Narcissistic personality disorder (NPD) is characterized by an extreme sense of self-worth.
NPD is closely associated with egocentrism - a personality characteristic in which people see themselves and their interests and opinions as the only ones that really matter. People with narcissistic personality disorder are not interested in the feelings of others - they lack empathy; they are unable to feel or appreciate feelings that are not their own.
The U.S. National Library of Medicine describes a person with narcissistic personality disorder as having an excessive sense of self-importance, an intense preoccupation with themselves, and no empathy for others.
Contents of this article:
- The term comes from a character in Greek mythology, called Narcissus.
- No lab tests exist for NPD.
- It is characterized by an extreme sense of self-worth.
- Other features include being quick to anger and prone to irritation.
- For the disorder to be diagnosed, the symptoms must be persistent and chronic.
What is narcissistic personality disorder?
The term comes from a character in Greek mythology, called Narcissus. He saw his reflection in a pool of water and fell in love with it. Narcissistic personality disorder belongs to a group of conditions known as dramatic personality disorders. Afflicted people have very unstable and intense emotions and a distorted image of "self."
Abnormal love of self, an excessive sense of importance and superiority, combined with a preoccupation with success and power do not reflect real self-confidence. The individual has a deep sense of insecurity. His or her self-esteem is extremely fragile. It is common for people with narcissistic personality disorders to set unrealistic goals.
A study carried out by the National Institute on Alcohol Abuse and Alcoholism, published in the Journal of Clinical Psychiatry, found that 7.7 percent of men and 4.8 percent of women develop narcissistic personality disorder (NPD) during their lifetime. The researchers also found that NPD rates are much higher among black men and women, Hispanic women, younger adults, and people who either never married or became divorced, widowed, or separated.
Narcissistic personality disorder traits
Below are the most common traits found in people with narcissistic personality disorder:
- An insatiable appetite for the attention of other people.
- Generally prone to extreme feelings of jealousy.
- Behave as if they deserve special treatment.
- Commonly exaggerate their achievements, talents, and importance.
- Extremely sensitive.
- Find it difficult to maintain healthy relationships.
- Have fantasies regarding their own intelligence, success, power, and good looks.
- If they have to take advantage of others to get what they want, they will, without regret or conscience.
- It does not take much for a person with NPD to feel rejected.
- Lack empathy - empathy is the ability to understand and share the feelings of other people. People with NPD disregard other people's feelings.
- Many believe that only others - "special" people - are really able to understand their uniqueness.
- May consider themselves as very skilled in romance; more skilled than anybody else.
- Most people see narcissists' goals as selfish ones.
- Obsessed with themselves.
- Respond to criticism with anger, humiliation, and shame.
- Seem arrogant.
- Tend to seek out praise and positive reinforcement from others.
- They may be perceived by others as tough-minded or without emotion.
- Usually expect others to agree with them and go along with what they want.
- Very easily hurt.
- Whatever they crave or yearn for must be "the best."
Diagnosis of narcissistic personality disorder
A thorough range of criteria need to be met before a diagnosis of NPD can be made.
Even though no specific lab tests exist that can diagnose NPD, some may be ordered, such as X-rays and blood tests.
The aim here is to rule out possible physical illnesses and conditions, which may be causing the symptoms.
There are several different types of personality disorder, some of them overlap, and it is possible to be diagnosed with more than one type.
An NPD diagnosis must follow the criteria written in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the APA (American Psychiatric Association).
The following must be present for a diagnosis of narcissistic personality disorder to be made:
- The patient's idea and importance of self is exaggerated.
- Fantasies about beauty, success, and power over-dominate the patient's thoughts.
- Patients think they are special, and relate only to other "special" people.
- They need to be admired all the time.
- They believe they are entitled to most things.
- They manipulate and take advantage of other people.
- They lack empathy - the ability to feel and recognize the feelings and needs of others.
- They envy other people.
- Their behavior comes over as haughty or arrogant.
What are the treatment options for NPD?
There is no known cure for NPD. Psychotherapy is often recommended - this is a type of counseling which aims to help the individual learn how to positively relate to other people. Psychotherapy may help the patient better understand what their problems are, which may bring about a change in their attitudes, resulting in better behavior.
Psychotherapy may involve CBT (cognitive behavioral therapy), family therapy, or group therapy. CBT helps the patient identify negative beliefs and behaviors, and to replace them with healthy and positive ones.
Psychotherapy aims to help patients build up their self-esteem and acquire realistic expectations of themselves and other people.
For some of the more distressing aspects associated with NPD, the doctor may prescribe a medication.
What are the causes?
Nobody is sure why people develop narcissistic personality disorder. Some suggest it might be associated with certain circumstances during childhood, such as very high parental expectations, over-pampering, neglect, and even abuse. Perhaps the individual learnt manipulative behaviors from their parents or household members during childhood.
If a child is brought up to think that vulnerability is not acceptable, their ability to tune into other people's feelings and needs may become undermined. The NewYork-Presbyterian Hospital states that recent evidence has pointed to a genetic predisposition and other biological or biochemical factors that are possibly linked to NPD.
A person with untreated NPD has a higher chance of substance abuse (including drugs and alcohol), depression, problems with relationships, difficulties at work or school, and suicidal behaviors or thoughts.
A recent study published in PLoS One found that males with narcissistic personality disorder have higher levels of cortisol in their blood. Cortisol is a stress hormone. Even those without much stress in their lives have higher levels. High blood cortisol is linked to a greater risk of developing cardiovascular problems.
Living with somebody who has NPD
More is known about the effects of NPD on the patient, rather than their loved ones and work colleagues. Learning to heal from the roller-coaster ride of living with somebody with NPD can be very challenging.
Family members of somebody with NPD describe the sufferer as:
- forever dissatisfied with what anybody around them does
- the narcissist will blame others and make them feel guilty for all their problems
- having short fuses, losing their tempers at the slightest provocation
- turning their backs and giving people the "silent treatment"
- physically and sexually abusive
The emotional and physical damage caused by somebody with NPD can be severe. Even the healthcare professional might become emotionally exhausted too. The narcissist tends not to go for strong individuals. Learning how to become more confident and assertive can help protect those living with somebody with NPD from long-term harm.