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Understanding Narcissistic Personality Disorder (NPD)

Narcissistic Personality Disorder (NPD)

One of the most dramatic personality disorders that have been subjected to mockery over long periods, Narcissistic Personality Disorder (NPD) is a serious psychological issue that causes severe social dysfunction in individuals.

The film ‘To Die For’ portrayed a female character (played by Nicole Kidman) who suffered from typical narcissism. This film brought to light, so vividly, the symptoms of a narcissistic personality. Wall Street, the 2010 drama film is also a great example of a movie that portrays Narcissistic Personality Disorder.

Even though personality disorder is a cause of amusement to many who lack knowledge about it, the true gravity of it is much more. People suffering from the disorder face many crises in life and engage in antisocial or self-destructive behavior in the long run.

Let us take a comprehensive look at what Narcissistic Personality Disorder is, how it is caused, and what we can do to help sufferers increase the quality of their lives.

What Is Narcissistic Personality Disorder

Since personality is a consistent part of one’s existence, it cannot be changed. However, it can be projected in positive ways and several such methods will be discussed below.

Narcissistic Personality Disorder (NPD) is a personality disorder characterized by a pattern of grandiosity, a constant need for admiration, and a lack of empathy for others. People with NPD often have an inflated sense of self-importance and may believe they are superior to others. They may also have a strong need for attention and may be preoccupied with fantasies of power, success, and attractiveness.

Narcissistic Personality Disorder DSM-5

NPD is diagnosed by a mental health professional, usually, a psychiatrist or psychologist, based on the criteria for narcissistic personality disorder listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

People with Narcissistic Personality Disorder are excessively preoccupied with personal issues. In colloquial terms, NPD is considered as self-obsession or self-centeredness. The main concern of people with NPD is to gain personal prestige and power even at the expense of others. Also, when they don’t, they experience severe emotional turmoil that may end up in self-destruction.

2% – 16% of the population can be diagnosed as having traits of narcissism and most of them (up to 75%) are men. As mentioned, because narcissism, just like all other personality disorders is difficult to pinpoint and differentiate as existent or not, it is a tough job to label people who experience this condition. In other words, all of us can be narcissistic but the question remains where to draw the line differentiating normality from suffering a mental disorder!

Narcissistic Personality Disorder Symptoms and Types

Millions of sub-types of Narcissistic Personality Disorder can be identified. Some of those categories include amoroso narcissism (includes histrionic features where the individual is excessively emotional and attention seeking), unprincipled narcissism (includes antisocial behavior and is one of the most common subtypes of NPD), and fanatic narcissism (includes paranoid features and is likely to occur among those who have lost a great deal of self-esteem).

Having a pervasive pattern of grandiosity, lack of empathy, need for admiration, and beginning (most likely) before adulthood are the key characteristics of NPD. They must be present in more than one context of an individual’s life with at least five of the following characteristics:
  1. an exaggerated sense of self-importance
  2. unnecessary boasting and suggesting associations (real or imaginary) with people or places of importance
  3. preoccupation with thoughts of unrealistic power, authority, beauty, or brilliance
  4. arrogant behaviors and attitudes
  5. lack of empathy
  6. being envious of others (this may go on harming others simply because they appear to be a challenge to the narcissist)
  7. needs excessive admiration (feeling of distress if not admired or recognized)
  8. has an exaggerated sense of entitlement where they believe that others must treat them specially
  9. mild to moderate paranoia or high self-consciousness
  10. likely to manipulate others in a way that favors them
  11. sense of uniqueness (imagined or exaggerated)

Causes of Narcissistic Personality Disorder

Theorists have put forward numerous reasons for the cause of Narcissistic Personality Disorder; some believe it is genetic or brain-related, while others argue that environment plays the most vital role. One theory related to pathological narcissism states that such conditions arise when people perceive themselves negatively. Such people, who believe in their lack of self-worth, try to control the views of others by different means.

Other theorists believe that over-indulging parents pave the way to narcissism, while others state that ignorant parents and lack of intimate relationships as children lead to a strange sense of self-reliance. Severe emotional abuse as children and having an oversensitive temperament are also recognized as potential causes for Narcissistic Personality Disorder.

NPD Diagnosis and Tests

All of us have a little dose of narcissism. Healthy narcissism is in fact self-love, which is crucial to remain healthy, but when narcissism becomes an obsession where the narcissist and the people around him are put in anguish, it can be diagnosed as a psychological disorder.

The Diagnostic and Statistic Manual for Mental Disorders states that at least five of the above symptoms should exist for a period over six months for a person to be diagnosed with the disorder. Even though narcissism, like other dramatic personality disorders, can be noted through observation, methodical tests include questionnaires and interviews with a qualified person.

Narcissistic Personality Disorder Treatment and Care

If diagnosed with the disorder, following treatment procedures can be used to overcome suffering due to narcissism. Schema therapy is a hybrid of cognitive behavioral therapy, psychoanalysis, and group therapy. It includes mindfulness, constructivism, and social skill development.

Schema therapy, used first by Dr. J.E. Young is used commonly to treat many forms of personality disorders. To treat those with Narcissistic Personality Disorder, the true cause must be understood. If narcissism is caused due to a distressful childhood, Young’s schema therapy focuses on improving skills such as guidance, safety, care, and healthy interpersonal and intrapersonal relationship skills and increases the overall quality of life.

In the most severe cases of Narcissistic Personality Disorder, in-patient care is required. If the individual displays frequent acting out or self-destructive behaviors or leads a chaotic lifestyle, long-term hospitalization with care focused on the problem is required.

Rather than individual psychotherapy, family involvement, and group therapy are greatly helpful. Methodical cognitive therapies during which individuals are taught how to perceive themselves in realistic ways and are given the needed skill of perspective-taking are the most effective modes of therapy.

Learning to control tantrums when things don’t go according to their desires is also a part of controlling narcissism. What needs to be understood is that no personality disorder is curable, but its symptoms can be reduced in such a way that the individual can function in his daily life, in a socially acceptable manner.


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