Why Everyone You Don’t Like Is A Narcissist
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We’ve written before about how psychiatry tends to name disorders after how they affect other people, rather than how they affect the bearer, and this is most exemplified when it comes to personality disorders. For example:
“You have a deep insecurity about never being good enough, and you constantly mess up in your attempt to overcompensate? You may have Evil Bastard Disorder!”
“You have a crippling fear of abandonment and that you are fundamentally unloveable, so you do all you can to try to keep people close? You must have Manipulative Bitch Disorder!”
See also: Miss Diagnosis: Anxiety, ADHD, & Women
Antisocial Diagnoses
These days, it is easy to find on YouTube countless videos of how to spot a narcissist, with a list of key traits that all mysteriously describe exactly the exes of everyone in the comments.
And these days it is mostly “narcissist”, because “psychopath” and “sociopath” have fallen out of popular favor a bit:
- perhaps for coming across as overly sensationalized, and thus lacking credibility
- perhaps because “Narcissistic Personality Disorder (NPD)” exists in the DSM-5 (the US’s latest “Diagnostic and Statistical Manual of Mental Disorders”), while psychopathy and sociopathy are not mentioned as existing.
You may be wondering: what do “psychopathy” and “sociopathy” mean?
And the answer is: they mean whatever the speaker wants them to mean. Their definitions and differences/similarities have been vigorously debated by clinicians and lay enthusiasts alike for long enough that the scientific world has pretty much given up on them and moved on.
Stigma vs pathology
Because of the popular media (and social media) representation of NPD, it is easy to armchair diagnose one’s relative/ex/neighbor/in-law/boss/etc as being a narcissist, because the focus is on “narcissists do these bad things that are mean to people”.
If the focus were instead on “narcissists have cripplingly low self-esteem, and are desperate to not show weakness in a world they have learned is harsh and predatory”, then there may not be so many armchair diagnoses—or at the very least, the labels may be attached with a little more compassion, the same way we might with other mental health issues such as depression.
Not that those with depression get an easy time of it socially either—society’s response is generally some manner of “aren’t you better yet, stop being lazy”—but at the very least, depressed people are not typically viewed with hatred.
A quick aside: if you or someone you know is struggling with depression, here are some things that actually help:
The Mental Health First-Aid You’ll Hopefully Never Need
The disorder is not the problem
Maybe your relative, ex, neighbor, etc really is clinically diagnosable as a narcissist. There are still two important things to bear in mind:
- After centuries of diagnosing people with mental health maladies that we now know don’t exist per se (madness, hysteria, etc), and in recent decades countless revisions to the DSM and similar tomes, thank goodness we now have the final and perfect set of definitions that surely won’t be re-written in the next few years or so ← this is irony; it will absolutely be re-written numerous times yet because of course it’s still not a magically perfect descriptor of the broad spectrum of human nature
- The disorder is not the problem; the way they treat (or have treated) you is the problem.
For example, let’s take a key thing generally attributed to narcissists: a lack of empathy
Now, empathy can be divided into:
- affective empathy: the ability to feel what other people are feeling
- cognitive empathy: the ability to intellectually understand what other people are feeling (akin to sympathy, which is the same but with the requisite of having experienced the thing in question oneself)
A narcissist (as well as various other people without NPD) will typically have negligible affective empathy, and their cognitive empathy may be a little sluggish too.
Sluggish = it may take them a beat longer than most people, to realize what an external signifier of emotions means, or correctly guess how something will be felt by others. This can result in gravely misspeaking (or inappropriately emoting), after failing to adequately quickly “read the room” in terms of what would be a socially appropriate response. To save face, they may then either deny/minimize the thing they just said/did, or double-down on it and go on [what for them feels like] the counterattack.
As to why this shutting off of empathy happens: they have learned that the world is painful, and that people are sources of pain, and so—to avoid further pain—have closed themselves off to that, often at a very early age. This will also apply to themselves; narcissists typically have negligible self-empathy too, which is why they will commonly make self-destructive decisions, even while trying to put themselves first.
Important note on how this impacts other people: the “Golden Rule” of “treat others as you would wish to be treated” becomes intangible, as they have no more knowledge of their own emotional needs than they do of anyone else’s, so cannot make that comparison.
Consider: if instead of being blind to empathy, they were colorblind… You would probably not berate them for buying green apples when you asked for red. They were simply incapable of seeing that, and consequently made a mistake. So it is when it’s a part of the brain that’s not working normally.
So… Since the behavior does adversely affect other people, what can be done about it? Even if “hate them for it and call for their eradication from the face of the Earth” is not a reasonable (or compassionate) option, what is?
Take the bull by the horns
Above all, and despite all appearances, a narcissist’s deepest desire is simply to be accepted as good enough. If you throw them a life-ring in that regard, they will generally take it.
So, communicate (gently, because a perceived attack will trigger defensiveness instead, and possibly a counterattack, neither of which are useful to anyone) what behavior is causing a problem and why, and ask them to do an alternative thing instead.
And, this is important, the alternative thing has to be something they are capable of doing. Not merely something that you feel they should be capable of doing, but that they are actually capable of doing.
- So not: “be a bit more sensitive!” because that is like asking the colorblind person to “be a bit more observant about colors”; they are simply not capable of it and it is folly to expect it of them, because no matter how hard they try, they can’t.
- But rather: “it upsets me when you joke about xyz; I know that probably doesn’t make sense to you and that’s ok, it doesn’t have to. I am asking, however, if you will please simply refrain from joking about xyz. Would you do that for me?”
Presented with such, it’s much more likely that the narcissist will drop their previous attempt to be good enough (by joking, because everyone loves someone with a sense of humor, right?) for a new, different attempt to be good enough (by showing “behold, look, I am a good person and doing the thing you asked, of which I am capable”).
That’s just one example, but the same methodology can be applied to most things.
For tricks pertaining to how to communicate such things without causing undue resistance, see:
Seriously Useful Communication Skills
Take care!
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How To Escape From A Despairing Mood
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When we are in a despairing mood, that’s when it can feel hardest to actually implement anything we know about getting out of one. That’s why sometimes, the simplest solutions are the best:
Imagination Is Key
Despairing moods occur when it’s hard to envision a better life. Imagination is the power to envision alternatives, such as new jobs, relationships, or lifestyle, but sadness can cloud our ability to imagine solutions like changing careers, moving house, or starting fresh. With enough imagination, most problems can be worked around—and new opportunities can always be found.
Importantly: we are not bound by our past or present circumstances; we have the freedom and flexibility to choose new paths. That doesn’t mean it’ll always be a walk in the park, but “this too shall pass”.
You may be thinking: “sometimes the hardship does pass, but can last many years”, and that is true. All the more reason to check if there’s a freer lane you can slip into to speed ahead. Even if there isn’t, the mere act of imagining such lanes is already respite from the hardships—and having envisioned such will make it much easier for you to recognise when opportunities for change do come along.
To foster imagination, we are advised to expose ourselves to different narratives, preparing ourselves for alternative ways of living. Thus, we can reframe life’s challenges as intellectual puzzles, urging us to rebuild creatively and find new solutions!
For more on all this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Behavioral Activation Against Depression & Anxiety
Take care!
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In Praise Of Walking – by Dr. Shane O’Mara
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At 10almonds we talk often of the health benefits of walking, so what’s new here?
As the subtitle suggests: a new scientific exploration!
Dr. Shane O’Mara is a professor of experimental brain research—and a keen walker. Combining his profession and his passion, he offers us a uniquely well-grounded perspective.
While the writing style is very readable, there’s a lot of science referenced here, with many studies cited. We love that!
We begin our journey by learning what we have in common with sea squirts, and what we have different from all other apes. What we can learn from other humans, from toddlers to supercentenarians.
As one might expect from a professor of experimental brain research, we learn a lot more about what walking does for our brain, than for the rest of our body. We’ve previously talked about walking and cardiovascular health, and brown adipose tissue, and benefits to the immune system, but this book remains steadfastly focused on the brain.
Which just goes to show, what a lot there is to say for the science-based benefits to our brain health, both neurologically and psychologically!
One of the things at which Dr. O’Mara excels that this reviewer hasn’t seen someone do so well before, is neatly tie together the appropriate “why” and “how” to each “what” of the brain-benefits of walking. Not just that walking boosts mood or creativity or problem-solving, say, but why and how it does so.
Often, understanding that can be the difference between being motivated to actually do it or not!
Bottom line: if there’s a book that’ll get you lacing up your walking shoes, this’ll be the one.
Click here to check out “In Praise of Walking” on Amazon, and start reaping the benefits!
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What the Most Successful People Do Before Breakfast – by Laura Vanderkram
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First, what this is not:this is not a rehash of “The 5AM Club”, and nor is it a rehash of “The Seven Habits of Highly Effective People”.
What it is: packed with tips about time management for real people operating here in the real world. The kind of people who have non-negotiable time-specific responsibilities, and frequent unavoidable interruptions. The kind of people who have partners, families, and personal goals and aspirations too.
The “two other short guides” mentioned in the subtitle are her other books, whose titles start the same but instead of “…before Breakfast”, substitute:
- …on the Weekend
- …at Work
However, if you’re retired (we know many of our subscribers are), this still applies to you:
- The “weekend” book is about getting the most out of one’s leisure time, and we hope you have that too!
- The “work” book is about not getting lost in the nitty-gritty of the daily grind, and instead making sure to keep track of the big picture. You probably have this in your personal projects, too!
Bottom line: if, in the mornings, it sometimes seems like your get-up-and-go has got up and gone without you, then you will surely benefit from this book that outstrips its competitors in usefulness and applicability.
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White Bread vs White Pasta – Which Is Healthier?
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Our Verdict
When comparing a white bread to a white pasta, we picked the pasta.
Why?
Neither are great for the health! But like for like, the glycemic index of the bread is usually around 150% of the glycemic index for pasta.
All that said, we heartily recommend going for wholegrain in either case!
Bonus tip: cooking pasta “al dente”, so it is still at least a little firm to the bite, results in a lower GI compared to being boiled to death.
Bonus bonus tip: letting pasta cool increases resistant starches. You can then reheat the pasta without losing this benefit.
Please don’t put it in the microwave though; you will make an Italian cry. Instead, simply put it in a colander and pour boiling water over it, and then serve in your usual manner (a good approach if serving it separately is: put it in the serving bowl/dish/pan, drizzle a little extra virgin olive oil and a little cracked black pepper, stir to mix those in, and serve)
Enjoy!
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In This Oklahoma Town, Most Everyone Knows Someone Who’s Been Sued by the Hospital
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McALESTER, Okla. — It took little more than an hour for Deborah Hackler to dispense with the tall stack of debt collection lawsuits that McAlester Regional Medical Center recently brought to small-claims court in this Oklahoma farm community.
Hackler, a lawyer who sues patients on behalf of the hospital, buzzed through 51 cases, all but a handful uncontested, as is often the case. She bantered with the judge as she secured nearly $40,000 in judgments, plus 10% in fees for herself, according to court records.
It’s a payday the hospital and Hackler have shared frequently over the past three decades, records show. The records indicate McAlester Regional Medical Center and an affiliated clinic have filed close to 5,000 debt collection cases since the early 1990s, most often represented by the father-daughter law firm of Hackler & Hackler.
Some of McAlester’s 18,000 residents have been taken to court multiple times. A deputy at the county jail and her adult son were each sued recently, court records show. New mothers said they compare stories of their legal run-ins with the medical center.
“There’s a lot that’s not right,” Sherry McKee, a dorm monitor at a tribal boarding school outside McAlester, said on the courthouse steps after the hearing. The hospital has sued her three times, most recently over a $3,375 bill for what she said turned out to be vertigo.
In recent years, major health systems in Virginia, North Carolina, and elsewhere have stopped suing patients following news reports about lawsuits. And several states, such as Maryland and New York, have restricted the legal actions hospitals can take against patients.
But with some 100 million people in the U.S. burdened by health care debt, medical collection cases still clog courtrooms across the country, researchers have found. In places like McAlester, a hospital’s debt collection machine can hum away quietly for years, helped along by powerful people in town. An effort to limit hospital lawsuits failed in the Oklahoma Legislature in 2021.
In McAlester, the lawsuits have provided business for some, such as the Adjustment Bureau, a local collection agency run out of a squat concrete building down the street from the courthouse, and for Hackler, a former president of the McAlester Area Chamber of Commerce. But for many patients and their families, the lawsuits can take a devastating toll, sapping wages, emptying retirement accounts, and upending lives.
McKee said she wasn’t sure how long it would take to pay off the recent judgment. Her $3,375 debt exceeds her monthly salary, she said.
“This affects a large number of people in a small community,” said Janet Roloff, an attorney who has spent years assisting low-income clients with legal issues such as evictions in and around McAlester. “The impact is great.”
Settled more than a century ago by fortune seekers who secured land from the Choctaw Nation to mine coal in the nearby hills, McAlester was once a boom town. Vestiges of that era remain, including a mammoth, 140-foot-tall Masonic temple that looms over the city.
Recent times have been tougher for McAlester, now home by one count to 12 marijuana dispensaries and the state’s death row. The downtown is pockmarked by empty storefronts, including the OKLA theater, which has been dark for decades. Nearly 1 in 5 residents in McAlester and the surrounding county live below the federal poverty line.
The hospital, operated by a public trust under the city’s authority, faces its own struggles. Paint is peeling off the front portico, and weeds poke up through the parking lots. The hospital has operated in the red for years, according to independent audit reports available on the state auditor’s website.
“I’m trying to find ways to get the entire community better care and more care,” said Shawn Howard, the hospital’s chief executive. Howard grew up in McAlester and proudly noted he started his career as a receptionist in the hospital’s physical therapy department. “This is my hometown,” he said. “I am not trying to keep people out of getting care.”
The hospital operates a clinic for low-income patients, whose webpage notes it has “limited appointments” at no cost for patients who are approved for aid. But data from the audits shows the hospital offers very little financial assistance, despite its purported mission to serve the community.
In the 2022 fiscal year, it provided just $114,000 in charity care, out of a total operating budget of more than $100 million, hospital records show. Charity care totaling $2 million or $3 million out of a $100 million budget would be more in line with other U.S. hospitals.
While audits show few McAlester patients get financial aid, many get taken to court.
Renee Montgomery, the city treasurer in an adjoining town and mother of a local police officer, said she dipped into savings she’d reserved for her children and grandchildren after the hospital sued her last year for more than $5,500. She’d gone to the emergency room for chest pain.
Dusty Powell, a truck driver, said he lost his pickup and motorcycle when his wages were garnished after the hospital sued him for almost $9,000. He’d gone to the emergency department for what turned out to be gastritis and didn’t have insurance, he said.
“Everyone in this town probably has a story about McAlester Regional,” said another former patient who spoke on the condition she not be named, fearful to publicly criticize the hospital in such a small city. “It’s not even a secret.”
The woman, who works at an Army munitions plant outside town, was sued twice over bills she incurred giving birth. Her sister-in-law has been sued as well.
“It’s a good-old-boy system,” said the woman, who lowered her voice when the mayor walked into the coffee shop where she was meeting with KFF Health News. Now, she said, she avoids the hospital if her children need care.
Nationwide, most people sued in debt collection cases never challenge them, a response experts say reflects widespread misunderstanding of the legal process and anxiety about coming to court.
At the center of the McAlester hospital’s collection efforts for decades has been Hackler & Hackler.
Donald Hackler was city attorney in McAlester for 13 years in the ’70s and ’80s and a longtime member of the local Lions Club and the Scottish Rite Freemasons.
Daughter Deborah Hackler, who joined the family firm 30 years ago, has been a deacon at the First Presbyterian Church of McAlester and served on the board of the local Girl Scouts chapter, according to the McAlester News-Capital newspaper, which named her “Woman of the Year” in 2007. Since 2001, she also has been a municipal judge in McAlester, hearing traffic cases, including some involving people she has sued on behalf of the hospital, municipal and county court records show.
For years, the Hacklers’ debt collection cases were often heard by Judge James Bland, who has retired from the bench and now sits on the hospital board. Bland didn’t respond to an inquiry for interview.
Hackler declined to speak with KFF Health News after her recent court appearance. “I’m not going to visit with you about a current client,” she said before leaving the courthouse.
Howard, the hospital CEO, said he couldn’t discuss the lawsuits either. He said he didn’t know the hospital took its patients to court. “I had to call and ask if we sue people,” he said.
Howard also said he didn’t know Deborah Hackler. “I never heard her name before,” he said.
Despite repeated public records requests from KFF Health News since September, the hospital did not provide detailed information about its financial arrangement with Hackler.
McAlester Mayor John Browne, who appoints the hospital’s board of trustees, said he, too, didn’t know about the lawsuits. “I hadn’t heard anything about them suing,” he said.
At the century-old courthouse in downtown McAlester, it’s not hard to find the lawsuits, though. Every month or two, another batch fills the docket in the small-claims court, now presided over by Judge Brian McLaughlin.
After court recently, McLaughlin, who is not from McAlester, shook his head at the stream of cases and patients who almost never show up to defend themselves, leaving him to issue judgment after judgment in the hospital’s favor.
“All I can do is follow the law,” said McLaughlin. “It doesn’t mean I like it.”
About This Project
“Diagnosis: Debt” is a reporting partnership between KFF Health News and NPR exploring the scale, impact, and causes of medical debt in America.
The series draws on original polling by KFF, court records, federal data on hospital finances, contracts obtained through public records requests, data on international health systems, and a yearlong investigation into the financial assistance and collection policies of more than 500 hospitals across the country.
Additional research was conducted by the Urban Institute, which analyzed credit bureau and other demographic data on poverty, race, and health status for KFF Health News to explore where medical debt is concentrated in the U.S. and what factors are associated with high debt levels.
The JPMorgan Chase Institute analyzed records from a sampling of Chase credit card holders to look at how customers’ balances may be affected by major medical expenses. And the CED Project, a Denver nonprofit, worked with KFF Health News on a survey of its clients to explore links between medical debt and housing instability.
KFF Health News journalists worked with KFF public opinion researchers to design and analyze the “KFF Health Care Debt Survey.” The survey was conducted Feb. 25 through March 20, 2022, online and via telephone, in English and Spanish, among a nationally representative sample of 2,375 U.S. adults, including 1,292 adults with current health care debt and 382 adults who had health care debt in the past five years. The margin of sampling error is plus or minus 3 percentage points for the full sample and 3 percentage points for those with current debt. For results based on subgroups, the margin of sampling error may be higher.
Reporters from KFF Health News and NPR also conducted hundreds of interviews with patients across the country; spoke with physicians, health industry leaders, consumer advocates, debt lawyers, and researchers; and reviewed scores of studies and surveys about medical debt.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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Come As You Are – by Dr. Emily Nagoski
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We’ve all heard the jokes, things like: Q: “Why is the clitoris like Antarctica?” A: “Most men know it’s there; most don’t give a damn”
But… How much do people, in general, really know about the anatomy and physiology of sexual function? Usually very little, but often without knowing how little we know.
This book looks to change that. Geared to a female audience, but almost everyone will gain useful knowledge from this.
The writing style is very easy-to-read, and there are “tl;dr” summaries for those who prefer to skim for relevant information in this rather sizeable (400 pages) tome.
Yes, that’s “what most people don’t know”. Four. Hundred. Pages.
We recommend reading it. You can thank us later!
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