In my last Bossypants blog, I wrote about Narcissistic Personality Disorder (NPD). Persons with NPD and assorted other personality disorder don’t think they have a disorder. Instead, they blame everyone around them for their troubles, and for the ubiquitous misery they cause.

Remember this old joke? How many psychologists does it take to change a light bulb? Only one, but the light bulb has to really want to change.

If the light bulb has a personality disorder, this is highly unlikely.

As co-authors of a Counseling and Psychotherapy Theories text, and some other psychologically fascinating books, my far less bossy husband ( and I engage in endless speculation about how to alleviate suffering and facilitate human growth and development. True, people rarely change for the better if they don’t want to. But people can and do change.

Most of us like to believe in free will, the human capacity for conscious choice. But we are finite beings. Biologically, we’re limited to the attributes we were born with, and whatever we might add surgically or medically to those basics. Broadly, this is referred to as “nature.” We are also shaped by the external world—by those who love us, feed us, admire us, or abandon us. And this is referred to as “nurture.” Nurture. Nature. Together, these two 1) account for a very large percentage of who we are, and 2) heavily influence–or even limit–our choices.

Further, some argue that free will is an illusion because we’re genetically programed to reproduce. Behaviors (and choices) are thus dictated by the biological mandate to successfully reproduce with the best partners as often as possible. The more offspring carrying forth our genes, the better—so the argument goes. Of course, no one has yet successfully interviewed a gene, so a lot of these “selfish gene” explanations remain theoretical, and exceptions to the rule are as interesting as the supposed rule. But we’ll leave this discussion for another day.

Here’s what Dr. Bossypants believes. We are sentient, conscious beings, and we do make choices. These choices are influenced by many factors, including:

  • our parents, first grade teachers or that coach we had in seventh grade
  • our biological attributes or needs
  • our desire to successfully reproduce
  • the drugs we take, repeated blows to our heads, and difficulties in our lives.

But even with those forces in play, choices are still to a large degree our own.

Making good choices is more difficult for some people than others, but having the ability and the right to make choices remains a defining feature of what it means to be human. Choices can be loving or hateful, constructive or destructive, selfish or generous. We can choose to be honest or to lie. We can choose to work for our own gain, regardless of what it costs others, or we can choose balance, keeping ourselves and our neighbors equally in mind.

From the perspectives of Alfred Adler, certain feminists, the Dalai Lama, Carl Rogers, Jesus, and many other highly educated and thoughtful people, humans are happiest and healthiest when they choose to be compassionate, generous, honest, and constructive. For what it’s worth, I concur.

And yes, that’s me, second to the last on the right. Whoa.



Thank you, Mayo Clinic


Well, hello there. Today I’m re-launching this particular blog, realizing I shouldn’t waste my expensive and difficult graduate education just because I want to write poetry.

The complexities of the human race require many prisms to achieve a decent level of understanding. I’m a clinical psychologist. I respect science. I honor the efforts humans make to solve problems and explain mysteries. I know, I know. It’s become very rewarding to twist scientific inquiry into whatever shape suits our self-interests, but people, listen: We are playing increasingly dangerous games. Self-serving delusions eventually shatter. Repeating something over and over might make you rich in dollars and clicks, but it won’t make it true.

I have friends who are not psychologists. They are cowgirls, artists, bus drivers, carpenters, hot air balloon pilots, dancers, plumbers, and gardeners. These lucky folks may have less occasion to ponder the many ways human personalities become diseased, destructive, entrenched, frozen, or malignant. But ponder, we must.

Dr. Bossy Pants has no need to re-create the wheel in her own words. Because the esteemed folks at Mayo Clinic are excellent writers, I’m going to quote them extensively below. I hope it will be helpful in our quest to understand our species, and seek healing and wholeness, as we the people continue to strive to form a more perfect Union.


Narcissistic personality disorder is a mental disorder in which people have an inflated sense of their own importance, a deep need for admiration and a lack of empathy for others. But behind this mask of ultraconfidence lies a fragile self-esteem that’s vulnerable to the slightest criticism.

A narcissistic personality disorder causes problems in many areas of life, such as relationships, work, school or financial affairs. You may be generally unhappy and disappointed when you’re not given the special favors or admiration you believe you deserve. Others may not enjoy being around you, and you may find your relationships unfulfilling. …

If you have narcissistic personality disorder, you may come across as conceited, boastful or pretentious. You often monopolize conversations. You may belittle or look down on people you perceive as inferior. You may feel a sense of entitlement — and when you don’t receive special treatment, you may become impatient or angry. You may insist on having “the best” of everything — for instance, the best car, athletic club or medical care.

At the same time, you have trouble handling anything that may be perceived as criticism. You may have secret feelings of insecurity, shame, vulnerability and humiliation. To feel better, you may react with rage or contempt and try to belittle the other person to make yourself appear superior. Or you may feel depressed and moody because you fall short of perfection.

DSM-5 criteria for narcissistic personality disorder include these features:

  • Having an exaggerated sense of self-importance
  • Expecting to be recognized as superior even without achievements that warrant it
  • Exaggerating your achievements and talents
  • Being preoccupied with fantasies about success, power, brilliance, beauty or the perfect mate
  • Believing that you are superior and can only be understood by or associate with equally special people
  • Requiring constant admiration
  • Having a sense of entitlement
  • Expecting special favors and unquestioning compliance with your expectations
  • Taking advantage of others to get what you want
  • Having an inability or unwillingness to recognize the needs and feelings of others
  • Being envious of others and believing others envy you
  • Behaving in an arrogant or haughty manner

Although some features of narcissistic personality disorder may seem like having confidence, it’s not the same. Narcissistic personality disorder crosses the border of healthy confidence into thinking so highly of yourself that you put yourself on a pedestal and value yourself more than you value others.

When to see a doctor

When you have narcissistic personality disorder, you may not want to think that anything could be wrong — doing so wouldn’t fit with your self-image of power and perfection. … (end of Mayo quote).

As a human community, striving to live responsibly and lovingly together on the astonishingly beautiful planet we’ve been given to care for, we need to put aside our narcissistic tendencies, even if they are not full-blown pathologies. That’s my opinion. And even though I’m bragging a bit here, it’s both an educated and prayer-informed opinion.