Should we think of NPD as a mental illness?

I am a member of the facebook support group Adult Children Raised by Narcissist Mothers, which has proved to be another invaluable resource, since having an unloving mother can be such an isolating and invalidating experience. (I have been amazed to find there are THOUSANDS - in fact probably millions - of adults out there desperately trying to piece their lives together after a lifetime of narcissistic abuse from one or sometimes both parents.) A few days ago, I submitted the following post, which received a range of interesting comments and insights, mostly from other women who are 'No Contact' (or 'Low Contact') with their Narcissistic Mother:

Is NPD a mental illness? A 'disability'?

This is a long post but I hope some of you will find it thought-provoking. 

Dr Sam Vaknin is a "self-aware" narcissist who most of you are probably familiar with. He is the author of a book called "Malignant Self-Love" and he has an informative YouTube channel. Sam claims that narcissism is a 'disability', an assertion that I have to admit I scoffed at when I first read it. (How can he have the audacity to claim that he and other narcissists suffer from a 'disability', when they have awareness and volition and they clearly can control how they behave and how they treat other people!)

Recently I read a post on another narcissism survivor support page which categorically stated that NPD is not a mental illness and that we should NEVER think of it as a mental illness - which led to one of the most important, fascinating, thoughtful and divisive threads on the subject of NPD I have yet seen. My own mother, without doubt, has an undiagnosed mental illness (possible borderline schizophrenia and/or bipolar), in addition to her full-blown NPD, which exacerbates (and is exacerbated by) her NPD. As you can imagine, being her daughter has been a shitstorm of unpleasantness. There are numerous overlaps between the cluster B personality disorders, and I think very few narcissists have only NPD. It's often the main source of their problems and disordered thinking and behaviour (and certainly the one that ultimately alienates them the most), but NPD nearly always, and I think inevitably, coexists with at least one additional disorder or mental illness, whether that's addiction, depression, anxiety or any one (or more) of the others recognised by The Diagnostic and Statistical Manual of Mental Disorders.

[The question of 'what came first?' is an entirely separate issue and I'll be writing about that in a separate post.]

I think the reluctance to perceive NPD as an illness (which, for some people, is just a synonym for 'disorder') is because the person with NPD isn't the one who suffers. (At least it certainly doesn't seem that way.) WE SUFFER. We have suffered, and we suffer still. Because of those unconscionable, fucked-up, abusive monsters who call themselves our 'mothers' and who demand that we respect and defer to them for the sole reason they gave birth to us, and regardless of what secret hell they put us through behind closed doors.

Most of us tend to associate illness with suffering. Cancer is suffering. Depression is suffering. To have a broken leg, or influenza, or a nervous breakdown, or insomnia, or PTSD, or ANYTHING that causes pain or curtails your enjoyment of life... It's all 'suffering'. We live, we suffer. Some might argue that it is impossible to have a meaningful life at all without suffering.

But NPD? Do narcissists suffer, or do they just live to cause suffering for others? Are the two necessarily mutually exclusive? I don't think so. NPD is predicated on a foundation of burning, seething and unquenchable JEALOUSY and RESENTMENT, with an ever-flowing undercurrent of fearsome, undiluted self-loathing and all-consuming insecurity, shame and confusion. The mask that says it loves/hates you (depending on whatever capricious mood the narcissist is in) is just that - a mask. Only a mask. Underneath the mask, what is there? Nobody knows, least of all the narcissistic mother herself.

Clearly, that's not a normal or healthy way to lead a life. I personally understand that to be suffering, albeit a different way of suffering that we, as normal people, as empaths, can readily relate to.

We are all familiar with physical disabilities, even if we are fortunate enough to not be directly affected by physical disability ourselves, and we all know (some of us only too well) the myriad of mental illnesses, disabilities and disorders. Some people suffer from both mental and physical disabilities  - cerebral palsy and Parkinson's, for example, or the consequences of severe head trauma (e.g. road traffic accident). But by their nature, most mental/psychological illnesses (apart from certain chronic addictions) are not outwardly obvious. Can you imagine what a narcissist would look like if their affliction showed on the outside?

Having given it a lot of thought and reflection, I believe narcissism is the worst emotional impairment - yes, disability, actual handicap - that any human can be afflicted with. This is not to understate or demean in any way the plight and suffering of those millions of people who have the 'obvious' life-limiting mental and/or physical illnesses and disabilities, but crucially those people ARE, generally, entirely capable of connecting with their fellow human beings. (I even enjoyed a loving, if inevitably odd and strained, relationship with my paranoid schizophrenic half-sister - because her heart was most definitely in the right place.) 

I think it is impossible, however, to be a narcissist and lead a meaningful, enjoyable life of love, happiness and pure pleasure.

Just because, as their victims, we naturally find it impossible to 'pity' narcissists, or to empathise with or even begin to understand their reasons for doing what they do, doesn't mean they are not suffering all the time, in ways we cannot even imagine. (Nor would we want to imagine.) 

It is true that NPD is not, officially at least, classified as a mental illness. I maintain it is, however, an emotional illness which is as horrifying and debilitating as any chronic mental illness. And let's not forget that our emotions provide the infrastructure of our mental state, our sanity, along with our cognitions, memories and perceptions.

We will never pity these people, and nor should we. But if we try to understand why they are the way they are, even if we can never forgive or certainly never excuse it, it should help us recover from the decades of remorseless, agonising torment we received from the one woman in our life who is supposed to love, cherish, encourage and protect us.