The Billow by Ivan Aivazovsky, 1889
When you’re up a creek without a paddle, don’t keep searching for an accurate diagnosis about the seriousness of someone’s narcissism before you start swimming for shore. If you’re waiting for an authority to definitively and qualitatively tell you that the person you suspect of being narcissistic is pathologically, permanently and forevermore NPD, you’re gonna sink to the bottom of the sea from sheer exhaustion. Either that or the narcissist will push you to the bottom of that sea if it looks like you’re swimming faster than s/he.
The fact is, there’s no specific point at which someone becomes malignant instead of benign. Malignant narcissism cannot be smeared on a Petrie dish and irrefutably diagnosed under a microscope. With a medical condition, you’ve either got diabetes or you don’t. You’ve got thyroid cancer or you don’t. You’ve got tuberculosis or you haven’t. That’s science. Even if narcissism has a genetic or biological component, it’s still not a medical condition to be excised with a scalpel or cured with a dose of penicillin. NPD is a psychological construct based on observable behaviors by a psychologist who is hopefully less crazy than the patient.
Psychologists measure pathological narcissism using nine criteria, but even interpretation of those nine criteria is subject to error. Clinical psychologists are collaborating to better define personality disorders but at this point, and likely for years to come, “Diagnosis remains more of an art form than a science.”
“The danger of the DSM---or any classification scheme---is that it is used in a system with so little monitoring of the decisions about when the line is crossed, and the DSM leaves enormous scope for subjectivity, opinion, judgment and bias in making those decisions.” ~Paula J. Caplan, "They Say You’re Crazy", page 80
Even if psychologists hone diagnostic criteria, it’s not gonna make much difference to the people in the boat. Psychologists can define, refine, combine and fine-toon criteria ‘til fish start flying, but it isn’t going to matter unless the pathological person submits to a diagnosis. So if you are waiting for absolute proof that the narcissist is as BAD as s/he appears to be, you may not get that proof until s/he does something that crosses the line of sanity.
I am beginning to believe the only way to determine pathological narcissism is by counting up the victims. So don’t be one. Don’t let your life be the determining factor as to whether or not someone with a narcissistic style would have been more accurately diagnosed as a malignant narcissist. Don’t worry about misdiagnosing someone who has maligned and treated you unfairly. You’re being too kind. I know you are. Most people who get along with narcissists are overly concerned about being fair. That’s why I love talking to targets, victims, and anyone who’s been a good enough person to get targeted in the first place.
Don’t sacrifice your life to see if the narcissist is so high on the narcissistic continuum that s/he merits dual membership in the Psychopathy Club. There is no glory in the gravestone epitaph, “Yup, I was right! S/he is as BAD as I thought s/he was.”
Stop looking for perfect answers because guess what? There aren’t any.
You must trust yourself to know when someone’s behavior has crossed the threshold of unintentional (benign) behavior into intentional (malignant) malice. You may doubt yourself or even fear you’re being paranoid when your intuition starts ringing for your attention. If those alarm bells are clanging like a light tower in the foggy sea, leave the situation. Don’t engage. Don’t react. Just walk away.
There’s a great book highly recommended by lay people and professionals alike. It’s called The Gift of Fear by Gavin de Becker.