Celebrity is the mask that eats into the face.

- John Updike


Why are celebrities so stupid?

How do people who are under constant scrutiny by tabloids, paparazzi, and real journalists engage in behaviors that are to the rest of us so obviously destructive, outrageous, or foolish?

Doctor Robert B. Millman, a professor of psychiatry at Cornell Medical School, thinks he has the answer: acquired situational narcissism.

Narcissistic Personality Disorder has been on the books - specifically on the pages of the Diagnostic and Statistical Manual of Mental Disorders - since 1980. The most basic criteria for a diagnosis of typical NPD is a pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy. More on typical narcissistic personality disorder can be found in the writeup under that title.

Acquired Situational Narcissism is a relatively new term, coined in 2000, and is not currently included in the DSM or in the International Classification of Diseases. For that reason it is not established as a personality disorder. It's scorned by some psychiatrists as pop psychology, but Millman, a professor of psychiatry at Cornell Medical School who is the acting psychiatric adviser to Major League Baseball, thinks there's a lot more to the disorder than just a fancy name.

Millman asserts that unlike typical narcissistic personality disorder, acquired situational narcissism is not an organic dysfunction that appears in early childhood or adolescence but is "acquired" by the "situation" of intense or overnight fame.

Millman stated in a 2002 National Public Radio interview that celebrities can quite literally become victims of their own success. Insisting that it is indeed a syndrome, Millman stated:

I don't think I've created a new syndrome, I think I've just identified something that's interesting. Traditional psychoanalytic theory always thought that narcissism - undue self-involvement, grandiosity, etcetera - had to do with early development, like infancy to the age of four...I've noticed that you can get created as a major narcissist a lot later than that.

Millman went on to say that "major celebrities - actors, politicians who have been in power for quite some time, sports figures, billionaires" evince a different sort of narcissism, one that echoes a number of the traits of typical narcisisstic personality disorder but that appears only after the person in question has risen to a stratospheric level of fame. ASN affects not only celebrities but people of great wealth, particularly billionaires and politicians, who come to believe that their power, money, and connections will shield them from any possible consequences.

According to Millman, the symptoms of ASN have to do with "excessive self-involvement, a remarkable lack of empathy, grandiose fantasies...and excessive need for approval - everyone's got to tell you how great you are." He says that this differs from typical NPD in that ASN is a condition that appears later in life and is directly attributable to the acquisition of fame, great wealth, or power. Sufferers lose sight of what "normal" people consider reality, and often act in ways that are significantly self-destructive, socially outrageous, or simply crazy.

Millman says that when ASN celebrities falter in their fame or go down a peg in the public eye, intense depression and even rage often result. Often, celebrities or power brokers feel isolated, alone, or become paranoid that everyone in their immediate circle is somehow using them to further their own desires for wealth or fame.

Millman treats several celebrity clients who come to him mystified as to how they can be so famous, successful, and powerful but be unable to function in healthy personal relationships. Millman says that the depression he witnesses in his famous clients is crushing, demoralizing, and often accompanied by suicidal ideations, a feeling of invulnerability, or extremely reckless behavior. He says that the pathology is exacerbated by the fact that the public at large finds it difficult to empathize with the trials of people who are wealthy or powerful.

Millman attributes the sorts of risky behavior that many celebrities are prone to - visiting prostitutes, engaging in extramarital affairs, smacking photographers around - to ASN. Because they live their lives in a "bubble of fame", surrounded by yes-men and hangers-on, they aren't able to connect with the reality of the consequences of such behaviors. Many celebrites, Millman says,

...do the dumbest things, they do remarkably risky things. They get themselves into huge trouble...and we think, "Are they stupid? How could they do this? Didn't they know people were watching?" I think the answer might be they were so self-involved that they weren't paying attention to the risks, weren't paying attention to the people out there who could hurt them...

If you're a billionaire or a celebrity and you walk into a room, everyone looks at you...you're kind of a prince. You have the power to change lives, and everyone is very conscious of that. Everyone's watching you, and I think the interesting thing is, you stop watching other people. They're kind of interchangeable, actors in your play...you're thinking not who these people are, but what do these people think of me? Do they know I'm still great? Do they think I'm great?

The snarky NPR interviewer then asked Millman if "humility pills" exist to treat ASN. Millman laughed and replied,

No, no, humility pills do not exist, but one of the answers might be to help people remember that it's important for them to maintain relationships with others and be paying attention. It's not to say that many of these people aren't remarkably charming; they are. But you get the sense that they really don't know who you are and they don't really care so much. They'll charm you when necessary. I think one of the answers is for them to open up a little bit and try to connect to others so that they're actually paying attention. For example, their wives or their husbands.

ASN is even more difficult to treat than typical narcissism, says Millman, because people who suffer from ASN are often surrounded by people who do nothing but praise them and reinforce their behaviors. People who have typical narcissistic personality disorder seldom seek treatment because their profound self-absorption prevents them from seeing the truth about their situations. People who have ASN have even more difficulty seeing their own faults, and few if any of them seek treatment for the primary cause of narcissistic behavior.

In other interviews, Millman acknowledged that many clients come to him for help with broken relationships or depression. He sees his job as telling them that they have an underlying issue with narcissism, that it's the narcissism that is causing the secondary problems. Many, he says, don't come back for further treatment.

There's a good chance that ASN might become the disease du jour among celebrities, though. Their narcissism may ironically be the very thing that draws them into treatment - which they might see as an opportunity to talk about themselves.

"Last night I had dinner with this old friend of mine - a celebrity - who was actually one of the inspirations for the idea," Millman says in one interview. "He thought it was so remarkable, because it explained his behavior. He said, 'I have high-class problems!' He just couldn't stop talking about it."

Sources: "Acquired Situational Narcissism", by Stephen Sherrill; The New York Times, December 9, 2001
National Public Radio interview with Doctor Robert Millman on Talk of the Nation, August 21, 2002