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Narcissistic Personality Disorder

 

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Narcissistic Personality Disorder (NPD) At a Glance
 by: Sam Vaknin, Ph.D.

Most narcissists (75%) are men.

NPD is one of a "family" of personality disorders (formerly known as "Cluster B").

Other members: Borderline PD, Antisocial PD and Histrionic PD.

NPD is often diagnosed with other mental health disorders ("co-morbidity") - or with substance abuse, or impulsive and reckless behaviours ("dual diagnosis").

NPD is new (1980) mental health category in the Diagnostic and Statistics Manual (DSM).

There is only scant research regarding narcissism. But what there is has not demonstrated any ethnic, social, cultural, economic, genetic, or professional predilection to NPD.

It is estimated that 0.7-1% of the general population suffer from NPD.

Pathological narcissism was first described in detail by Freud. Other major contributors are: Klein, Horney, Kohut, Kernberg, Millon, Roningstam, Gunderson, Hare.

The onset of narcissism is in infancy, childhood and early adolescence. It is commonly attributed to childhood abuse and trauma inflicted by parents, authority figures, or even peers.

There is a whole range of narcissistic reactions - from the mild, reactive and transient to the permanent personality disorder.

Narcissists are either "Cerebral" (derive their narcissistic supply from their intelligence or academic achievements) - or "Somatic" (derive their narcissistic supply from their physique, exercise, physical or sexual prowess and "conquests").

Narcissists are either "Classic" - see definition below - or they are "Compensatory", or "Inverted" - see definitions here: "The Inverted Narcissist".

NPD is treated in talk therapy (psychodynamic or cognitive-behavioural). The prognosis for an adult narcissist is poor, though his adaptation to life and to others can improve with treatment. Medication is applied to side-effects and behaviours (such as mood or affect disorders and obsession-compulsion) - usually with some success.

Please read CAREFULLY!

The text in italics is NOT based on the Diagnostics and Statistics Manual, Fourth Edition (1994).

The text in italics IS based on "Malignant Self Love - Narcissism Revisited", second, revised, printing (2001)

An all-pervasive pattern of grandiosity (in fantasy or behaviour), need for admiration or adulation and lack of empathy, usually beginning by early adulthood and present in various contexts. Five (or more) of the following criteria must be met:

  • Feels grandiose and self-importance (e.g., exaggerates achievements and talents to the point of lying, demands to be recognized as superior without commensurate achievements)
  • Is obsessed with fantasies of unlimited success, fame, fearsome power or omnipotence, unequalled brilliance (the cerebral narcissist), bodily beauty or sexual performance (the somatic narcissist), or ideal, everlasting, all-conquering love or passion
  • Firmaly convinced that he or she is unique and, being special, can only be understood by, should only be treated by, or associate with, other special or unique, or high-status people (or institutions)
  • Requires excessive admiration, adulation, attention and affirmation - or, failing that, wishes to be feared and to be notorious (narcissistic supply)
  • Feels entitled. Expects unreasonable or special and favourable priority treatment. Demands automatic and full compliance with his or her expectations
  • Is "interpersonally exploitative", i.e., uses others to achieve his or her own ends
  • Devoid of empathy. Is unable or unwilling to identify with or acknowledge the feelings and needs of others
  • Constantly envious of others or believes that they feel the same about him or her
  • Arrogant, haughty behaviours or attitudes coupled with rage when frustrated, contradicted, or confronted

Some of the language in the criteria above is based on or summarized from:

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition (DSM IV). Washington, DC: American Psychiatric Association.

The text in italics is based on:

Sam Vaknin. (2001). Malignant Self Love - Narcissism Revisited, second, revised, printing. Prague and Skopje: Narcissus Publication.

For the exact language of the DSM IV criteria - please refer to the manual itself !!!

 

About The Author

Sam Vaknin is the author of "Malignant Self Love - Narcissism Revisited" and the editor of mental health categories in The Open Directory, Suite101, and searcheurope.com.



 

 

 

 

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Dr. Mike Shery is the director of ACRS and is a licensed clinical psychologist. He has practiced clinical psychology for approximately 24  years and is affiliated with almost all health plans, including: ValueOptions, Medicare, Cigna, Cigna Behavioral Health, United Health Care, Aetna, First Health, Healthstar, Blue Cross Blue Shield of Illinois, ComPsych, Magellan Health, HFN, Tricare, Humana, most union local plans,  most school district plans, Unicare, ChoiceCare, CAPP, Multiplan, Mental Health Network, Managed Health Network, PHCS, PPONext, Tricare, Humana Military-Tricare, United Behavioral Health and Beech Street.

  

He is board certified as a specialist in professional counseling by the International Academy of Behavioral Medicine,

Counseling and Psychotherapy.  He a member of the American Counseling Association.

 

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