I’m well aware of what has popularly been termed the “Goldwater Rule,” which is a section in the American Psychiatric Association’s Principles of Medical Ethics that states that a psychiatrist should not provide a diagnosis to someone that he or she hasn’t personally examined.
The implications of this rule are clear for my application of the term “narcissist” to my ex-boyfriend, as well as for millons of other people who apply this term to their exes, friends and family members. My ex-boyfriend, as far as I know, has never been to see a mental health professional, much less been diagnosed as a narcissist.
So who am I to call him a narcissist? Not only has he never been properly diagnosed, I’m not even medically qualified to do any diagnosing, as I do not have a background in behavioral health.
I will willingly concede these points, and offer a few of my own about why I will continue to use this label on my blog.
First, most narcissists never seek treatment because they do not believe anything is wrong with them by definition. This means that they are unlikely ever to be diagnosed in the traditional sense. In fact, we know very little about narcissists through medical diagnoses, except for the violent ones who are also psychopathic and have committed crimes, been caught, and ended up in prison. These are not the types, however, that most of us are likely to come into contact with.
Second, narcissists are difficult to detect. They are visible not so much by what they present to the world in general as by the pattern of similar individual experiences shared by their victims. This is the same concept that we can observe when watching a scary movie and one of the characters thinks he or she may be in danger and uses tropes from vampire lore to determine whether another character is a vampire or not. The hero can’t just come out and ask the other character because he or she is unlikely to get a truthful answer so must instead use all of the signs from classic vampire mythology to figure it out, such as: does the other character react negatively to holy water? Do they avoid garlic? When standing in front of a mirror, is their reflection missing?
Narcissistic abuse is like this. It is the victims of narcissist abuse that reflect back and illuminate the narcissist for who he or she truly is. The damage to victims follows a recognizable documented pattern that has been named and can now be identified as meeting criteria for narcissistic behavior by the person who perpetrates it. Given that most people who perpetrate it will likely never be examined by a mental health professional, examining the actions as a representation of the person is perhaps the closest we can come to identifying the people who engage in it as narcissists. It is an inductive labeling process and identifying it leads to identifying its perpetrators for the purposes of protecting people from harm.
Third, though this inductive labeling process is unorthodox, it ultimately doesn’t really matter how we label narcissists when they are not the beneficiaries of that label. The discussion about labeling is merely a semantic discussion. A toxic person is a toxic person. The best reason to use the label is that it allows victims to discover that there is a term for what they have experienced and that they are not alone. This is important because as victims realize there is a well-established body of knowledge on this type of systematic abuse, they also begin to realize that the abuse was not their fault, that there was nothing they could have done to change the outcome of the relationship, and that the world can make sense once again when they have the language to describe what they have been through.
Using the term ‘narcissist’ helps to empower victims by giving them control back over their own realities. As an advocate for survivors, I will use this agreed-upon term to describe the experience I went through and lend my support to the other survivors out there.