The Sun's frontpage for 7 October 2013. Photo via @SuttonNick on Twitter
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Laurie Penny on The Sun: fearmongering about mental health is what's really monstrous

The paper's frontpage claim that "1,200 killed by mental patients" is misleading - and it exposes exactly the kind of prejudice that implies people with mental health problems are violent, unstable monsters.

"1,200 killed by mental patients." Today's drooling Sun headline plays on precisely the kind of fearmongering that people with mental health problems have come to fear most, implying that they are violent, unstable monsters - as well as lazy benefit scroungers making up their illnesses in order to milk the system. The headline is entirely misleading. In fact, the most recent available figures show that "there has been a fall  in homicide by people with mental illness, including people with psychosis" since 2004.

The Sun claims that, far from seeking to stigmatise the mentally ill, its cover story draws attention to how many have been let down by poor mental health provision over the past decade. That's why it led with the sort of weary sensationalist headline that exploits prejudice against the sick and vulnerable to sell papers.

In Britain and across the global north, one in four people will experience significant mental health problems in their lifetimes. With the right treatment and support, most of those people are able to make a full recovery, but some need ongoing care, particularly in a society where employers are often less than understanding about how depression, anxiety and other mental health conditions affect people's ability to hold and keep a job. It's no wonder that some people choose not to disclose their mental health history, often struggling without help for years, between fear of getting sacked and the persistence of cruel, lazy sterotypes like the grotesque 'Mental Patient' and 'Psycho Ward' Hallowe'en costumes recently released by Asda and Tesco respectively - in which you could dress up as a terrifying crazy person, strait-jacketed, covered in blood and brandishing a meat cleaver. It's stigma like this that make people with severe and ongoing mental health difficulties up to ten times more likely to be the victims of violent crime than they are to perpetrate it.

Mental health problems can be scary - but not in that way. They're frightening to go through, and they're particularly frightening to go through alone. In my experience, a more accurate 'Mental Patient' costume would be a slightly funky-smelling jumper - when I'm having a bout of the blues, I'm usually strict about doing laundry, but sometimes it takes me a while to actually get the stuff out of the washing machine and hang it up, leading to a distinct whiff of damp Persil. Hardly Normal Bates, but trust me, on the inside I'm quaking.

Like a lot of people, I sometimes get depressed and anxious. On precisely none of these occasions have I flown into a murderous rage and stabbed up a stranger. Mostly, I just want a cup of tea and a cuddle, and perhaps to curl up with Netflix until I feel better.

The Sun is right about one thing, though - it is indeed a disgrace that the mental health care system in the UK is so chronically short of funds, meaning that those in most need often miss out on essential care. As austerity takes its toll on the emotional resilience of an already stressed and unequal society, there is now even less provision to take care of people with severe depression, debilitating anxiety, or more chronic conditions like psychosis, schizophrenia and bipolar disorder.

Part of the reason people with mental health difficulties continue to face such poisonous prejudice, part of the reason the government is able to impoverish and stigmatise those receiving care in the community with relative ease, is that there has been a relentless campaign against mentally ill benefit claimants, a campaign led by right-wing tabloids like the Sun. The Sun has fought for years to make withdrawal of care from people with mental health difficulties socially acceptable. The Sun, and its editors' former riding partners in government, have stood by whilst more and more mental patients commit suicide after that care is withdrawn and they are plunged into lonely, desperate destitution. That it now claims to be championing their cause, even as it paints the mentally ill as savage, violent semi-humans - that's what's truly monstrous.

Laurie Penny is a contributing editor to the New Statesman. She is the author of five books, most recently Unspeakable Things.

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I am special and I am worthless: inside the mind of a narcissist

There's been a lot of discussion about narcissists this week. But what does the term actually mean?

Since the rise of Donald Trump, the term “narcissistic” has been cropping up with great regularity in certain sections of the media, including the pages of this journal. I wouldn’t want to comment about an individual I’ve never met, but I thought it would be interesting to look at the troubling psychological health problem of narcissistic personality disorder (NPD).

People with NPD (which is estimated to affect about 1 per cent of the population) have a characteristic set of personality traits. First, they have a deeply held sense of specialness and entitlement. Male NPD sufferers frequently present as highly egotistical, with an unshakeable sense of their superiority and importance; female sufferers commonly present as eternal victims on whom the world repeatedly inflicts terrible injustices. In both cases, the affected person believes he or she is deserving of privileged treatment, and expects it as a right from those around them.

Second, NPD sufferers have little or no capacity for empathy, and usually relate to other people as objects (as opposed to thinking, feeling beings) whose sole function is to meet the narcissist’s need for special treatment and admiration – known as “supply”. In order to recruit supply, NPD sufferers become highly skilled at manipulating people’s perceptions of them, acting out what is called a “false self” – the glittering high achiever, the indefatigable do-gooder, the pitiable victim.

The third characteristic is termed “splitting”, where the world is experienced in terms of two rigid categories – either Good or Bad – with no areas of grey. As long as others are meeting the narcissist’s need for supply, they are Good, and they find themselves idealised and showered with reciprocal positive affirmation – a process called “love-bombing”. However, if someone criticises or questions the narcissist’s false self, that person becomes Bad, and is subjected to implacable hostility.

It is not known for certain what triggers the disorder. There is likely to be a genetic component, but in many cases early life experiences are the primary cause. Narcissism is a natural phase of child development (as the parents of many teenagers will testify) and its persistence as adult NPD frequently reflects chronic trauma during childhood. Paradoxically for a condition that often manifests as apparent egotism, all NPD sufferers have virtually non-existent self-esteem. This may arise from ongoing emotional neglect on the part of parents or caregivers, or from sustained psychological or sexual abuse.

The common factor is a failure in the development of a healthy sense of self-worth. It is likely that narcissism becomes entrenched as a defence against the deep-seated shame associated with these experiences of being unworthy and valueless.

When surrounded by supply, the NPD sufferer can anaesthetise this horrible sense of shame with the waves of positive regard washing over them. Equally, when another person destabilises that supply (by criticising or questioning the narcissist’s false self) this is highly threatening, and the NPD sufferer will go to practically any lengths to prevent a destabiliser adversely influencing other people’s perceptions of the narcissist.

One of the many tragic aspects of NPD is the invariable lack of insight. A narcissist’s experience of the world is essentially: “I am special; some people love me for this, and are Good; some people hate me for it, and are Bad.” If people with NPD do present to health services, it is usually because of the negative impacts Bad people are having on their life, rather than because they are able to recognise that they have a psychological health problem.

Far more commonly, health professionals end up helping those who have had the misfortune to enter into a supply relationship with an NPD sufferer. Narcissism is one of the most frequent factors in intimate partner and child abuse, as well as workplace bullying. The narcissist depends on the positive affirmation of others to neutralise their own sense of unworthiness. They use others to shore themselves up, and lash out at those who threaten this precarious balance. And they leave a trail of damaged people in their wake. 

This article first appeared in the 16 February 2017 issue of the New Statesman, The New Times