It’s never your turn, you’ve given ‘til you’re empty, you’re an ornament, but never radiant enough. The symptoms of narcissistic personality disorder destroy souls. What you need to know…
‘A persistent manner of grandiosity, a continuous desire for admiration, along with a lack of empathy…’
According to one version of the story, he turned away the romantic advances of the nymph, Echo. So the gods punished him by making him fall in love with his reflection in a pool of water.
When he discovered that the object of his love couldn’t return the favor, he pined away and died.
The term narcissism was coined in 1899 by German psychiatrist Paul Näcke. Several years later Welsh psychoanalyst Ernest Jones called it the “God-complex.”
Narcissism, narcissistic, narcissist – if we’re going to toss words around, especially of that intensity and impact, we need to make sure we know what we’re talking about.
Tons of info here, so you may want to favorite the piece for ongoing reference.
Let’s dig in…
What is narcissism?
As we get started, it’s important to know that the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) doesn’t recognize narcissism as a disorder. So we’ll use narcissistic traits to paint our picture.
How ’bout these…
Arrogance, conceit, argumentativeness, vanity, frustration, obsession with appearance, fretfulness, cycling between superiority and inferiority, selection of a partner with similar background and characteristics, striving to be better than their friends.
Keep in mind, these are traits, not disorder criteria. And as much as any of the above may make someone unpleasant to be around, there are tons of folks who possess several of them. Not all are pathological.
What is narcissistic personality disorder?
So what is narcissistic personality disorder? Well, NPD comes down to grandiosity, seeking excessive admiration, and a lack of empathy.
The keyword with NPD, as with any personality disorder, is persistent.
Those with NPD act with an air of entitlement and control, are dismissive of others, and exhibit a condescending attitude.
Keep in mind, those are the externals.
On the inside
Internally, those with NPD wrestle with intense feelings of inadequacy and low self-esteem.
No wonder someone with NPD is often incapable of dealing with disapproval or any measure of pushback.
Narcissistic personality disorder diagnostic criteria
Enter the DSM-5, which recognizes NPD. Its definition, with diagnostic criteria, goes like this…
A persistent manner of grandiosity, a continuous desire for admiration, along with a lack of empathy. It starts by early adulthood and occurs in a range of situations, as signified by the existence of any five of the next nine standards…
- A grandiose logic of self-importance
- A fixation with fantasies of infinite success, control, brilliance, beauty, or idyllic love
- A credence that he or she is extraordinary and exceptional and can only be understood by, or should connect with, other extraordinary or important people or institutions
- A desire for unwarranted admiration
- A sense of entitlement
- Interpersonally oppressive behavior
- No form of empathy
- Resentment of others or a conviction that others are resentful of him or her
- A display of egotistical and conceited behaviors or attitudes
Anybody you know? Maybe you?
Here are some tidbits worth knowing…
- Some 18% of males present with NPD, compared to 6% of women. Within the general population, the prevalence rate of NPD is less than 1%, but rises to 2-16% within the clinical population.
- A good number of those with narcissistic traits hit the psychiatrist’s office. Thing is, they’re often pursuing treatment for other issues such as mood and anxiety disorders.
- Major depressive disorder is seen in 45-50% of those with NPD and bipolar disorder in 5-11%. But the biggie is substance use. 24-64% have substance use disorders.
- It makes sense that NPD shares characteristics with the other cluster B (dramatic, overly emotional or unpredictable thinking or behavior and interactions with others) personality disorders. So there has to be a thorough diagnostic process. The other “B’s” are antisocial personality disorder, borderline personality disorder, and histrionic personality disorder.
Interesting, don’t you think?
Before we move on, we need to take a quick look at malignant narcissism. The combination of NPD and antisocial personality disorder makes it the most severe type of narcissism.
So much involved and so little space. I’ll turn you over to verywell health.
Treatment for narcissistic personality disorder
When it comes to treatment for NPD, it’s all about therapy.
Individual psychoanalytic therapy is often at the core; however, other therapies may be utilized – cognitive behavioral therapy (CBT), family and couples therapies, and group work.
Of note is the CBT schema-focused therapy, which emphasizes addressing narcissistic schemas, as well as dicey moods and coping mechanisms.
In general, when it comes to therapy for NPD a combination strategy is often recommended.
That means direct confrontation with the goal of eliminating or weakening grandiosity and encouraging a measure of grandiosity in an effort to strengthen a naturally deficient self-image. It’s a matter of balance on a per case basis.
Meds aren’t used to directly address NPD. However, they may be used to treat accompanying issues such as depression, bipolarity, and anxiety.
It’s important for someone with NPD to receive close long-term monitoring because of the potential for suicide. This is especially important if depression and/or mania are involved.
I might add that it would be a good idea for those intimately involved with someone with NPD to have a safety plan handy based on personal experience.
Finally, though there is help available for NPD, it isn’t pursued nearly as much as is indicated. And that’s because many with NPD have no idea a problem exists – with them. So why seek treatment?
Beyond tossing words around
Narcissistic personality disorder can be hell on earth for those involved with someone who has it. Believe it or not, in many cases, it can be hell for that someone as well.
That’s why we needed to go beyond tossing words around and really get down to the facts.
I think we pulled it off.
Tip of the hat to Dr. Helen Okoye, MD, MBA, MS-Epi for the resource material, which appeared on theravive.
I’m thinking you’ll find Gaslighting: 11 Cruel & Power-Grabbing Techniques relevant and helpful.
For more Chipur mood and anxiety info and inspiration articles, peruse those titles.