One of the reasons I am bringing this to your attention is because I had mistakened dementia for narcissism with someone in my life at one time. In the beginning, she was sweet, thought extra-marital affairs were incredibly damaging to family and partners, was remarkably even-tempered and thoughtful, believed in a healthy diet, hated cigarette smoke, and appeared to love me and appreciate me. In fact she made big complicated meals when I'd go to her house for a visit.
Then she turned into the opposite as she aged, turning cruel - very unnerving. She was eating a lot of sweets constantly, and also let food rot in the refirigerator and even served it up that way. She took up smoking cigarettes, was having affairs, was inappropriate in touching someone, was dysregulated emotionally in a way I had never seen from her before. She got both paranoid and frightened but also careless and not frightened by issues that would normally frighten others. She was sensitive to the smallest slight where she hadn't been before. She seemed progressively intolerant of other people, seemed remarkably critical of others and unhappy in a way I hadn't seen before either. She blamed others for her unhappiness, raged about things that seemed inconsequential, created a "walking on eggsells environment", and was rejecting of others over minutae. Before then, she seemed to have no narcissistic traits.
But because I wasn't studied up on psychology enough in those days, I assumed that she was a closet narcissist, perhaps of the vulnerable covert type that can suddenly surprise you, and not in a pleasant way. I had that "Oh, no!" kind of feeling upon seeing this drastic cange in her
Then I took care of her even though it wasn't my duty, and she wasn't my relative. She seemed quite vulnerable after an incident outside her house in the middle of the night. She was deaf and the incident was quite alarming, so I stayed with her until someone else could step in.
At some point, I was unceremoniously kicked out and never knew why.
After years of silence between us, she contacted me and said that she missed me.
Then I thought she might be trying to hoover me in some way, and I grew suspicious, backed away, afraid it was an idealize, devalue and discard cycle which is an abuse cycle narcissists use. I just didn't want to be in that cycle, and I felt pretty sure I would be.
A month later she died of Alzheimer's disease in a nursing home.
Then I found out she had left me something in her Will. Upon being contacted about that, I felt so beside myself with guilt, so confused. and I thought, "This isn't characteristic of narcissists! Did I get something wrong about her?"
I did get something wrong. She had Alzheimer's, and Alzheimer's can mimic narcissism. A lot.
If you read any post in this blog, I hope you read this one and do not make the mistake I did.
Here are some cross-over traits:
* Can a person take things really personally when they have Alzheimer's? Yes.
* Can a person with Alzheimers over-react when they feel criticized? Yes, very common - this is one that threw me off personally. When someone gets snippy, overly defensive, and shows aggression, passive-aggressveness or hostility, the alarm bells go off in my head and I usually have the knee jerk reaction of backing off, and minimizing my presence in the relationship. After all, it's the big narcissism detector for a lot of people ... except it may not be narcissism; it may be Alzheimer's instead, something I did not know then.
* Can a person with Alzheimer's appear to have a lack of empathy? Yes. For a person with Alzheimer's and a person with Narcissistic Personality Disorder it is caused by brain atrophe, except the person with Alzheimer's will decline quite rapidly in cognitive abilities than the narcissist will.
* Can a person with Alzheimer's seem really manipulative? Yes, very much so.
* Can a person with Alzheimers ghost you? Yes.
* Can a person with Alzheimers appear to gaslight you? Yes.
* Can a person with Alzheimer's start blame-shifting a lot? Yes. Very common.
* Can a person with Alzheimers appear to be antagonistically inclined? Yes.
* Can a person with Alzheimer's appear selfish and self centered? Yes, frequently.
* Can a person with Alzheimer's reject you for no reason? Yes.
* Can a person with Alzheimer's appear to do things just to get attention? Yes.
* Can a person with Alzheimer's appear to be hyper critical and mean? Yes. Even verbal abuse can be present.
* Can a person with Alzheimer's appear to be exploitative? Yes. Symptoms include financial aggression and hoarding, impulsive spending, accusatory behavior, selfish and demanding behavior.
* Can a person with Alzheimer's appear to be controlling? Yes.
* Can a person with Alzheimer's appear to be domineering? Yes.
* Can a person with Alzheimer's appear to be argumentative? Yes, even aggressive and angry.
* Can a person with Alzheimer's appear to have a favorite child? Yes. It's usually a child who offers the most stability and caretaking.
* Can a person with Alzheimer's cheat on their spouse? Yes.
* Can a person with Alzheimer's have impulsive or inappropriate sex? Yes. - that link points to an article about it (partial, copied here in dark red):
Yes, people with Alzheimer’s or other dementias can exhibit impulsive, inappropriate, or increased sexual behavior (hypersexuality) due to brain damage. This is a common symptom resulting from loss of inhibition, reduced judgment, or a need for affection, often caused by frontotemporal lobe atrophy. * Key Aspects of Impulsive Sexual Behavior in Dementia: What it looks like: Actions can include inappropriate touching, public undressing, masturbation in public, or explicit, uncharacteristic sexual comments.
* Can a person with Alzheimer's appear to stop loving their children? Yes. They may appear cold or to have forgotten their child.
* Can a person with Alzheimer's appear to be abusive? Yes.
* Can a person with Alzheimer's be violent and dangerous? Yes, especially in mid - late stages.
* Can a person with Alzheimer's appear to be playing the victim of someone else? Yes.
* Can a person with Alzheimer's steal from others? Yes, but it is rarely with malicious intent.
* Can a person with Alzheimer's triangulate in relationships? Sort of. With real narcissists, there is a calculated, complex manipulation behind it or Machiavellian behaviors with dark triad type of personality. With Alzheimer's it appears as drama, accusations and fear of abandonment.
* Can a person with Alzheimer's appear to be sadistic? Yes.
*But most of all: Can a person with Alzheimer's appear to have Narcissistic Personality Disorder? Yes.
In other words, you may not be able to tell the difference between someone with Alzheimer's and Narcissistic Personality Disorder, especially in the elderly.
Except to make things confusing, what is the earliest age you can get Alzheimer's? 30s, 40s and 50s.
The person I am referring to above was comparatively young when she died. In most ways, she seemed like someone who would live to ninety or a hundred, just people in her family did. It did not come to be.
To make things yet even more confusing, look at this:
Do people with Narcissistic Personality Disorder end up with dementia more frequently than others do? Yes, there is increased risk and a more rapid cognitive decline once they are diagnosed. That link goes to an article, and a part of the article says this (typed in dark red):
Key Findings on Narcissism and Dementia
* Structural Brain Changes: Studies have found that individuals with narcissistic traits show reduced gray matter in brain regions responsible for empathy and emotional regulation, similar to areas affected in dementia.
* Increased Vulnerability: Research has indicated that high levels of "narcissistic vulnerability" (a facet of narcissism) may be linked to a greater risk of developing Alzheimer's disease, this study from Austin Publishing Group indicates.
* Exacerbation of Symptoms: Dementia often causes a person's underlying personality traits to become more rigid; in the case of NPD, this can intensify narcissistic traits, making the person more demanding, critical, and unmanageable.
* Diagnostic Challenges: Because narcissists may refuse to admit vulnerability or cognitive decline, they may avoid seeking medical help, which can lead to a delayed dementia diagnosis, according to this video on YouTube.
For me it begs the question, "Can Narcissistic Personality Disorder be a type of Alzheimer's?" For that I did not get a clear answer except that there are similarities and there can be a mis-diagnosis. The same answer came up when I replaced the word Alzheimer's with "dementia".
One thing I find over and over again in forums (this is just one) is that it is very common for a golden child to end up bullying siblings (go directly to Google AI and the suggested articles on the side). This is especially true as a narcissistic parent ages. You can also read what happened in this regard in Peep's comments section in this post. Or just Google around - there is plenty of information about this phenomenon.
Also, narcissism often appears in children and then they grow out of it. A Golden child is less likely to grow out of it. And then they may get the kind of dementia that mimics the more severe cases of narcissism when they are old. If they are a golden child, they learn that they are entitled to special treatment, and exempt from rules or following ethics. They are also taught to compete to stay on top in terms of special privileges. When they are not "shining bright" and making the parent look good, this is the time that scapegoats may be hoovered temporarily to get the golden child jealous of the scapegoat.
In contrast, family scapegoats become independent-minded and independent in their decisions, and experience rapid emotional maturity and adopt resilience because they learn at an early age not to trust because of the invalidations and gaslighting in narcissistic families, unless they can be brainwashed to believe in non-truths, that they are flawed, and other kinds of nonsense.
We also know that the brains of narcissists and people with Alzheimer's are atrophied.
And while family scapegoats don't have atrophied brains, their cognitive abilities can be impaired during times of abuse and high stress until they heal. Being traumaized interferes with the neuroplasticity of the brain too - that link tells how. What may be interesting about the link is that the brain "disrupts neurotransmitters like dopamine and serotonin", producing a kind of on-going "sad effect" and depression.
I think any scapegoat can relate to having depression.
While the rest of the family gets rid of accountability by trying to transfer their own blame, unhappiness, depression, and sins on to the scapegoat, the scapegoat begins to feel like an outsider because of the hopeless situation of being chronically sad while the rest of the family indulges in happy pastimes.
Only when the chemical change happens (getting out of depressive and sad thoughts, and usually by greatly minimizing contact, or using techniques like the DEEP method, or ending contact with the family altogether), does the brain's neuroplasticity start to function the way it is supposed to function.
In forums I've heard stories where a family tries to convince a scapegoat that they are crazy, stupid and inept. Sometimes poor grades exacerbate these judgements. However, once that scapegoat found out they had a narcissistic family and went low contact as a teenager, and no contact during college, they excelled, got on the dean's list, won scholarships, and got to the top in their careers. Most of the scapegoats I know are highly, highly successful (some are even famous), more successful than their peers by a long shot. Most did not party, or party as much as their peers in college, and are able to snap back even when sabotaged. Most of them are in the arts (music, visual arts, dance or writing), and considering what happened to them, it is remarkable that they excel in these hard-to-make-money careers.
There are a few scapegoats who were too disabled or depressed, or went the way of addictions or on-going depression, or believed in the family brainwashing who aren't successful, but I found them to be in the minority.
For scapegoats who pushed themselves to be successful in a field, the greatest challenge in life was giving up on their family of origin, the utter heartbreak of it all, the years of struggling to survive afterwards (often alone, with no support, and even sabotaged by proxy from members of their family), the realization that all members would be talked into false narratives, and all of the healing challenges that come afterwards - sometimes years and years of trauma therapy, or the compulsion to keep returning over and over again, only to find themselves in much worse conditions in their family than they were in before.
Only until they can go through this "ring of fire" do their minds start to change, and their abilities and resilience have a dominant place in their life. Usually when depression and sadness are no longer part of your everyday experience, everything changes pretty drastically. That is what I have seen in scapegoats.
If I was to have some poetic license, I'd say that the scapegoat is like a rubber band that is sabotaged by pulling it back. However, when it is let go (through a narcissistic discard or through a scapegoat initiating no contact), they tend to fly. Perhaps the further they are pulled back, the further they fly. Why? Because a really subtle sabotage is more likely to be believed as necessary than an extremely obvious and hurtful sabotage.
On the other hand, for the members who have gone down the narcissistic road, the less accountability and empathy a person feels, the more atrophied their brains are. - This link points to research that is significantly pointing this way at the time of this writing (go directly to Google AI and the 27 sites that discuss this).
Anyway, using these facts, what I have to say in the next paragraph is both fact sprinkled with a little speculation (the links are usually facts).
The more entitled golden child (as opposed to the "good-slave-for-the-parent" type of enabling golden child) is raised to be a fighter, to compete, to win, to please otherwise critical people or narcissists with power, to beat down competition and align with the powerful to get more power, prestige and money. They learn that power is the be-all and end-all in terms of both survival, types of relationships to be in, and the kind of resilience it takes to be first, way ahead of their siblings in terms of family resources, privilege, accomodation, and approval. And like the narcissistic parent they manipulate and triangulate so that they can stay on top.
The scapegoat is raised to be independent whether that's the narcissistic parent's intention or not, to be resilient and mature because they go through childhood being intermittently ignored or rejected. They are taught, unintentionally I'd imagine, to be blamed for things that aren't true (gaslighting - where the signal to the scapegoat is to be independent of a narcissist's opinions, approval and reasoning processes), shamed over things that are speculative or belief-oriented (invalidations, the signal to the scapegoat is to be perceptive, wary of the narcissistic parent, and resistant to false narratives), to get triggered and highly anxious when they are expected to compete, and given a carrot stick every now and then to keep them in this awful game or role. And by the way, the role is seen as absolutely essential, so carrot sticks become necessary for the scapegoat's continued family involvement
However, most scapegoats can't endure this role for a whole lifetime because they get sick both physically and mentally, and as I've remarked above, they are too sad to move forward in this role.
In order to continue to be survive and be resilient they have to put in herculean efforts to heal (every day practices to change their brains and ways of thinking through procedures, methods, certain kinds body exercises, emotional excercises, and not giving into learned helplessness, not giving into despair and a disabled state - if they have the money for all of the therapy needed to get back on their feet). Depending on how long they've put up with abuse, and the varying types of abuse and stresses they've lived through, they have to heal or they'll die - at least that is what many of them come to think. For the family, the scapegoat's disappearance into healing is either an afront to their ego, their "perfect image" of themselves, and a cause for more punishments or aggression against the scapegoat, or the scapegoats who have left are treated like sacrifices to appease the Gods. Or the golden child. Or the parents of the golden child. Or the family legacy of "authoritarianism" and power hierarchies.
In the Jewish tale of the scapegoat, the goat was packed down (literally had a pack on its back) with the objects that represented the communities' sins and sent out to the desert to die. If that isn't being sacrificed, I don't know what is.
Most scapegoats of narcissistic families are sacrificed with the thinking that goes: "We'll be much better off without the scapegoat."
However, these families mostly find they are not better off. Someone is likely to want to hoover the scapegoat back to take on all of the burdens the scapegoat used to fulfill, all of the family shame, all of the bullying and abuse. The family members who tend to take on the role of hoovering a scapegoat back tend to be siblings (they may see their more golden status start to crack and shift when the narcissist(s) show they absolutely need to have another scapegoat).
Assuming the scapegoat cannot be hoovered, and assuming that scapegoat gradually heals, and no longer has symptoms of depression and sadness, they can and do say (from what I've seen) that they are much more capable, feel quite a bit smarter and wiser not being in a sabotaging, anxious state where they are required to feel fearful, flawed, unloved and hurt.
Narcissists, in contrast, can decline. They have to find another scapegoat to feel their sense of "normal" and "uplifted". They usually do not have the ability to generate this themselves (they get validation from outside sources which is one reason they brag and tell people they've won competitions, and are better than other people). If you yank narcissistic supply away from an entitled narcissist, they usually go into a rage and get paranoid (often called narcissistic collapse).
A narcissistic collapse means they will go from a grandiose state (ego stroked) to a victim state (not ego stroked).
Some of what happens on a brain level during a narcissistic collapse can be found through this link. The shorthand version is this: They go through "heightened amygdala activation (fear/rage center) and decreased prefrontal cortex activity (rational, inhibitory center)". Their amygdala becomes hyper-active such that they experience lack of narcissistic supply as "an existential threat instead of a disappointment". The prefontal cortex stops functioning, leading to dysregulation of emotions with little to no impulse control (they become impulsive: reckless, or dangerous). It also effects the anterior insula and cingulate cortex (meaning they feel psychological pain). It can also mean a Dorsal Vagal Shutdown (depression, helplesness and emotional numbness).
All of this comes from feeling "entitled" to have a scapegoat. Most scapegoats leave narcissists, so it shouldn't surprise them when their scapegoat decides on this path, but it does. And because they cannot see how much damage they are doing, or for the more sadistic narcissists, they get off on the constant pain of their scapegoats, they are often not prepared for a narcissistic collapse. If they could put themselves in their scapegoat's shoes, they'd understand, but they can't.
So since the lack of empathy, the inability to understand the perspectives of others, and since desperate acts to hold on to power can mean less and less empathy, the brain can and does continue to atrophy.
One other thing: Alcohol abuse disorder contributes to significant brain atrophy and alcohol use disorder tends to be a comorbidity of Narcissistic Personality Disorder. - meaning that narcissistic alcoholic families are impossible to live in. I can't emphasize how awful it is enough - truly horrific.
Even if it's only the grandparents with alcohol use disorder (and not children or parents), it still translates to incredible dysfunction and an unhealthy family dynamic - in other words, it tends to be generational trauma. However, usually parents or a child becomes an alcoholic because alcohol use disorder happens in families with personality disorders and abuse.
Perhaps Alzheimer's has a more frequence occurance in alcoholic and narcissistic families - research suggests it does. And this is the speculative part: Perhaps with both disorders happening inside individuals they are already part of the way into Alzheimer's Disease.
And this is quite controversial:
Perhaps the brain issue with narcissists is also as involuntary as the person with Alzheimer's? What do you think? Neither narcissism or Alzheimer's changes in any significant way and tend to get worse. However, let's not get too far into "everything they do is never their fault." Certainly a lack of empathy is not their fault, and often caused by atrophy in the anterior insula, anterior cingulate cortex and ventromedial prefontal cortex, but abuse and manipulating other people is definitely a choice.
And another speculation:
If there were strict rules, laws and severe consequences for the abuse of children, is it possible narcissists might actually give up on child abuse? Or never take it up in the first place? Is that possible? Obviously it is a choice because they often do not display child abuse in public.
Could a lack of child abuse in a society change human beings in terms of evolution so that there was more tolerance, more empathy, more compassion, better use of our brains, less alcoholism, less wars, and less Alzheimer's? What do you think?
I tend to think, "yes."
However, wouldn't addictions have to be given up to make the world more peaceful? Alcohol is the big one. But there are others:
* Addictions to computers which keep us from from each other and don't teach us skills about healthy relating.
* Addictions to power, domination, controlling and manipulating others, getting narcissistic supply out of others in the way of flattery and emotional reactions - all of which lead to a lack of empathy.
* Addiction to excess money, things, compulsive spending, compulsive desires for more things, compulsive self care (being pampered by others to the point of entitlement) - leads to a lack of empathy for others too.
* Addiction to over eating, and couch potato living (more of a new phenomenon as our ancient ancestors did not live that way)
* Addiction to compulsive sex (using others for sexual relief), pedophilia, sexual abuse of children, rape, and so on - you have to have a brain that says you are entitled to these forms of sex, so you are likely to not have empathy either.
* Addiction to wars and invasions (ongoing "deterrent detractor thinking and obsessions", controlling populations, controlling other leaders of countries, controlling a population's preferred leaders, controlling opinions, border wars). A lot of people don't think wars are addictions but I think they are if human beings must always be involved in them and drawn to them - they present such unhealthy and dangerous situations, much like abuse with addictions do, and end up to equal more destruction, blowback and resentment than positive outcomes, at least during a war and for at least a couple of decades after a particular one has ended.
Wars and child abuse are the leading contributors to PTSD.
Many people think it's not possible for people to give up alcohol (or excessive alcohol) - that it will always be with us. Many believe that wars will always be with us, century after century of them with no let-up. In fact, many people believe that human beings will always develop addictions, and perhaps AI will be just another one to take up space in addictive personalities (you won't have to have to endure the inconvenience of thinking or problem solving any more because robots are so much smarter and are light years ahead of us in terms of capabilities).
I've heard that in order to survive in an AI dominated world run by oligarchs, it will demand more narcissism from us. And sometimes people think narcissism is becoming more dominant, that we can afford to live in a less and less empathetic world. They seem to want more dictatorial authoritarian governments (even voting them in), although some populations are beginning to do a double-take.
And I do notice more and more empaths are retreating and drawing inward, as if they are being wounded by the brutal world. They are making peace sanctuaries out of their homes. Or they are making hoarding a full time occupation for when robots, oligarchs and invasive types of people take over. The main thing is that they are being crucified and taken advantage of because of their empathy. They are experiencing significant "burn out".
I personally feel that we are all at a cross-road between war or peace, narcissism or empathy, authoritarianism or democracy, the human species becoming so narcissistic that we self destruct or the human species becoming more empathetic so that evolve and grow into a more peaceful species. And it is all up to us.
Now I'll move away from speculation and guessing the fate of the world ...
More on Alzheimer's Disease:
Alzheimer's appears more frequently in women who have had a hysterectomy.
Alzheimer's Disease is a type of diabetes, linked to insulin resistance (often called "Type 3 Diabetes").
Alzheimer's Disease is more prevaent in people with alcohol use disorder (significant risk).
Alzheimer's Disease is more prevalent in people who have C-PTSD.
Alzheimer's Disease is more prevalent in African Americans.
Alzheimer's Disease is more common in women than men.
Alzheimer's Disease is more prevalent in people who are overweight.
Alzheimer's Disease is more prevalent in people who have a family history of Alzheimer's.
War veterans have an increased risk of getting Alzheimer's.
Sexual abuse survivors have an increased risk of getting Alzheimer's Disease.
Significant stress over your life time can significantly impact whether you get Alzheimer's Disease.
Heart disease patients have an increased risk of getting Alzheimer's Disease. - significant risk.
I hope this post has been helpful.
by Dr. Ramani
(Dr. Ramani Durvasula is a clinical psychologist, writer, professor Emerita at California State University, Los Angeles, California and is a recognized expert on narcissistic abuse)
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