Some would say that my first hypothesis above was right: the doctors in the various hospitals were wrong, and I was never a “true” Narcissist or a “true” Borderline. Symptoms are not always proof of a particular illness, and there are those who aren’t even sure that personality disorders exist, or can be accurately diagnosed. All I can prove is that I was repeatedly diagnosed with the same personality disorder cluster again and again during multiple hospitalizations. And if — perhaps a big “if” — the shrinks were right, then I think the friends and mentees and students and family and spouse who know me best today can say that yes, Hugo Schwyzer is capable of being loving and empathetic. (Either that, or I’m a pretty swell actor.) The narcissism that was — and at moments still perhaps is — in me is not nearly as manifest as it once was.
In the end, I believe that personality disorders can be managed. The disorder is, in some sense, so much a part of my identity that it can never be fully removed, just as my physical allergy to alcohol means that I can almost certainly never drink in moderation again. But just as spiritual work and physical abstinence keeps my alcoholism in check, so too does this constant intentional focus on “lowering the volume on KHGO” work, I pray and believe, to keep my narcissism under control. I believe in the Twelve Step model of mental illness and addiction as a disease. Thus I believe that the disease is in me, and in me forever; one aspect of that disease is made manifest in a disordered, narcissistic personality. But recovery — though perhaps not a cure — is real. If I choose to ignore my “work”, the volume on that self-obsessed broadcast will quickly drown out everyone and everything that doesn’t meet my immediate needs. But if I do the conscious work I’ve been taught to do, then I will hear you, and feel you, and be able to connect to you without first evaluating how it is you can validate me.
And I’ve got people in my life who can attest to all this: to the man I was and the man I am and the difference between the two. That’s a happy thing.
UPDATE March 2012: I first wrote this post a month before the birth of my daughter. More than three years later, I can say that becoming a Dad has been more exhausting and challenging — and more exciting and rewarding — than I ever could have imagined. I’ve talked to many adult children of narcissistic parents, and their stories of bewilderment and betrayal are sobering. One day at a time, I do everything I can to be as connected to Heloise as I can be, to be present with her. Blessedly, I don’t spend much time at all worrying how she feels about her papa; what matters is the certainty and love and reassurance I can bring to her.
And yet, I’m vigilant. If narcissism never really goes away, and is rather something from which I get a “daily reprieve contingent upon the maintenance of my spiritual condition”, I can’t afford not to be. Especially with a daughter.