NARCISSISTIC PERSONALITY DISORDER

Narcissistic personality disorder has become a controversial condition, mainly because it’s often misunderstood. It’s also been stigmatised as a personal choice of behaviour, which it’s not.

People with Narcissistic Personality Disorder (NPD) are often regarded as self-centred, lacking empathy, and having a great need for attention and recognition. But underneath this apparent sense of superiority are other important aspects at play. People with NPD can face challenges in their relationships because of how they’re perceived and how they act.

What is narcissistic personality disorder?

NPD is a formal mental health diagnosis and not just a type of personality or a personal choice. As a cluster B (dramatic and erratic) personality disorder, NPD is mainly characterised by behaviours that are:

• Dramatic and exaggerated

• Emotional and intense

• Erratic and unpredictable

What narcissistic personality is not

Most of us will display at least one narcissistic trait at some point in our lives. These may be considered narcissistic behaviours or attitudes, but they differ from a personality disorder in severity, frequency, and duration.

Narcissism, or at least some aspects of it, could be a personality trait in some people. In others, the severity and intensity of these narcissistic traits are such that they permanently affect and hurt how they relate to others and themselves.

Narcissism as a personality trait might occasionally appear in some of our behaviours or thoughts. For example, you could have an ongoing rivalry with a co-worker. This might lead you to make snarky comments around them or exaggerate the praise you receive from your boss when they’re around. But this is an occasional reaction related to this specific co-worker instead of a generalised attitude toward everyone else all the time.

On the other hand, narcissism in someone with NPD is a persistent and characteristic trait. For example, you have an ongoing rivalry with all your co-workers and even your boss. You think you’re more intelligent and capable than them, and you should be the one in a higher role. This happened to you in your last two jobs. In general, you feel you’re far superior to the people you encounter at school, work, and other places.

Remember that NPD is a mental health condition. It doesn’t refer to someone:

• Having high self-esteem

• Displaying social confidence

• Being assertive

• Being proud of their real accomplishments

• Taking care of their physical appearance

• Being competitive

• Disliking you

  
  

Symptoms of NPD

More specifically, doctors diagnose narcissism when a person shows five or more specific symptoms. Not everyone with narcissistic personality will have these symptoms at the same degree or intensity. Still, five of them need to be present over time and across different situations for a diagnosis to be made.

• Grandiosity and self-importance

• Fantasies of perfection and superiority

• Sense of specialness and uniqueness

• Need for praise and attention

• Strong sense of entitlement

• A tendency to exploit others

• Lack of empathy

• Jealousy, envy, and distrust

• Arrogance and scorn

Overt narcissism vs. covert narcissism

Overt narcissism

This subtype of narcissism, also called grandiose narcissism, is the most recognised. It’s mainly characterised by attitudes and behaviours that are arrogant, pretentious, dominant, exhibitionist, aggressive and self-assured.

Covert narcissism

This other subtype of narcissism refers to people whose attitudes and behaviours are more typically anxious, overly sensitive particularly regarding criticism, insecure, defensive, depressive and withdrawn.

Even if this type of narcissism is less obvious, someone with covert narcissism will still exhibit self-absorbed behaviours, secretly believe they’re superior to everyone else, and have a decreased ability to put themselves in other people’s shoes.

Causes and contributing factors of NPD

NPD may result from environmental influences, early life experiences, genetics, or cultural factors. Trauma, neglect, or excessive praise during childhood may contribute to its development.

Treatment of narcissistic personality disorder

Therapy has the potential to help someone with NPD develop skills and strategies that can help them change the way they relate to others and themselves. The challenge is that many people with personality disorders don’t often seek treatment until the disorder starts to significantly interfere or otherwise impact their lives.

In any case, long-term psychotherapy seems to be the most effective treatment for NPD. When the person commits to long-term treatment, a therapist may be able to help them:

• Regulate and understand their own emotions

• Identify behaviours and attitudes that may lead to conflict with other people

• Manage reactions to criticism and feedback

• Develop skills to build more intimate and stable relationships

• Explore, tolerate, and understand other people’s perspectives

  
  

These goals are specific to every case and vary according to the person’s needs and the therapist’s approach. It is possible to manage NPD symptoms with commitment to staying in therapy long-term. Treatment can help regulate emotions and change hurtful behaviours to healthy ones.