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Narcissistic vs. Antisocial or Sociopathic Personality Disorders

Allan Schwartz, LCSW, Ph.D. was in private practice for more than thirty years. He is a Licensed Clinical Social Worker in the states ...Read More

I receive many E.Mail questions from people asking about antisocial personality disorder. Clearly, there is a lot of confusion about the distinction about these two behavioral disorders. Let’s see if this article can clear up some of that confusion.

What is a personality disorder?

This is the definition give by the Mayo Clinic:

A personality disorder is a type of mental illness in which a person has trouble perceiving and relating to situations and to people, including themselves. This means that there is a rigid and unhealthy pattern of thinking and behaving  impairs relationships in social encounters, at work, at home and in school. Very often the person does not realize they have this disorder. Instead, their is a tendency to blame others when problems arise.

Its important to note that there are many types of personality disorders and that, in real life, they overlap so that a clear diagnosis is difficult for mental health professionals to make.

Narcissistic PD:

According to the DSM IV (Soon to be replaced by DSM V), Narcissistic Personality Disorder is characterized by grandiosity, the constant need for admiration and a lack of empathy for others. They regularly brag about themselves and their achievements. They want power and try to make others believe that they are brilliant and perfect.

Underneath all of these characteristics is an individual who is quite fragile. Just look at the characteristics described and think the opposite. Instead of believing that they are grand, powerful and perfect, they harbor deep feelings of shame, self doubt and sensitivity to criticism.

They are haunted by feelings of emptiness and degradation.
In other words, they are fragile just beneath all of the bragging there is lots of envy of the accomplishments of others and a need to devalue them.

During my years of private psychotherapy practice, I had a number of patients who suffered from this disorder. Attempting to reduce me in intelligence and therapeutic skill, I could feel their loneliness, hollowness and emptiness. It was sometimes difficult to be empathic when they became particularly with arrogant. However, after slow and painstaking work, those who stayed with the therapy went a long ways to understanding themselves and accepting their inner hurt. That was the road to recovery that often took place after they left treatment.

Antisocial or Sociopathic Personality Disorder

At one time this was referred to as psychopathic pd, then, sociopathic and now, Antisocial PD because it is a lot more accurate than the other terms.

According to the DSM IV, this disorder is characterized by a of disregard for, and violation, of the rights of others.
 
They can appear arrogant, therefore, resembling those with narcissistic personality. However, narcissistic personalities are not impulsive, aggressive and deceitful as compared to those with antisocial personalities.

People who are antisocial often violate the law resulting in being arrested. They lie to and manipulate others to their own gain. However, they are very self destructive, seem to have no awareness of consequences and repeat the same destructive patterns of behavior. They lack any remorse for the harm they have caused others. At times, this type of personality appears in the news in the form of a murderer who has been apprehended by the police and show indifference in front of the news cameras.

These people will not enter psychotherapy because they are unaware of what they do. As stated above, they blame others when they have committed acts of violence. In sum, they see no need to enter psychotherapy.

One final note:

There are always degrees of mental illness from mild to severe. This is true in the cases of either narcissistic or antisocial pds.

I hope this clarifies this for people. Please let me know if you are confused, unsure or if this article is not clear.

As always, your comments are welcome.

So, do you, or did you, have a relationship with either of these either through family, friends, husbands, or wives? I hope to read your comments.

Allan N. Schwartz, Phd

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