narcissistic personality disorderAmbition’s dark side regularly captures our attention. The relentless quest for status, fame and power is not only off putting but also damaging to the extent that the quest comes at a cost — getting to the top by climbing over the backs of others, potentially injuring them in the process.

Narcissistic personality disorder

Psychiatry, in its inclusive spirit, has a diagnosis for the dark side of ambition: narcissistic personality disorder. Here are some of the pertinent diagnostic criteria: grandiose sense of self-importance; preoccupation with fantasies of unlimited success, power and brilliance; belief of being special and unique; requiring excessive admiration; entitlement; interpersonal exploitation; envy; and arrogant attitudes. Dark indeed.

But the fruits of ambition also capture our attention. President Kennedy’s challenge to put a man on the moon in a decade launched an extraordinarily ambitious project with spectacular success and spinoffs with substantial social benefits.

But ambitions need not be so grand to be fruitful. For many of us, identity is forged by our life projects that embody our ambitions, be they great or more modest. And ambitious projects need not be as tangible as putting a man on the moon. Raising and caring for a family is ambitious and perhaps the ambition most crucial to our collective well-being. We might say that ambition accounts for much of our cultural progress and achievement. Without ambition, we stagnate as individuals, institutions and societies.

Ambition: virtue and vice

Perhaps we should think of ambition as a double-edged sword — potentially a virtue and a vice. Ambition goes awry when it is driven more by the status of the self than the value of the project. But we should not think of healthy ambition as selfless.

I was inspired to write this piece by the thinking of a contemporary philosopher whom I greatly admire, Christine Korsgaard. She articulates the ideal integration of the self with ambitious projects. Befitting her profession, she gives the example of wanting to write a book (on Kant’s ethics) that would be good enough as to be required reading in all ethics classes. She acknowledges that this desire could be perceived as “raw vanity” (the dark side). But she sees the desire differently; in her own words, excerpted from her book, Self-Constitution: Agency, Identity and Integrity:

“I think that such a book would be a good thing and my ambition is not conceivable without that thought. It is an ambition to do something good …. I think someone should write a book on Kant’s ethics good enough that it will be required reading. I think that this is something for which there is a public reason.

This doesn’t, however, mean that my ambition is just a disinterested response to that public reason …. I don’t just want it to be the case that someone writes the book. I want to be the someone who writes that book.” (pp. 210-211, emphasis in original).

Self-ConstitutionKorsgaard goes on to acknowledge that the personal component to ambition is often essential to carrying out the arduous work of one’s projects. She is keenly aware that this personal ambition might lead one to subvert others’ efforts to carry out the same project, for example, undermining a colleague’s attempt to write the book. She wisely asserts, “This is not an expression of ambition, but rather a very familiar perversion of it.”

More broadly, I think this “perversion” includes ambitious self-enhancement devoid of investment in worthy projects for their own sake. The desire to be “Number One” is ubiquitous in our culture. We must ask: For what purpose? Toward what end? Sheer shelf-aggrandizement will not do. With such misguided directions of ambition, we move from what we psychologists call “healthy narcissism” (as Korsgaard brilliantly exemplifies) to “pathological narcissism.” And who wants that?

References

APA (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, DSM-5. Washington, D.C. American Psychiatric Association.

Korsgaard, C.M. (2009). Self-Constitution: Agency, Identity, and Integrity. New York: Oxford University Press.

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CI logoMy name is not Anonymous, but it will suffice for this blog post because I must be, well, anonymous.

Volunteering to help others in a crisis

I’m one of hundreds of suicide/crisis hotline volunteers around the United States, and who we are is not important relative to our callers. Their crises are what we focus on, and we use an alias because the only thing callers need to know about us is that we have a sincere desire to help them get to a point where they can help themselves.

I get nervous on the drive over to the hotline location. I’ve been trained well on the crisis model, but there’s no script and these calls are high stakes. I want to say just the right things to help people validate their feelings, but it’s a challenge because I never know what kind of calls I’ll get. Here are just a few of the people I’ve tried to help:

  • A man with a diaper fetish.
  • Many distraught teenagers who have broken up with their girlfriend or boyfriend.
  • A girl who had been sexually abused by both her biological mother and father, and having left that abusive situation was raped in a group home.
  • A husband crying because his wife found another liquor bottle hidden in their house, and it was the last straw – she wanted him to leave forever because of his drinking. “You could stop anytime you want to,” she screamed at him.
  • A wife whose husband had cheated on her and then wouldn’t let their daughter go to a friend’s quinceañera because he thought she’d have sex with her boyfriend that night.
  • Elderly people who were isolated and lonely.
  • People who want to end their life because the emotional pain they’re experiencing is too overwhelming to bear. (We have specific ways of caring for these callers. Our job is to buy time in the hope that the help we provide will allow the callers to reconsider and come to a different decision.)

A need in common

What do these callers all have in common? An urgent need to talk to someone who does not know them, who cannot see them, who will actively listen and who will not judge them for anything they say or don’t say. Sometimes, I’m so actively listening that my head is bowed and my hands cup the earphones of my headset so I can hear every word. It’s important to get into the rhythm of each caller’s speech so you don’t talk over them — that way I have a better chance of helping them expand their options.

Taking care of myself

When I leave my shift, I close my ring binder of training notes and say to myself that I’ve done what I could. Enough callers thank me each shift to make up for the ones who still feel powerless when they hang up. (The best thank-you I’ve received so far is from a Vietnam vet who told me he would not put a shotgun in his mouth and pull the trigger that night because he felt better talking to me.) When I get home, I count my blessings and take care of myself. I have a mug of hot chocolate, an Epson salts bath and call it a night.

National network

There’s a network of United States hotlines so if one city is short of staff/volunteers, the calls roll over to people who are available. Volunteers are never alone, there is always a paid staff member there, and staff members are usually the ones who work the phones in the deepest dark of night up till dawn.

If you’re even slightly interested in volunteering on a crisis hotline, I urge you to contact your local office and at least go through the training. Then decide. If it’s not a good fit for you, no worries; you will have learned valuable communication skills. If you do end up volunteering, you’ll know that you’re having a direct and positive effect on people’s lives.

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KG blog imageI am a nutrition geek. The science behind how our body and brain work is so amazing to me. The foods we eat help our brain work efficiently, and I love being able to teach others the link between food and mood.

National Nutrition Month

March is National Nutrition Month, and while my colleague, Tessa, and I were researching various handouts for our Nutrition Challenge, we were reminded we have to create many of our handouts because there’s so much misleading information out there.

For example, we ordered bookmarks made by the Academy of Nutrition and Dietetics. They should be fantastic, right? I was super excited after I pushed the purchase button. When they arrived, I quickly tore open the package, pulled out a bookmark and read: “Balancing calories: Enjoy your food but eat less.”

Wait … what? I love my food; why should I eat less? Is there something wrong with the way I eat? Am I eating too much? Am I expected to eat more of things I do not enjoy and eat less of the foods I love? Then I quickly pushed my mental pause button and checked in with myself.

I am a normalized eater. I eat intuitively by eating when I am hungry and stopping when I am full. (Well, other than my favorite fun food: peanut butter M&Ms. Those are impossible for me to eat intuitively.)

Yet the world we live and work in is obsessed with calories and perceived healthy eating. While my dietitian brain understands that many Americans overeat and that those words on the bookmark were intended to educate them on eating in moderation, I also know many people struggling with their relationship to food will take that simple bullet point to heart.

What my bookmarks would say

If I had designed my own bookmarks, these are the bullet points I would include:

Eat to fuel your body!

  • Calories are intended to provide your body with energy for optimal function, not to manipulate your weight.
  • Provide your brain with energy every 3-4 hours and enjoy an evening snack 2-3 hours before you go to bed. Maximum brain recovery and repair happen while you are sleeping.
  • While eating, check in with your body and listen for hunger and fullness cues. Follow those cues!

Eat to maximize your mood!

  • Carbohydrate-rich foods like grains and fruit help tryptophan enter your brain and release serotonin, which promotes happiness and a sense of calm.
  • Enjoy fatty fish like salmon and tuna 3-4 times a week for brain and mood health. Dislike fish? Enjoy walnuts or flaxseed instead.
  • A hydrated body can think more clearly and move nutrients around your body more efficiently.

Eat to show respect to your body!

  • Eat a variety of foods. Each food group and even color group of food provides your body with unique vitamins, minerals and antioxidants. There is no perfect food. Eat the rainbow.
  • Eat in moderation. Be mindful not to over-eat or under-eat. Let your hunger and satiety cues lead the way.
  • There are no good or bad foods. All foods fit — it’s up to you to find a strategy to balance it out.

Mental and physical health depend on a well-nourished and respected body. Please think about incorporating my bullet points into your eating. Enjoy food. Love your body. Have a nourishful day.

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Woman’s Obituary Highlights Child Abuse

by Michele Arnold January 25, 2015

I read the obituary of Marianne Theresa Johnson-Reddick with interest. She tortured people by her cruelty. This abusive mother did not get a free pass to the afterlife. Two of her eight children let the world know how they were all “abrasively exposed to her evil and violent life” in her obituary. “Mom” ran a […]

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Grocery Store-based Screening Better than Lucy’s Mental Health Advice

by Nancy Trowbridge January 22, 2015

On the shelf of my cubicle sits a Hallmark-brand Peanuts tree ornament with Charlie Brown seeking Lucy’s 5-cent psychiatric help. It reminds me of watching every holiday Peanuts TV special while growing up and the mental health setting where I work today. Hallmark moments create a warm feeling, don’t they? A kind of Hallmark moment […]

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Is Depression a Brain Disorder? Yes and No

by Jon G. Allen, PhD December 12, 2014

Thirty years ago, I submitted a manuscript for publication and received the following response from the editor: “There is nothing new here, but some ideas warrant repeating.” The manuscript was published. I have already written about the problems in reframing psychiatric disorders as brain disorders, but I was inspired to write yet another post about […]

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Of course I’m envious!

by Herman Adler, MA October 17, 2014

A few years ago I wrote a blog post about the trait of stubbornness and its application to personality disorders. This time, I’m here to delve into the complicated and misjudged trait of envy. According to the DSM-V, the trait “often envious of others” is among the traits of narcissistic personality disorder. Two perfectly reasonable […]

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Tackling the Problem of Domestic Violence

by Dallas Adams, LCSW October 10, 2014

Why write about domestic abuse and violence in a mental health blog? Especially since these two behaviors are not caused by mental illness? I write about domestic violence and abuse here because domestic violence and abuse can result in physical injury, psychological trauma and, in severe cases, even death. The devastating consequences of domestic violence […]

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Quiet: A Book for Introverts

by Jon G. Allen, PhD October 3, 2014

Being a prototypical introvert, I was drawn to Susan Cain’s popular book, Quiet: The power of introverts in a world that can’t stop talking. Cain’s subtitle could have been shorter: “In praise of introversion.” Sadly, her subtitle also could have been: “In defense of introversion.” The basic premise of her book: About a century ago, […]

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Is anomie the enemy? Another perspective on the increase of school shootings

by Hannah Szlyk, LMSW September 30, 2014

Anomie: the breakdown in the bond between the individual and community is evidenced when there is a discrepancy between the values and ideologies of society and what is achievable in normal life. This term, popularized by French sociologist Emile Durkheim in his 19th century book Suicide, was referenced in a discussion of the recent school […]

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