Narcissistic Rage

While the manic phase in what is commonly known as ‘bipolar disorder’usually involves manic flight into grandiose fantasy and impulsive behavior, on occasion it leads to rage, violence, suicide and even murder.  The DSM-IV refers to this as “dysphoric mania” or a mixed state, where manic and depressive symptoms occur simultaneously.  Outbursts of rage also occur in other disorders:  they feature in Intermittent Explosive Disorder, Borderline Personality Disorder, Narcissistic Personality Disorder and various types of narcissistic behavior; anyone dominated by feelings of shame may be prone to occasional outbursts of rage, which are often an intense form of blaming, one of the primary defenses against shame.  While the DSM-IV defines these disorders as unique categories of mental illness, with individual diagnosis codes, they actually exist along a spectrum and have much in common.  Most of the clients I’ve seen who demonstrated features of Borderline Personality Disorder or presented with Bipolar Disorder...