Sunday, May 04, 2008

Penetrating the stone wall of narcissism

Narcissistic rage within the medical and academic communities
Available on OII's webstie at:

Narcissistic personality disorder is a major social problem and medical experts and others in the academic community are more prone to this severe mental illness than the population in general. [1] NPD (Narcissistic personality disorder) is defined as a pattern of grandiosity and a need for admiration or adulation which usually begins by early adulthood. Five or more of the following criteria must be met: [2]

• Feelings of grandiosity
• Obsessed with fantasies of success, power, fame and brilliance
• Firm conviction that they are unique and should associate only with those of special status
• Requires excessive admiration
• Feelings of entitlement
• Exploitative and manipulative behavior of others
• Devoid of empathy
• Envious of others
• Arrogant behavior coupled with rage when frustrated, contradicted or confronted.

"Medical narcissism is a term coined by John Banja in his book Medical Errors and Medical Narcissism. He uses the psychological concept of narcissism to explain the culture by which many medical practitioners downplay medical errors and often avoid taking personal responsibility. He claims this is part of the dehumanization of the patients from the practitioner's perspective. John Banja provided evidence that there is a higher incidence of practitioners in the medical profession with narcissistic personality disorder than the general population, and that there is a resultant general narcissistic culture in the medical profession of self-righteousness, arrogance, and denial." [3]

Medical narcissists as well as others who suffer from NPD invariably exhibit symptoms of narcissistic rage when reacting to what they perceive as the slightest injury (narcissistic injury). Narcissistic injury is any real or imagined threat to the narcissist's grandiosity and self-perception as entitled to special treatment and recognition, regardless of his actual accomplishments, if any. [4]

After years of intersex activism, some influential academics and medical researchers, Alice Dreger, Anne Lawrence and Eric Vilain et al., have all exhibited the symptoms of a violent narcissistic rage against the intersex community and have caused great damage to a vulnerable group of people who were just emerging into the collective consciousness.

Their own narcissism has been perpetuated by their own grandiosity as the gatekeepers of all sex variations with their own image as a man or woman as the standard which should be imposed on all people, especially the intersexed. Defining a person by a checklist of sex markers and arbitrarily assigning the individual as male or female without permission or any input from the child is dehumanizing and one of the most blatant forms of medical narcissism. These doctors and academics are pretending to be omniscient and in possession of some profound knowledge which is unknowable to anyone – the "true" sex of a child whose sex cannot be defined as male or female to begin with. Then, they assume that this omniscience gives them the right to surgically and/or hormonally alter the child's body long before the child has developed any awareness of their own individuality and autonomy.

The current terminology used to stigmatize and justify such medical (mal)practice, DSD or Disorders of Sex Development, originated from the narcissistic rage of the academic and medical community against the intersex community which had started to question these practices and demand accountability and respect for intersex children.

Typical of the schoolyard bully, these academics and doctors reacted with an attitude of "how dare they question our authority". The victims of their abuse, by daring to denounce it, had to be further bullied and silenced because the narcissist will not entertain the slightest criticism without flying into a rage that is totally disproportional to the points being made by the victim. The narcissist cannot admit to an error and intersex treatments are particularly prone to what would be serious medical errors if designed for treating almost any other group of people. Lack of informed consent, surgical and hormonal manipulation of an individual's body and labeling the individual as mentally ill for refusing the medical abuse which assigned the person a wrong sex: all these present serious ethical issues which the medical community should take seriously.

Instead of taking the criticisms of the intersex community seriously, their pathological narcissism has only become more impenetrable as they scramble to protect themselves against lawsuits and a loss of their self-perceived grandiosity.

The deepest wound that many intersex people live with is the lie that we are all either a male or a female. This violence against many intersexed people is so profound and brutally denied that intersex activism has almost been crushed by replacing the term “intersex” with “disorders of sex development” without any real consultation with those directly affected – intersexed people themselves.

Many of the same people are reacting the same way to the trans community. Some of them who have falsely accused some transsexuals of responding with narcissistic rage, have misinterpreted the condition, based upon narrow reading (Kohut) and thus have failed to find in themselves more severe narcissistic pathologies, including "borderline" ideology. For a more balanced approach to this, we suggest they and others read Kernberg's critiques of Kohut. Kernberg, saw a far more fragmented self, which is more descriptive of the traits exhibited by certain writers who have written recently about narcissistic rage in transsexuals than the transsexuals these writers were describing.

For such reading on the misunderstanding of narcissistic rage and its misinterpretation and displacement upon others (transsexuals), see Kernberg's criticisms of the limitations of Kohut's view of narcissism.

For more on borderline disorders in physicians, see

For more on how such conditions can cause a physician to sexually abuse others, see

Some OII members clearly see that certain "professionals" studying transsexualism and intersex do indeed have more severe narcissistic disorders which lead to borderline personality expression. (We realize that BPD is a "controversial diagnosis". However, it certainly is no more controversial than the "diagnosis" of autogynephilia, which although not listed in the DSM, is believed by a few not-overly-suspicious OII members, to be "nominated" for its inclusion in the DSM).


Disturbances suffered by those with borderline personality disorder are wide-ranging. The general profile of the disorder typically includes a pervasive instability in mood, extreme "black and white" thinking, or "splitting", chaotic and unstable interpersonal relationships, self-image, identity, and behavior, as well as a disturbance in the individual's sense of self. In extreme cases, this disturbance in the sense of self can lead to periods of dissociation. These disturbances have a pervasive negative impact on many or all of the psychosocial facets of life. This includes the ability to maintain relationships in work, home, and social settings.

For those persons who see in black and white and who quickly change from over-valuing and then to de-valuing those with whom they disagree, and whom they criticize even more stringently without merit, and without re-examining themselves, it is suggested that they seek modern psychoanalysis.

This is the treatment which caused analysts since Freud’s time to wonder: "can the stone wall of narcissism be penetrated?" And Spotnitz has responded with a resounding yes to that question. Although we doubt that those who pathologize transsexual and intersexed persons will be amongst Spotnitz's successes (in that their own stone wall of narcissistic defense surrounding their narcissistic rage and borderline symptoms will be penetrated), we still say to these hacademics: "Please give it the old college try".


Further reading:

For a review and critique on understanding of pathological narcissism of Heinz Kohut, see the following and the writings of Otto Kernberg.