Misdiagnosing Narcissism - Asperger's Disorder
19 Aug 2005
Asperger's Disorder is often misdiagnosed as Narcissistic 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
hampered and conversational skills (the give and take of verbal intercourse) are
primitive. The Asperger's patient body language - eye to eye gaze, body posture,
facial expressions - is constricted and artificial, akin to the narcissist'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 the
inevitable 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 by
passionately 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 a weapon to obliterate his "enemies"
and discarded sources with. Cerebral narcissists derive narcissistic supply from
the consummate use they make of their innate verbosity.
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.
By: Dr. Sam Vaknin
(The use of gender pronouns in this article reflects the clinical facts: most
narcissists and most Asperger's patients are male).
AUTHOR BIO:
Sam Vaknin is the author of Malignant Self Love - Narcissism Revisited and After
the Rain - How the West Lost the East. He served as a columnist for Global
Politician, Central Europe Review, PopMatters, Bellaonline, and eBookWeb, a
United Press International (UPI) Senior Business Correspondent, and the editor
of mental health and Central East Europe categories in The Open Directory and
Suite101.
Visit Sam's Web site at http://samvak.tripod.com
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