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Narcissism Part 10: Narcissistic Personality Disorder

Narcissism 9

Narcissistic Personality Disorder is a mental health diagnosis. Only qualified mental health professionals can or should diagnose NPD. There are thorough and effective assessment tools that a professional can administer, that, combined with other qualitative measures, can make an accurate diagnosis possible.

I am not a mental health professional. I’m a pastor. In writing about narcissism, it’s important to me that my readers understand the limitations about what I’m able to address on this subject.

For narcissism to rise to the level of a Personality Disorder (NPD), there are multiple criteria that must be professionally assessed. Don’t use the term NPD or Narcissistic Personality Disorder in describing anyone or labeling anyone if you are not qualified to do so. If you’re wondering whether or not you are qualified, then you’re not.

NPD goes beyond deeply entrenched selfishness as a way of doing relationships. NPD means that this person doesn’t have the capacity to connect in healthy ways. Someone with NPD is not going to demonstrate meaningful change apart from the miraculous intervention of God that imparts to them capacity they do not currently have. Think of a blind person with no eyeballs. There is no amount of medicine, medical intervention, or therapy that is going to help them begin to see. They don’t actually have the capacity. It’s not there. It’s not simply a matter of them needing to choose to “receive healing” from God. The very capacity they are missing is their receiver. They don’t have one.

NPD, whenever it might be diagnosed, is an issue that has been present since early childhood development. It has to do with the way their brain formed when it was forming. There are ways of seeing, perceiving, responding and interacting with others that an NPD person simply doesn’t have the capacity to start doing. There is no “try harder” solution.

I’ve known plenty of extremely selfish people who have demonstrated significant, meaningful and lasting change. When these people hit rock bottom, when they are on the brink of losing relationships that they value, when their image comes crumbling down around them, they will sometimes engage their heart, begin to seek God, begin to seek help, and gradually begin to make changes in partnership with God and other people that affect the needed change. Prior to this change, I, as a non-professional, have sometimes wondered if they might be NPD (a diagnosis I am not qualified to make). But I wonder.

Then, in those instances where that person begins to make changes, to practice and learn empathy, to begin to grow in the ways they connect with others, to begin to surrender to God as their source of identity and worth, that’s when I stop wondering whether or not they were NPD. Those are not the changes that a person with NPD makes. NPD, by definition, means they are incapable of responding in those ways. I am not qualified to diagnose when someone is NPD, but I have enough common sense to recognize those who clearly are not.

But it’s also possible that God performed a creative miracle. He gave them eyes and now they can see. He re-routed their entire neurological wiring and installed capacities they did not previously have. Now they are on the journey of maturing in those new capacities.

Either way, God’s goodness is on display.

Not everyone who exhibits narcissistic tendencies or behaviors has NPD. Whether or not that person has NPD, the proper way to relate to the behaviors and tendencies involves setting and maintaining boundaries. Setting limits in this way will result in either a) the selfish person moves on to someone else and continues the pattern of destructive relationships, or b) begins to make the adjustments needed to cultivate relational health. If (b), then that means they were either 1) not NPD to begin with and began to exercise and mature in capacities they always had but never developed, or 2) they were NPD and God miraculously supplied them with capacities they did not develop in early childhood.

If you are in relationship with someone diagnosed as NPD, then please benefit from the wise counsel and qualified help of a mental health professional regarding what boundaries you need to set, how to set them and when. Do not delay setting boundaries in order to wait on a miracle. That is not faith; it is enablement.

For more from our 10 part series on narcissism, check back next week or read previous posts:

Part 1 | Communicating Needs In A Relationship

Part 2 | Life With A Narcissist

Part 3 | Understanding Human Development

Part 4 | What Do I Do?

Part 5 | Why They Are Un-Confrontable

Part 6 | Why Intimacy Is Impossible

Part 7 | The Narcissistic Parent

Part 8 | Can A Narcissist Change?

Part 9: I’m Not A You, I’m A Me 

About Alan Smith

Alan is married to Nancy, and father to Lauren (16), Anna (14) and Teddy (9). He is the pastor of Freedom Ministries at Gateway Church in Southlake,Texas, and is the author of the new book "Unveiled, The Transforming Power of God’s Presence and Voice."
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