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Thursday, October 22, 2009

T3 - Narcissistic Personality Disorder

Narcissistic Personality Disorder gets its name from Greek mythology about Narcissus, a man who was renowned for his beauty. He was very cruel in some of the stories about him, disdaining some people who love him. As divine punishment, he falls in love with a reflection in a pool, not realizing it was his own. He dies there, unable to leave the beautiful image. For more info, read this article.

So, in the spirit of Narcissus, individuals who are in love with themselves get diagnosed with this personality disorder. Typically, they have an inflated view of themselves, deeply crave admiration from others, and show a lack of empathy. But behind the facade is a very vulnerable person, sensitive to the slightest criticism.

There are nine criteria for determining this PD, and five of them are required for diagnosis.

1) grandiose sense of self - often will appear boastful, pretentious, inflate their accomplishments or overestimate their abilities; inherent in this judgment of their own worth is the devaluation of the worth of others

2) preoccupied with fantasies of unlimited success, power, brilliance, beauty or ideal love - to their way of thinking, their admiration and privilege are long overdue; they may compare themselves with famous, rich, privileged people; sometimes, this is called the "God complex"

3) believe that they are superior, special and unique and expect others to recognize this - they only want to associate with other high-status people or institutions; people of lesser rank can't "understand" them; they may attribute these qualities of perfection to those they do associate with, which in turn enhances their own value; they only want the "best" doctors and restaurants

4) require excessive admiration - due to a fragile self-esteem, constant attention is required, and it had better be of the positive, "you-look-so-good" variety; they fish for compliments and actually expect their arrival at a party to be greeted with fanfare and fawning; they may be genuinely astonished if others don't covet their possessions, looks, charm, etc.

5) has a sense of entitlement - they expect (unreasonably so) to be treated favorably over others; they feel they should be catered to and can be quite furious/confused when this isn't the case

6) is interpersonally exploitative - this could be conscious or unwitting; romantic relationships might only be entered into if the person can see some "gain" from it (like advancing their social status or enhancing their self-esteem); they expect to be given whatever they want or feel they need, no matter the cost to others

7) lacks empathy - has a hard time recognizing or identifying with the desires/feelings of others; they may go into lengthy detail about their own concerns at inappropriate times; they might grow contemptuous and impatient with others talking about their problems (i.e., not the center of attention); they often are oblivious to how hurtful their remarks can be (i.e., telling a coworker who wanted the same job promotion how wonderful the new job is); others who relate to people with Narcissistic PD find "emotional coldness and lack of reciprocal interest"

8) often envious of others or believe that others are envious of them - when others have possessions of successes, people with NPD begrudge them and feel that they are more deserving; they will devalue accomplishments of others, even more so if those accomplishments are praised or acknowledgment

9) display arrogant, haughty behaviors or attitudes - snobbish/patronizing/disdainful ways of thinking, behaving and relating to others

Now that you've gotten an idea for the type person a Narcissist really is, I want you to think about how in the world this person would maintain any type of relationship. No one can say anything remotely negative about them. If their partner/spouse isn't constantly admiring them, there's problems in paradise. They disregard the sensitivities of others, which doesn't bode well for a mutual respectful relationship. So the above characteristics have to be looked at in terms of how this person relates to others. This disorder has to cause some clinical impairment in social, occupational or other important are of functioning. See treatment below.

Of all the people diagnosed with this disorder, 50-75% of them are male. Adolescents seem to go through a stage where many have some of these traits, but that doesn't mean they will go on to have NPD. (Adolescents are generally just more into themselves!) For a diagnosis, the individual has to be 18 years old.

A couple of risk factors have been pieced together from various researchers. Here's a list:
  • An oversensitive temperament as a young child
  • Overindulgence and overvaluation by parents
  • Excessive admiration that is never balanced with realistic feedback
  • Unpredictable or unreliable caregiving from parents
  • Severe emotional abuse in childhood
  • Being praised for perceived exceptional looks or talents by adults
  • Learning manipulative behaviors from parents
I found a cool quiz online here if you're interested. Personality disorders are very hard to treat, but I haven't found them hard to diagnose. A high number of individuals with PDs also have an Axis I diagnosis (like depression, anxiety, or an eating disorder, see my post on Axes here) that usually becomes the focus of treatment. By the very nature of Narcissism, the individual would never want to admit they have a problem. Sometimes hospitalization is required for treatment of this disorder.

People with this disorder might not realize they have a problem until they are educated about the illness. Personally, I focus on behavioral modification and communication and social skills training. These individuals aren't necessarily bad people, but they need someone to help them understand the illness and how they can combat it to make their life better.

Questions about this disorder? Drop them to me in the comment section and I'll do my best to answer.

Q4U: This disorder is commonly found in political leaders and entertainment industry professionals. Who are some people you think might fit the bill (don't let my photo pic bias you)?

Wordle: signature


Anonymous said...

Who fits the bill? The current president. I don't think he truly believes he is the Messiah that others claim him to be, but I do think that he has some exaggerated ideas about himself. For example, that he is the only one who can save our society from certain ills.

In order to protect myself from spam I will remain anonymous.

Anonymous said...

Another thing, he has gone out of his way to snub other world leaders, such as France and Britain, even returning gifts given to past presidents by Britain. He blames them for slavery, apparently, but such odd behavior on the part of a world leader seems very out of place, as if he is trying to make himself seem more important. He courts the attention of those who flatter him, and snubs those he thinks are unworthy.

I have found him very puzzling to watch.

Wendy Paine Miller said...

This one is fascinating to me, especially because, as you wrote, how would these people function in relationships?

Tried to think of some famous people who fit the bill, but I don't know if I'm qualified enough or willing to judge enough to make a guess. Anytime I seem to do that, a finger gets pointed back at me about something I struggle with.

I love learning about these disorders. My mom's convinced I should be a counselor. I tell her that I counsel my characters. That's why this blog has such appeal for me.
~ Wendy

Nighfala said...

It struck me, as I read it, that most villains are portrayed as narcissistic. I know mine fits this description.

It seems to be a stereotype. Or, perhaps one must be narcissistic in order to be insensitive and selfish enough to be a really bad Bad Guy?

Natalie said...

So interesting (as usual Jeanne). I like Christine's thought that many villains are portrayed as narcissistic--I can think of a lot.

Pseudo said...

You have descibed my mother to a T. Ack.

Jessica Nelson said...

I've heard some people say that the tv character House is narcissistic, but he doesn't seem to be all the stuff above.
This is interesting to think about. I'm not sure if I know anyone this way, though a particular former pastor is coming to mind.
You have to assume that narcissists get married, right? How would a spouse deal with this? Or do narcissists have a high statistic of NOT marrying?

Stephanie Faris said...

I think everyone has a touch of's human nature to believe our lives are special and want that to be recognized. I had a friend that I finally had to drop because she was hurting every man who entered her life. She expected men to treat her like a queen, buying her things and constantly catering to her. She thought she was better than everyone else. And her looks were EVERYTHING. Her entire day revolved around getting her hair done, working out, eating only Subway (because she couldn't risk putting on weight). At the age of 26, she'd already had two boob jobs (the first one was "too far apart," although no one she showed could see anything wrong with them -- and she showed EVERYONE), a nose job, liposuction, laser hair removal, and Restalyn injected in her imagined forehead wrinkles.

Is that narcissism? Or just someone who's spoiled rotten! She seems to fit the other criteria as well. One thing I noticed was she seemed to believe she was entitled to great things in life and anyone who didn't kiss up to her was deemed not good enough for her. She was always saying people were "dragging her down" as a way to explain why she could never keep a friend.

Jeannie Campbell, LMFT said...

stephanie - definitely sounds like narcissism to me. making excuses for why sh can't keep a friend, and being so into herself in the way you described seems to fit. she sounds spoiled, of course, and her upbringing might very well have had a huge impact on her being the way she is.

Jeannie Campbell, LMFT said...

thanks anonymous for your comments. we're all entitled to an opinion without hate mail. :)

jessica - i'd think that they DO get married, but might likely pick a woman who has issues of her own, you know? like a dependent personality who would do anything to keep a person around. stay tuned for more info on this personality disorder!

Roni Loren said...

Unfortunately, I've known one too many of these. (And they weren't therapy clients.)

Rosslyn Elliott said...

Oo - I've been waiting for this one. :-)

This PD is my current villain, and he is one repulsive dude.

Thanks for the info!

Katie Ganshert said...

Very interesting posts, and very interesting comments. I didn't know people through Obama was a mesiah. How messed up is that? Great story fodder, Jeannie. Are you back from CA yet?

Tara McClendon said...

So that's my problem. (Just kidding). I did marry a man who looks very similar to me. People ask us if we're related, and my husband says, "Yeah, she' my wife." His answer gets some interesting looks. I blame it on the big eyes and smiles. Have a great weekend.

Gutsy Living said...

During my lifetime, I think I've met one or two people like that. One was a French aristocrat who's parents owned a castle in the Loire Valley.

AngBreidenbach said...

Yes, they get married :-) and divorced and remarried and divorced...or they run through women with multiple break-ups. Crazy cycle! I've watched someone do this for years.

I think a man who has multiple affairs has this kind of a problem. He needs the constant attention.

When a person can't maintain a relationship, ya' gotta wonder.
Love this blog, Jeannie.

Anonymous said...

Yes, npd's marry and they cheat. Met mine in hs and was pursued by him; very flattering. He went on to become a very successful physician with my support. Married 29 years; 2 children. Has cheated on me 3 times that I am aware of and 2 other times that I don't have proof of. Left the family for 2nd gf; he begged to come back after 3 years; made him go to therapy for a year before I was convinced he had made changes he could stick with. Did not know he had developed a porn and drug addiction during his time away. After 5 years he began to devalue me and the children; he was verbally abusive (which is term that he said was invented by divorce lawyers); he was depressive. We went back to therapist who suggested he get on meds and do therapy. Of course it never happened. I found evidence of his drug use; went back to therapist who told him to get into a program; didn't happen. Found out about affair with married woman; has taken 3 years to get him out of the house. He has destroyed our family. Still need to finalize a divorce; his need for control is suffocating and he is not making this easy for anyone. Need for constant adulation is overwhelming. As one therapist told me, "it doesn't matter what you do; he will always ask what have you done for me lately" It took me a long time to understand...

Unknown said...

Nothings Wrong With Me!! I'm Perfect! Perfectly Fucked Up in The Head.I Know it and am Still Much More Knowledgable than your average Corporate Robot.So What!!

How can Anyone Lack Empathy?The Apathy that society has towards the Disabled and Poor is Sickening.

Just Come to the Finanacial District of San Francisco and You will find many Subjects.This is Apathy Headquarter.I see the Narcism Daily when they Ignore Hungry Human Beings.Not Because they Are Inebriates it is because they don't Care.Society tells them It's OK to hate.

Food is Not Enabling it is Feeding Someone.

I watched a Group of Narcissists have a Wealthy Club Meeting(No Shit) at Harringtons.They were Bragging about how wealthy thay were as Human Beings Picked through Mc Donalds trash for food Just a few feet from them.

I have been Dealing with PTSD which has some symptoms of Anger Minus the self Inflated feeling.My Head is Physically Big Enough without my Ego inflating it anymore. PEACE

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Both comments and questions are welcome. I hope you enjoyed your time on the couch today.