There is no laboratory test for the diagnosis of narcissistic personality disorder. Typically a trained psychiatrist or psychologist will evaluate a patient who, by early adulthood, demonstrates grandiose thinking or behavior, has an unusual need for admiration, and shows a lack of empathy for other people. These maladaptive patterns must be present in a variety of contexts.
In addition, a person with narcissistic personality disorder will demonstrate five or more of the following criteria (taken from the DSM-IV):
- Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
- Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
- Believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
- Requires excessive admiration
- Has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
- Is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
- Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
- Is often envious of others or believes that others are envious of him or her
- Shows arrogant, haughty behaviors or attitudes
While it is tempting to do amateur psychology, that is not the point of this blogpost. Only a professional can diagnose and treat narcissistic personality disorder. Nevertheless, it is important for laypeople to be aware that this condition exists, and that it exists in the low-carb community in particular.
Low-carbers are vulnerable. Typically they have been overweight for many years and have a poor self-image as a result. Many have tried and failed at various weight loss schemes. Couple those experiences with the societal stigma against overweight people, and self-worth becomes almost nonexistent.
Along comes low-carb. For once, these formerly-obese people find themselves successful at something. They are able to move their bodies, to buy clothes, and to go out in public without a sense of shame. And, in some cases, they find a mentor who is able to take advantage of all their vulnerabilities.
The mentor provides a diet outline that seems to work. The mentor creates an internet community that gives support and a place to belong to people who were formerly outsiders. All of that is good.
But if the mentor has narcissistic personality disorder, the mentor starts to overstate the benefits of his or her diet plan without commensurate proof (Point #1). The mentor sets himself or herself up as the ideal example of the diet plan (Points #2 and #4). The mentor begins to lay down specific rules that require either automatic compliance or, failing that, expulsion from the community (Points #3 and #5). The mentor may show friendliness, charm and empathy when it provides an advantage (Point #6), but in the end will behave in an arrogant, abusive manner toward people who have disappointed him or her in any way (Point #9).
In my experience, low-carbers tend to think the best of people, even of people who abuse them. When they encounter a person with narcissism, they often hope that by careful reasoning or sympathetic friendship, they can help that person see his or her problem, deal with it, and adopt a more successful style of living. Unfortunately, the treatment of narcissism requires psychotherapy (see this PDF for a fascinating outline of what's involved), and even then the treatment is unlikely to be successful if the patient is not a willing participant in the therapy.
In the meantime, when you encounter another low-carber who is self-absorbed, who believes himself or herself to be superior to others, who belittles others, and who is willing to manipulate others to achieve his or her own ends, recognize that this is a person who can derail your journey into good health. It may be difficult, but if the person is harming you while he or she claims to be helping you, it may be time to end this relationship and develop new ones in the low-carb community.