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Dr Simon Rogoff's avatar

Thanks Nathalie. This is a thoughtful piece of work that aligns well with my clinical experience over recent years. Clinical and research understanding of personality disorders has developed massively. What we call it is a different question. But there has never been more concensus about what people with these problems need in order to function better. And one of the things they need is accountability. In a culture of identity shopping, neuro divergence and cPTSD are easier to accept or adopt as self applied labels. But diagnosistic systems are not intended to offer identity. They are intended to signpost towards help with functioning better.

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Josh Slocum's avatar

This is really well done, and you know I agree that this is what's going one. Thank you for putting it out there. Many, many people know that what you're writing is true, but they will pretend they don't know it.

There's one point on which I'd add something, or perhaps disagree a bit.

You wrote:

"While there is truth in these patterns in specific populations of women6, this framing makes it incredibly difficult for those who recognise narcissistic traits in themselves to seek help."

My view? That's too bad. The behavior is stigmatized because it *deserves to be stigmatized.* Sympathy-first for the one with a personality disorder (as compared to sympathy-first for the person affected by her Cluster B behavior) is where we're already at. That's why we're here.

I don't care if the narcissist finds it "stigmatizing." I want them to find it stigmatizing. Why? Because most Cluster Bs-not all, but most-are not ever going to change. We're not going to get an appreciable number of narcissists to suddenly see themselves for who they are by "avoiding stigma."

Avoiding stigma is what has allowed Cluster Bs to normalize their behavior and to abuse with abandon. Not only are they not recognized as abusive, their abuse itself is validated and praised as "authenticity."

I care first about helping people avoid the effects of Cluster Bs, because I think that will help more people than (what I believe is) a vain hope that "offering palatable terms" will make a Cluster B suddenly realize she's the problem.

What do you think?

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