/* The Superiority Complex Defence Mechanism Disorder of each cluster <3 [ Just a tongue-in-cheek meme, not a statement of every single person with these disorders ]
… That said, here’s a breakdown of the feelings of superiority of these three disorders and how they differ. As usual, these are general frameworks. Actual individuals may not have all these traits/have different ones, or may have overlapping ones [ especially, but not necessarily, if they are comorbid ].
Schizoid Personality Disorder
Goal:Safety
Defence against: Feelings of intrusion
Manifests as: Doing everything alone, secrecy [ to avoid other people’s input and thus “control” of their decisions ], unclear goals and expectations of both themselves and others, distaste for emotions and seeing it as “dramatic”, distaste for people and refusal to be in relationships
Differences from NPD and OCPD: Does not tend to impose their own standards/expectations on others [ preference to avoid people altogether ]; does not seek outward validation/may be uncomfortable with positive acknowledgement and reassurance, relatively more apathetic to failureand criticism [ may feel unaffected or unconsciously shut down negative emotions ]; tendency to give up more easily
People with ScPD, due to their detachment from emotions and preoccupation with thoughts, are often more adept at objectively assessing the thoughts and behaviour of other people. Coupled with their buried hypersensitivity to emotions, this often leads the schizoid to see others as dramatic and sometimes stupid.
In reality, the schizoid may not necessarily genuinely see themselves as a “great” person [ although seeing themselves as “incompetent” is not necessary either ]: rather, their apprehension towards other people [ or specifically, emotions, both other people’s and their own ] leads them to adopt a “superiority complex” as a method of protecting the self. The schizoid learns to be hyper-independent, convincing themselves they are capable of doing everything alone to avoid the need to ask for help, disclosing their emotions to others or entering relationships as much as possible.
The schizoid’s mechanism of shutting down their own emotions due to the inability to handle them leads to a mindset where emotions are seen as a “frivolous” thing, and other people who more readily display them may be devalued for this reason.
Unlike people with NPD, who are more likely to want to show their competency to other people, the schizoid prefers to keep things to themselves, and may be unwilling to share things they are genuinely passionate about/good at [ for example, works of art ] due to the belief the perception/input of others are intrusive and controlling.
People with ScPD often feel “helpless” and unable to control their situation similar to those with OCPD. However, they respond by shutting down their emotions in general and passively accepting things as they are. They may often think that reacting to things “dramatically” is beneath them.
Maladaptively, this leads to struggles in relationships because the schizoid often has difficulty sympathising with other people, and may find their genuine attempts at kindness annoying or even dangerous. The schizoid may also be unable to manage their own tasks or needs alone due to the inability to disclose their emotions, ask for help or commit to things that are too difficult.
Narcissistic Personality Disorder
Goal:Self-worth
Defence against: Feelings of worthlessness
Manifests as: Desire to “prove” self to others, taking on leadership roles, comparison with or devaluation of other people, extreme reaction to failure and criticism, high need for admiration
Differences from ScPD and OCPD: More willing to form relationships or work with others [ especially to achieve validation ]; often has genuine (if nebulous/volatile) confidence in their own capabilities; better decisiveness and ability to finish the tasks they set out to do [ People with ScPD may be too apathetic/anhedonic/unmotivated to have clear goals, people with OCPD may be too preoccupied with doing things a certain way to be efficient ]; tendency to feel negative judgments about them are undeserved/incorrect; higher tendency to change their preferences, standards, behaviour, etc. in accordance to what others expect
People with NPD often feel the need to be admirable due to an ingrained belief that this is the only way they can be worthy of love.
As such, they will often take on tasks with the aim of “proving” they are “worthy” of admiration. Unlike the schizoid who prefers to keep things to themself, the narcissist will often want to display the things they are good at in order to receive validation from others.
This can lead to them wanting prominent roles in their endeavours, or actively seeking out relationships with others to receive validation or to have somebody to “prove” their competency to.
Similar to those with OCPD, they are sensitive to criticism. However, unlike people with OCPD who may obsessively feel the need to “fix” themselves and adhere closer to rigid rules to escape reproach, people with NPD may instead devalue other people’s opinions or to shift their goals/standards to deflect the feeling of “falling short.”
Maladaptively, they may devalue or put down other people, which can lead to struggles in maintaining relationships or cause conflicts among others. They may also take on more work than they are capable of due to overestimation of their own abilities and/or the desire to prove their own competency to others, leading to burnout and exhaustion. They may be ill-equipped to handle the feelings of insecurity and shame that come with failure or criticism, which can be the cause of other more maladaptive behaviour such as intense withdrawal, lashing out or self-destructive habits.
Obsessive-Compulsive Personality Disorder
Goal:Control
Defence against: Feelings of helplessness
Manifests as: Doing everything alone, preoccupation with what they do/how to do so, imposing rigid rules on others, extreme reaction to failure and criticism, high need for validation
Differences from ScPD and NPD: Higher or more rigid standards/rules/processes of how things “should” be navigated; tendency to get “stuck” on the same goal or to keep abiding to the same standards to their detriment [ People with ScPD will tend to abandon things instead, people with NPD may feel confident enough in their own work to have a decisive “finish line” or will change their goals/standards to better suit what they are already doing ]
People with OCPD feel a higher level of anxiety than most people, and thus adopt the “superiority complex” to combat this. Like people with NPD, people with OCPD tend to be more sensitive to failure and criticism, and their adherence to strict standards is often due to the belief that other people will have nothing to criticise them for if they are able to perform “perfectly” enough.
People with OCPD often have rigid standards of behaviour, whether it comes to their ethical standards, the process of which tasks must follow, or the rules people must abide to. They often want to do their tasks in only a specific way, and like the schizoid will often want to do everything by themself due to believing other people will only slow them down. However, while people with ScPD may primarily believe others are too emotional/frivolous, but not necessarilyincompetent, people with OCPD may be more critical of how others perform due to wanting them to abide to their personal standards.
Similar to people with ScPD, people with OCPD often feel a high sense of obligation and responsibility to the things around them and are made to feel helpless because of this. Unlike the schizoid who responds to this by avoidance and passivity, people with OCPD are more likely to “redirect” the feeling into certain tasks [ or the way these tasks are performed ], in order to regain a sense of having control/influence over their situation.
The belief that there is an undeniably “correct” way to do things makes OCPD somewhat similar to OCD [ of which the comorbidity rates are higher than that with other personality disorders ], however they are not the same due to the lack of egodystonic obsessions/compulsions that present the way they do in OCD.
Maladaptively, their rigid standards can make relating to others difficult as they may become critical or distrustful of others for not understanding or complying with their expectations. They may also often struggle with inefficiency, due to the inability to follow their own standards or the preoccupation with perfectionism. The belief that their own method of living is superior makes unfamiliar situations highly distressing.
Traits in Common
Low/no empathy; downplaying of other people’s emotions
Difficulty assessing the effect they have on other people; either overestimating or underestimating the depth of their relationships, or vacillating between doing the two
Difficulty trusting other people, which often leads to hyper-independence[ NPD: Higher tendency to work with others but may want to take on leadership roles/decide who does what ]
Difficulty disclosing their genuine emotions due to fear of being perceived negatively [ ScPD: Fear of people interfering in an attempt to “help”; NPD: Fear of being seen as incompetent and unworthy of love/relationships; OCPD: Fear of losing their “grasp” of themselves/their circumstances and being subjected to the criticism or demands of others ]
Desire for an extreme degree of control over their own circumstances; difficulty accepting the input of others [ ScPD: Less negative reaction to criticism, but still unlikely to actually put it into practice due to apathy or devaluation of other people’s opinions ]
Repetitive and stagnated tasks/habits; inability to try new things [ ScPD: Apathy/anhedonia/avolition and refusal to ask for instruction makes the schizoid unlikely to have clear goals; NPD/OCPD: Fear of failure and criticism makes them unlikely to do something if they are not certain they can do it well ]
Especially when writing in a modern real-world setting, one thing to take into account when thinking about your autistic character is their diagnosis status. Diagnosis might sound straightforward, but there are actually many things to take into account when talking about it. In this masterpost, you will find factual information about diagnoses - how they work, what they look like concretely, what are their shortcomings as well as some words about self-diagnosis - and questions to ask yourself when writing your autistic character.
What is autism, officially?
Autism is a complicated concept and we spend the majority of our time on this blog trying to explain it in a nuanced and multifaceted way. If you haven’t read it already, we suggest reading this masterpost about how to write an autistic character. Another post we have helps specify what autism is; this post describes different functioning labels and why they aren’t particularly beneficial or useful. The main thing to understand about functioning labels in the context of diagnosis is, generally, a diagnostician is required to specify levels of functioning in an autism diagnosis. The autistic community has a rather large definition of the concept, while the “official” definition of who counts as autistic is somewhat narrower.
Diagnosing autism is often a difficult process. Since we don’t know the source(s) of autism on a biological level, we can’t do, for example, an easy test like a brain scan to check for autism with absolute certainty. As a consequence, a professional who wants to know whether or not someone should be diagnosed with autism will look at that person’s behavior first and foremost, and, if possible, will ask questions about their subjective experience. As a result, the diagnostic criteria focus exclusively on the person’s behavior.
Here are the DSM-V criteria, and here is a link to a PDF which lists stereotypical examples for each of the criteria. The DSM-V is used in many countries around the world as a reference to diagnose mental illnesses and other conditions, in most cases these are the criteria that will be used during diagnosis. Other classifications with other sets of criteria exist, such as the CIM-10 (which still recognizes Asperger’s Syndrome and autism as separate diagnoses), are still in use in some countries.
A brief history of the DSM
The DSM is meant to describe all known mental illnesses recognized by the American Psychological Association’s (APA). There have been five editions to date, and many changes have been made to which disorders and mental illnesses are considered valid and their criteria. These changes were made in response to new research about the mind in general or about specific disorders.
The DSM is written based on research published by mental health professionals (practicing therapists, psychology researchers and students of researchers, psychiatrists, doctors, etc.). To get research findings recognized by the APA, the findings must be replicated enough times across published literature that any reader can be confident in the conclusions made by researchers.
If enough research emerges which prompts the board of the APA to reconsider the way the criteria in the DSM are written, and enough criteria are changed that the current edition stops being clinically useful or relevant to research, the DSM gets rewritten, and a new edition published. There are many debates about what criteria to include and which diagnoses are considered valid. Some diagnoses are added, removed, or changed in new editions of the DSM. The currently accepted edition of the DSM is the DSM-5 (or DSM-V).
In the DSM-5, there were several major changes, including grouping together Asperger’s Disorder, Autism, Pervasive Developmental Disorder Not Otherwise Specified, and related disorders into the broader category of Autism Spectrum Disorder. Some people were diagnosed with, for example, Asperger’s Disorder before this change was made, but would now meet the criteria for Autism Spectrum Disorder. They do not need to get re-diagnosed, and mental health professionals can still take their diagnosis into consideration.
Here are some things to consider :
When and where was your character diagnosed? What was the diagnostic manual used during their diagnosis, and how does that affect their identity? You might find part of our functioning labels masterpost about Asperger’s Syndrome useful for more detail about this specific diagnosis
Which diagnostic criteria does your character meet? Are there some criteria they don’t meet? How did that influence the diagnostic process?
How diagnosis works
Diagnoses are given when someone comes to a professional/clinician with experiences causing them distress or impairment. Depending on the country, there are multiple professionals qualified to give diagnoses - doctors, psychologists, psychiatrists, for example - and they have to collect evidence in order to make diagnoses. In order to do so, some researchers develop tests to help check whether someone meets diagnostic criteria, and standardize them to large groups of people to make sure the tests are valid, i.e. truly measure what the researcher wants the test to measure. These tests are then used to determine whether or not someone can be diagnosed, that is, whether or not they meet a sufficient number of criteria.
In general, a diagnosis is given if someone meets a certain number of criteria within the list. For an Autism Spectrum Disorder diagnosis, someone must meet the criteria of “persistent deficits in social communication and social interaction across multiple contexts” and “restricted, repetitive patterns of behavior, interests, or activities.” They can meet these criteria currently or in their history, and the DSM-V mentions symptoms may be masked later in life, but must have shown up during early development. The symptoms must also cause distress or impairment and must not be better explained by a different disorder.
The diagnostic process itself can vary from country to country. Typically, there are two main phases to a diagnosis: first a screening, and then a full evaluation.
If parents, teachers, healthcare professionals or the person themselves suspect a child or adult is autistic, they will go to a professional, usually a pediatrician, psychiatrist or psychologist. Different screening tools can be used, depending on the context and the age of the person to be diagnosed. They include questionnaires filled out by the person or their relatives, guided interviews or short tests in which the person is asked to demonstrate a variety of behaviors. The Autism Quotient is an example of a screening tool for adults, the M-CHAT is a screening tool for children. You can download these tools as well as others on this page. The screening is usually a short process that doesn’t last more than one hour. Different tools are used for children and for adults. In some places, children may be systematically screened at a certain age, at daycare, school or at a well child appointment.
If the screening shows that there is a possibility that the person is autistic, they will undergo a full evaluation. This evaluation is usually done by at least one, but up to a team of professionals which can include psychiatrists, psychologists, nurses, speech therapists, occupational therapists, psycho-motor therapists, etc. This is where the standardized tests are used. In most cases, the person will have to take at least a cognitive test (IQ test) and a test more specific to autism, in which their abilities in the domains of communication and social interactions, as well as specific autistic traits, are recorded, such as the ADOS. Here is a video where you can see an example of an ADOS test for a child. Family members might be questioned about the early childhood of the individual as well as their daily life. This phase of diagnosis is a lot more involved and can span several days.
After diagnosis, the professional will meet with the person who was being diagnosed and/or their parents to explain the results in detail. This is also usually the point where treatment/management plans will be discussed, focusing on the areas of need discovered during diagnosis. For example, if the person showed lots of sensory difficulties but no problem with speech, they might be advised to go see an occupational therapist rather than a speech therapist. This is a link which discusses what a diagnosis process can look like for an older child or teenager.
This description of how diagnoses are given does not have to match your story, especially if the setting is different. It’s a guideline, and you can do more research and thinking on what this process may look like in your story. Here are some questions you can consider during this process:
Where does your story take place - a certain country, a different planet, a fantasy setting? Are there mental health professionals there, or some kind of doctor? If the place exists, what diagnostic processes are common there? If it doesn’t, what can you imagine a diagnostic process would look like? Is their concept of autism similar to ours? What are the differences and how do they reflect on the diagnostic process?
When is your character diagnosed? If on earth, you may look up what mental health resources were available in the past, or imagine what mental health resources would be available in the future. If somewhere else, how do you imagine diagnostic tools evolved? Are there diagnostic tools at the time of your story? Is someone trying to build a process of diagnosis? Do the clinicians in your story know what autism is?
If the character being diagnosed is a child, how well do they understand what is going on and happening to them? What have they been told about the testing? How do they feel about it now, if you’re writing from the perspective of an adult reminiscing?
How do they feel during diagnosis? Are they scared? Overwhelmed? Do they find the testing difficult or easy? What do they think of the professionals diagnosing them?
What are they told about their diagnosis after the testing? How do they feel about it? Do their feelings change over time? Is any treatment/intervention/therapy plan started? If so, how does the diagnosed person feel about this process? Does it help them? Does it stigmatize autism?
The mess of professional diagnosis
Diagnosing autism is very difficult, for several reasons:
There’s huge territories of symptom overlap and comorbidity between autism, ADHD, dyslexia, and other neurodivergences, which makes differential diagnosis complex and not always successful.
Individual autistic traits, such as atypical social communication, sensory problems, executive dysfunction, etc. may also be seen in an individual without them being autistic.
Autism diagnosis is based on behavior and on external observation of this behavior. Its neurological sources aren’t clear and there is no easy, yes-or-no test. A lot will depend on the subjective point of view of the diagnostician, even though standardized tests help make the process more consistent.
Many people have learned to mask and hide their autistic traits, potentially making outside observation of these traits - if necessary to the diagnostic process - more difficult.
Autism has been studied more and is more well-known in some subtypes of the population (i.e. white, male children). That stereotype frames the public mentality, and that affects the mentalities of psychologists and neurologists studying and diagnosing autism. People that don’t fit this archetype may have a harder time getting diagnosed.
Diagnoses are made to be standardized enough that people halfway across the world will, hopefully, be talking about the same disorder or disease as a different doctor/psychologist/researcher. This is usually a good thing, but it can also mean that some people who have more atypical profiles (because of unusual identities, comorbidities, upbringings…) can sometimes be missed during the diagnosis process. It is also worth keeping in mind that the criteria evolve very regularly; someone who isn’t included now could be in ten years, and vice-versa.
People change. Someone who would have definitely been diagnosed as a child might not fit the criteria as an adult. This doesn’t mean they’ve stopped being autistic or been “cured”, it just means their traits have evolved as they’ve found better coping tools. Whether that’s the case or not, getting a diagnosis as an adult is often a lot more difficult. Not a lot of research has been done about what autistic adults are like. There can be fewer groups of mental health professionals open to giving autism diagnoses to adults; these specialists are less knowledgeable about it, and might be reluctant in many cases to give a diagnosis that could be marginalizing for the person.
These are all reasons that make diagnosis difficult and could lead to a misdiagnosis (or even to a refusal of even starting the diagnosis process). Misdiagnosis in very, very common, especially in women and in people who were diagnosed as adults. This is one of the many reasons that could lead someone to self-diagnose.
Something to take into consideration is the history of autism in the DSM, and how mental health professionals may use or misuse it for diagnosis. Originally, autism was thought to be a different form of schizophrenia (sometimes it was called Childhood Schizophrenia) because the children brought to clinicians for evaluations were noticing and being affected by sensory experiences which most people weren’t. Eventually clinicians noticed the diagnosed individuals did not truly meet the criteria for schizophrenia, though even today clinicians still confuse these diagnoses.Many autistic people can meet criteria for ADHD, and some people mistake the hyperfixations and sometimes rigid preferences of autistics for obsessions and compulsions of someone with OCD.
Here are some things to think about:
Was your character’s diagnosis story straightforward, or did they have to undergo misdiagnoses and referrals before finally being diagnosed? (Common misdiagnoses are OCD, ADHD, BPD, or schizophrenia, though these can also be co-morbid)
Did their symptoms look to a diagnostician like they could meet a diagnosis different from autism? Did your character have any other psychological conditions which affected the diagnostic process?
How confident was the professional making the diagnosis? Did any of your character’s identities, comorbidities or behaviors make diagnosis more difficult?
The process of self-diagnosis
Some people do not have access to a professional diagnosis. Some examples of barriers to diagnosis are:
Doctor/psychologist visits and hours spent evaluating can be a very expensive process, and not everyone has insurance or enough money to pay for this.
Some parts of the world do not have enough medical care available to people because there are not enough doctors for the population. Long waiting lists and overworked doctors may prevent someone from wanting to seek diagnosis. General doctors may not specialize in psychology, and feel under-prepared to properly screen for autism.
Many people have learned to mask their symptoms. There are many pressures from society to fit in, and autistics are often forced to learn to look “normal” - by parents or peers. Many who have learned to mask have a hard time relaxing and acting more naturally.
Some clinicians have very conservative screening standards and refuse to evaluate if a client/patient does not meet expected criteria for the screen (i.e. missing social cues, avoiding eye contact, “atypical” vocal patterns).
While professional diagnosis can be validating and provide a path to accessing resources and accommodations, some do not want a professional diagnosis at all. Usually the reason someone might avoid receiving a diagnosis is stigma. If a parent or other adult is responsible for and has access to the individual’s healthcare records, they may not trust that person to treat them well. They might be afraid of discrimination or disempowerment by healthcare providers, workplaces and the government (for adoption for instance). They may feel isolated if they receive the diagnosis. Others may not want it because they feel confident in their self-knowledge and want to avoid the expense. Parents may avoid getting their children diagnosed because they don’t want them separated into different classrooms in school, or may not have the money for healthcare.
A person seeking self-diagnosis may have an experience which gets them thinking about autism and recognizing themselves in that label and people associated with it. For example, the individual may have met someone autistic and related to them like no-one they had ever met before. Perhaps a caregiver anecdotally mentioned to them it was a possibility. Finding the diagnostic criteria for autism spectrum disorder is relatively easy online, and some start by reading about the criteria. Most people who self-diagnose spend a lot of time researching autism as well as other neurodivergences, reading writing by autistic authors about their experiences, taking tests online, etc. Some self-diagnosed autistic people may end up knowing as much, if not more, about their condition as most professionals.
Self-diagnosis also usually comes with a lot of self-doubt, “impostor syndrome” and changes of mind. Lack of recognition by healthcare professionals, lack of access to accommodations and benefits, and gate-keeping are all experiences frequently associated with self-diagnosis.
If your character is self-diagnosed, ask yourself :
Why isn’t your character professionally diagnosed? Do they wish to be one day? Have they tried to get a professional diagnosis without success? If so, how do they feel about it?
How confident is your character in their self-diagnosis? Did they do a lot of research? How did that make them feel? Do they have an accepting community, whether locally or online? Do they have to deal with others gate-keeping because they lack an official diagnosis?
Are there some accommodations, therapies or benefits your character needs but can’t obtain without diagnosis? How does it impact their life?
Diagnosis & Identity
Think about your character’s journey with diagnosis, and how it impacts their identity, how they feel about themselves and how they think of themselves.
At what age were they diagnosed?
Did they have an active role in the diagnostic process; did they seek it out? Did they accept it or resist it?
How did their diagnosis or lack thereof affect their education/work experience? Did they receive accommodations? Were they kept from doing certain things because others believed they couldn’t?
How did their diagnosis or lack thereof affect the development of coping skills?
How did they learn about autism? If diagnosed as a child, were they told about their diagnosis? In what terms? If not, how did they find out? How did it make them feel? What impact did this have on their choice to identify as autistic (another way to think about this was, were they in denial because of shame or some other reason, or did they rejoice in finally having an explanation for their experiences? Or something in between)? How did they react to their diagnosis or lack thereof?
Who, if anyone, are they comfortable telling? Did anyone find out who the character didn’t want to know? Did their parents tell someone, if applicable? Does anyone know about their diagnosis/identity, officially confirmed or otherwise?
Do they interact with other autistics - online or in person? Do they have autistic friends? Do they feel part of a community, autistic/neurodivergent or otherwise?
What makes them feel included or not? What makes them feel similar or dissimilar to other autistics, or to the stereotype of how autism is perceived by the public and/or their community?
Are there moments of doubt about their diagnosis?
If officially diagnosed, how long did that process take? Are they currently seeking diagnosis?
Does your character encounter stigma as a result of their diagnosis or lack thereof?
These questions can help you think about your character’s experience. Diagnosis is tricky business. I hope this provides some nuanced ideas on diagnosis of autism and autistic identity.
