MEMORANDUM

BRIEF BACKGROUND

This memorandum will discuss Dr. Os eligibility as an adverse witness in the marriage
nullity case.

For the record, Dr. P, a psychiatrist, already had a finding that plaintiff is suffering from a
grave and incurable Narcissistic Personality Disorder (NPD). This disorder serves as the basis for
plaintiff to file a declaration of the nullity of her marriage with respondent on the basis of
psychological incapacity as provide for under Article 36 of the Family Code1. In the case of Ngo-
Te vs. Te, the court already held that Narcissistic Personality Disorder can be the basis of
declaring a marriage null and void ab initio. In such case, the Court discussed that the wifes
being afflicted with Narcissistic and Antisocial Personality Disorder makes her unable to assume
the essential marital obligations. Such conclusion takes into account the wifes disregard for the
rights of others, her abuse, mistreatment and control of others without remorse, her tendency to
blame others, and her intolerance of the conventional behavioral limitations imposed by
society.2In the same light, we hold that the marriage should be declared null and void on the
ground of psychological incapacity, specifically by virtue of Narcissistic Personality Disorder.

However, Dr. O, a Doctor of Philosophy in Psychology argues that there is no sufficient

basis for declaring Narcissistic Personality Disorder saying that the latter did not meet the criteria
listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Hence, we pose the
question of whether or not Dr. O is qualified to be an adverse witness and declare that plaintiff is
not suffering from NPD. Moreover, we shall have a closer look on whether or not her arguments
hold water.

ITEMS FOR DISCUSSION

1. What is the difference between a psychologist and a psychiatrist?

2. Is a psychologist qualified to diagnose Narcissistic Personality Disorder?
3. Does Dr.s conclusions as to: (a) Mrs. Yu not meeting the criteria/symptoms for NPD and
(b) Interview and the Use of Mental Status Examination not being sufficient to diagnose
NPD, hold water? Does she have sufficient basis for her conclusions?
4. Arent Dr.s conclusions and findings contradicting?

MAIN DISCUSSION

Psychologist versus Psychiatrist

The terms psychology/psychologists and psychiatry/psychiatrists are often used

interchangeably. However, there are important distinctions between the two.

1
Art. 36. A marriage contracted by any party who, at the time of the celebration, was psychologically incapacitated
to comply with the essential marital obligations of marriage, shall likewise be void even if such incapacity becomes
manifest only after its solemnization. (As amended by Executive Order 227)
2
Ngo-Te vs Te G.R. No. 161793 (February 13, 2009)
 As to education, training and credentials, psychologists have a doctoral-level degree in
psychology. Usually, they receive a graduate training in psychology and pursue either a Ph.D.
(Doctor of Philosophy) or Psy.D (Doctor of Psychology). On the other hand, psychiatrists have a
degree in medicine (M.D.). They have specific training in the assessment, diagnosis, treatment
and prevention of mental illnesses.3

Moreover, psychologists, generally, cannot prescribe medications. On the other hand,

psychiatrists, having a degree in medicine, can prescribe.4

Finally, psychology focuses on conducting psychotherapy, administering psychological

tests and conducting research. On the contrary, psychiatry gives emphasis to medicine and
prescribing medications.5

Persons Qualified to Diagnose NPD

Personality disorders such as NPD are typically diagnosed by a trained mental health
professional, such as a psychologist or psychiatrist. A diagnosis for narcissistic personality
disorder is made by a mental health professional by comparing your symptoms and life history
with those listed there. They will make a determination whether your symptoms meet the criteria
necessary for a personality disorder diagnosis.6

Many providers of health care may help make the diagnosis of narcissistic personality
disorder, including paediatricians, primary-care providers, licensed mental-health therapists,
psychiatrists, psychologists, psychiatric nurses, and social workers. The person with NPD may
be asked a series of questions from a standardized questionnaire or self-test to help assess the
presence of the illness.7

In Choa vs Choa8, the Supreme Court already held that personal examination is
required in order that a correct conclusion will be arrived at regarding the personality of
an individual.
Obviously, Dr. Gauzon had no personal knowledge of the facts he
testified to, as these had merely been relayed to him xxx. The former was working
on pure suppositions and secondhand information fed to him xxx. Consequently,
his testimony can be dismissed as unscientific and unreliable. Dr. Gauzon tried to

3
http://psychology.about.com/od/psychotherapy/f/psychvspsych.htm. What's the Difference Between a
Psychologist and a Psychiatrist?
4
Ibid.
5
Ibid.
6
http://psychcentral.com/disorders/narcissistic-personality-disorder-symptoms/. Narcissistic Personality Disorder
Symptoms
7
http://www.medicinenet.com/script/main/mobileart.asp?articlekey=38103&page=5. Narcissistic Personality
Disorder
8
Choa vs Choa, G.R. No. 143376, November 26, 2002
 save his credibility by asserting that he was able to assess petitioners character,
not only through the descriptions given by respondent, but also through the
formers at least fifteen hours of study of the voluminous transcript of records of
this case. Even if it took the good doctor a whole day or a whole week to examine
the records of this case, we still find his assessment of petitioners psychological
state sorely insufficient and methodologically flawed.9(Emphasis supplied)

In fact, in conjunction with the individual's history, the psychiatric interview and
mental status examination are considered the main tools leading to diagnosis of this
disorder.10

Moreover, in Ngo-Te vs. Te11, where the Supreme Court granted the petition to
declare the marriage between the spouses involved based on psychological incapacity
(i.e. Narcissistic and Antisocial Personality Disorder and Dependent Personality
Disorder), the interviews and psychological evaluations made by the expert witnesses
were deemed sufficient to conclude that the spouses were suffering from psychological
incapacity.

Going back, in the case at bench, the psychological assessment, which

we consider as adequate, produced the findings that both parties are afflicted
with personality disordersto repeat, dependent personality disorder for
petitioner, and narcissistic and antisocial personality disorder for respondent. xxx

Both parties being afflicted with grave, severe and incurable

psychological incapacity, the precipitous marriage which they contracted on
April 23, 1996 is thus, declared null and void.12 (Emphasis supplied)

In fact, the myriad of methods in determining NPD can be categorized into three:
semi-structured interviews, self-report inventories, and projective techniques - each
category having its own advantages and disadvantages. Semi-structured interviews are
fairly reliable and valid method of diagnosis; Self-report instruments are best at screening
for the presence or absence of personality disorders and identifying personality disorder
clusters; and projective methods are useful in the differential diagnosis of NPD from
related personality disorders.13 In other words, there are various ways of determining the
existence of NPD and no hard and fast rule can be set in such determination.

9
Ibid.
10
http://www.mdguidelines.com/narcissistic-personality-disorder. Narcissistic Personality Disorder
11
Ngo-Te vs. Te, G.R. No. 161793, February 13, 2009
12
Ibid.
13
Assessment of Narcissistic Personality Disorder: A Multi-Method Review by Hilsenroth, Handler and Blais (1996)