Dsm v narcissistic personality disorder
Narcissistic Personality Disorder - PsychDB
Table of Contents
Narcissistic Personality Disorder
Primer
DSM-5 Diagnostic Criteria
Psychopathology
Kohut
Kernberg
Differential Diagnosis
Treatment
Guidelines
Resources
Primer
Narcissistic Personality Disorder is a personality disorder where individuals have a grandiose sense of their own self-importance but are also extremely sensitive to criticism. They have little ability to empathize with others, and they are more concerned about appearance than substance. It is characterized by arrogance, grandiosity, a need for admiration, and a tendency to exploit others. Individuals with this condition often have a sense of excessive entitlement and may demand special treatment.
Epidemiology
Prevalence estimates range between 0% to 6.
2% in community samples.
50% to 75% of diagnoses are male.
Prognosis
Vulnerability in self-esteem makes individuals with narcissistic personality disorder very sensitive to “injury” from criticism or defeat.
Impairment can be severe, and may include marital problems and interpersonal relationships conflicts
Individuals may face occupational difficulties, and show an unwillingness to take risks in competitive or other situations in which defeat is possible.
Individuals with narcissistic personality disorder may have more difficulties to the aging process, especially when it comes to new physical and occupational limitations related to ageing (“mid-life crisis”).
Comorbidity
Anorexia nervosa and substance use disorders (especially cocaine) are comorbid
Associated personality disorders include histrionic, borderline, antisocial, and paranoid personality disorders
DSM-5 Diagnostic Criteria
A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by 5 (or more) of the following:
Has a grandiose sense of self-importance (e.
g. - exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
Requires excessive admiration
Has a sense of entitlement (i.e. - unreasonable expectations of especially favourable treatment or automatic compliance with his or her expectations)
Is interpersonally exploitative (i.e. - takes advantage of others to achieve his or her own ends)
Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
Is often envious of others or believes that others are envious of him or her
Shows arrogant, haughty behaviors or attitudes.
Psychopathology
Narcissistic personality disorder can be broken into 3 concepts:
Overt: Grandiose, stereotypical loud
Covert: More fragile, self effacing, overly aware of others
Malignant: a combination of narcissistic personality disorder and antisocial personality disorder
Kohut
The psychoanalyst Heinz Kohut believed narcissism is developmentally arrested at an early stage, when an individual needs a feedback environment to maintain their cohesive selves.
He formulated that self-object transferences recreate the situation with parents that was not fully successful during childhood (mirroring, idealising).When a narcissist does not get response they need (i.e. - an empathic deficit), they are prone to fragmentation of the self (experience a narcissistic injury).
Common concepts introduced by Kohut are:
Mirror transference (i.e. - “I’m great, look at me!”)
Idealizing transference: (i.e. - “You are great, and I’m great because I am with you!”)
Twinship transference (i.e. - “You are great and I am just like you!”)
Kernberg
Psychiatrist and psychoanalyst Otto Kernberg viewed the narcissist’s grandiosity and exploitation as evidence of oral rage, which results from the emotional deprivation caused by an indifferent and spiteful parent.
When this occurs, the child's sense of being special, provides an emotional escape from perceived threat/indifference by the parent.
The grandiosity and entitlement that develops protects a split off the “real self.”Here, the “real self” contains strong, unconscious feelings of envy, deprivation, fear, and rage.
Thus, the defensive structure in narcissistic personality disorder is remarkably similar to one seen in borderline personality.
Differential Diagnosis
High-achieving individuals
Many highly successful individuals can have personality traits that might be considered narcissistic. Only when these traits are inflexible, maladaptive, and persisting and cause significant functional impairment or subjective distress do they constitute narcissistic personality disorder.
Borderline personality disorder (BPD)
A stable self-image and relative lack of self-destructiveness, impulsivity, and abandonment concerns help distinguish narcissistic personality disorder from BPD
Histrionic personality disorder
Excessive pride in achievements, lack of emotional display, and disdain for others' sensitivities help distinguish narcissistic personality disorder from histrionic personality disorder.
Antisocial personality (ASPD)
Individuals with ASPD and narcissistic personality disorders share features such as tough-mindedness, glibness, superficialness, exploitation, and a lack of empathy. However, ASPD is characterized by impulsivity, aggression, and deceit. In addition, individuals with ASPD may not want the admiration and envy of others, and narcissistic personality disorder usually lacks the history of conduct disorder in childhood or criminal behavior in adulthood.
Obsessive-compulsive personality disorder (OCPD)
In both narcissistic personality disorder and OCPD, there may be perfectionism and the belief that others cannot do things as well. However, in OCPD, there is frequent self-criticism, while dose with individuals with narcissistic personality disorder are more likely to believe that they have already achieved perfection.
Paranoid personality disorder and schizotypal personality disorder
Suspiciousness and social withdrawal usually distinguish those with schizotypal or paranoid personality disorder from those with narcissistic personality disorder.
When these qualities are present in individuals with narcissistic personality disorder, they are usually driven from fears of having any flaws or imperfections revealed.
Mania or hypomania
Grandiosity may emerge as part of manic or hypomanic episodes, but the association with mood change or functional impairments helps distinguish these episodes from narcissistic personality disorder.
Substance use disorders
Narcissistic personality disorder should be distinguished from symptoms that may develop in association with persistent substance use (e.g. - stimulant induced mania)
Treatment
Mentalization-based therapy, transference-focused psychotherapy, schema-focused psychotherapy, and dialectical behaviour therapy (DBT) for significant self-destructive behaviors.
Higher functioning narcissistic personalities may do well in psychodynamic (or psychoanalytic) psychotherapy, and supportive psychotherapy may also be useful.
Individual psychotherapy is viewed by many as the basic treatment of choice. Psychotherapy can be very challenging for therapists, and confrontation and mirroring techniques are suggested.
Recommended Reading
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Guidelines
Resources
For Patients
For Providers
Articles
VICE: How Narcissists Took Over the World
Research
cluster-b
References
1) American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.
2) American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.
3) American Psychiatric Association.
(2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.
4)Jauk, E., Weigle, E., Lehmann, K., Benedek, M., & Neubauer, A. C. (2017). The relationship between grandiose and vulnerable (hypersensitive) narcissism. Frontiers in Psychology, 8, 1600.
Narcissistic Personality Disorder - PsychDB
Table of Contents
Narcissistic Personality Disorder
Primer
DSM-5 Diagnostic Criteria
Psychopathology
Kohut
Kernberg
Differential Diagnosis
Treatment
Guidelines
Resources
Primer
Narcissistic Personality Disorder is a personality disorder where individuals have a grandiose sense of their own self-importance but are also extremely sensitive to criticism. They have little ability to empathize with others, and they are more concerned about appearance than substance.
It is characterized by arrogance, grandiosity, a need for admiration, and a tendency to exploit others. Individuals with this condition often have a sense of excessive entitlement and may demand special treatment.
Epidemiology
Prevalence estimates range between 0% to 6.2% in community samples.
50% to 75% of diagnoses are male.
Prognosis
Vulnerability in self-esteem makes individuals with narcissistic personality disorder very sensitive to “injury” from criticism or defeat.
Impairment can be severe, and may include marital problems and interpersonal relationships conflicts
Individuals may face occupational difficulties, and show an unwillingness to take risks in competitive or other situations in which defeat is possible.
Individuals with narcissistic personality disorder may have more difficulties to the aging process, especially when it comes to new physical and occupational limitations related to ageing (“mid-life crisis”).
Comorbidity
Anorexia nervosa and substance use disorders (especially cocaine) are comorbid
Associated personality disorders include histrionic, borderline, antisocial, and paranoid personality disorders
DSM-5 Diagnostic Criteria
A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by 5 (or more) of the following:
Has a grandiose sense of self-importance (e.g. - exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
Requires excessive admiration
Has a sense of entitlement (i.
e. - unreasonable expectations of especially favourable treatment or automatic compliance with his or her expectations)Is interpersonally exploitative (i.e. - takes advantage of others to achieve his or her own ends)
Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
Is often envious of others or believes that others are envious of him or her
Shows arrogant, haughty behaviors or attitudes.
Psychopathology
Narcissistic personality disorder can be broken into 3 concepts:
Overt: Grandiose, stereotypical loud
Covert: More fragile, self effacing, overly aware of others
Malignant: a combination of narcissistic personality disorder and antisocial personality disorder
Kohut
The psychoanalyst Heinz Kohut believed narcissism is developmentally arrested at an early stage, when an individual needs a feedback environment to maintain their cohesive selves.
He formulated that self-object transferences recreate the situation with parents that was not fully successful during childhood (mirroring, idealising).When a narcissist does not get response they need (i.e. - an empathic deficit), they are prone to fragmentation of the self (experience a narcissistic injury).
Common concepts introduced by Kohut are:
Mirror transference (i.e. - “I’m great, look at me!”)
Idealizing transference: (i.e. - “You are great, and I’m great because I am with you!”)
Twinship transference (i.e. - “You are great and I am just like you!”)
Kernberg
Psychiatrist and psychoanalyst Otto Kernberg viewed the narcissist’s grandiosity and exploitation as evidence of oral rage, which results from the emotional deprivation caused by an indifferent and spiteful parent.
When this occurs, the child's sense of being special, provides an emotional escape from perceived threat/indifference by the parent.
The grandiosity and entitlement that develops protects a split off the “real self.”Here, the “real self” contains strong, unconscious feelings of envy, deprivation, fear, and rage.
Thus, the defensive structure in narcissistic personality disorder is remarkably similar to one seen in borderline personality.
Differential Diagnosis
High-achieving individuals
Many highly successful individuals can have personality traits that might be considered narcissistic. Only when these traits are inflexible, maladaptive, and persisting and cause significant functional impairment or subjective distress do they constitute narcissistic personality disorder.
Borderline personality disorder (BPD)
A stable self-image and relative lack of self-destructiveness, impulsivity, and abandonment concerns help distinguish narcissistic personality disorder from BPD
Histrionic personality disorder
Excessive pride in achievements, lack of emotional display, and disdain for others' sensitivities help distinguish narcissistic personality disorder from histrionic personality disorder.
Antisocial personality (ASPD)
Individuals with ASPD and narcissistic personality disorders share features such as tough-mindedness, glibness, superficialness, exploitation, and a lack of empathy. However, ASPD is characterized by impulsivity, aggression, and deceit. In addition, individuals with ASPD may not want the admiration and envy of others, and narcissistic personality disorder usually lacks the history of conduct disorder in childhood or criminal behavior in adulthood.
Obsessive-compulsive personality disorder (OCPD)
In both narcissistic personality disorder and OCPD, there may be perfectionism and the belief that others cannot do things as well. However, in OCPD, there is frequent self-criticism, while dose with individuals with narcissistic personality disorder are more likely to believe that they have already achieved perfection.
Paranoid personality disorder and schizotypal personality disorder
Suspiciousness and social withdrawal usually distinguish those with schizotypal or paranoid personality disorder from those with narcissistic personality disorder.
When these qualities are present in individuals with narcissistic personality disorder, they are usually driven from fears of having any flaws or imperfections revealed.
Mania or hypomania
Grandiosity may emerge as part of manic or hypomanic episodes, but the association with mood change or functional impairments helps distinguish these episodes from narcissistic personality disorder.
Substance use disorders
Narcissistic personality disorder should be distinguished from symptoms that may develop in association with persistent substance use (e.g. - stimulant induced mania)
Treatment
Mentalization-based therapy, transference-focused psychotherapy, schema-focused psychotherapy, and dialectical behaviour therapy (DBT) for significant self-destructive behaviors.
Higher functioning narcissistic personalities may do well in psychodynamic (or psychoanalytic) psychotherapy, and supportive psychotherapy may also be useful.
Individual psychotherapy is viewed by many as the basic treatment of choice. Psychotherapy can be very challenging for therapists, and confrontation and mirroring techniques are suggested.
Recommended Reading
Buy on Amazon
PsychDB is an Amazon Associate and earns from qualifying purchases. Thank you for supporting our site!
Guidelines
Resources
For Patients
For Providers
Articles
VICE: How Narcissists Took Over the World
Research
cluster-b
References
1) American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.
2) American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.
3) American Psychiatric Association.
(2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.
4)Jauk, E., Weigle, E., Lehmann, K., Benedek, M., & Neubauer, A. C. (2017). The relationship between grandiose and vulnerable (hypersensitive) narcissism. Frontiers in Psychology, 8, 1600.
90,000 Narcassic personality disorder - the Center for Psychological Assistance "Enlightenment"- main
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Psychotherapist Sergey Egorovich
Psychologist, family psychologist Teperik Rimma Fedorovna
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Kopyv Andrey Feliksov Conflictologist, psychologist, clinical psychologist Tsuranova Natalya Aleksandrovna
Nochevkina Alena Igorevna
3. Narcissistic personality disorder3.1. Definition and Diagnostic Criteria for Narcissistic Personality Disorder
Narcissistic Personality Disorder has been included in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Health (DSM) since version III 1 .
According to DSM-IV (1994), it refers to group B personality disorders: with manifestations of theatricality, emotionality and lability. Narcissistic personality disorder is defined as "an exaggeration of self-importance and an increased preoccupation with issues of self-esteem." The diagnosis of narcissistic personality disorder is made if the idea of one's own greatness (expressed in fantasies or in behavior), the need for admiration from others and the impossibility of empathy, which manifest themselves in various life situations and the presence of which are not evidenced by less than five of the following symptoms:
1. A grandiose sense of self-importance (eg, exaggeration of one's own achievements and talents by the patient, expectation of recognition without adequate merit).
2. Preoccupation with fantasies of unprecedented success, unlimited power, brilliance, beauty, or ideal love.
3. The patient's belief in his own uniqueness and ability to communicate with or be associated with other special or high-status people (or institutions).
4. The need for excessive admiration from others. nine0053
5. The feeling of being chosen, i.e. unreasonable expectations of very good treatment or unquestioning obedience to demands.
6. In personal relationships, the tendency to exploit others, ie. use other people to achieve their own goals.
7. Inability to show empathy, unwillingness to understand the feelings or needs of others or to put oneself in their place.
8. Feeling envious of others or the belief that others envy him. nine0053
9. Behavior or attitudes are distinguished by arrogance, arrogance, arrogance.
Attempts have been made to determine the "weight" of the various traits. For most writers, perhaps the most "narcissistic trait" is grandiosity (DSM-IV trait 1). At the same time, based on the results of the research, it is proposed to consider other signs as leading ones. Thus, J. Dawson (Dawson J.H., 1992) comes to the conclusion that “a sense of being chosen and special rights” (5th sign according to DSM-IV) can be considered as an “indicator” of narcissistic personality disorder.
E. Ronningstam and J. Gunderson (Ronningstam E. A Gunderson J., 1995, 1996) conducted a study of changes in the severity of pathological narcissism after three years of treatment. Of the nine DSM-IV criteria, six showed significant changes: “preoccupation with fantasies” (2nd attribute), “uniqueness” (3rd attribute), “arrogance” (9th attribute), “feeling of being chosen” (5 -th sign), "tendency to exploit others" (6th sign), "weakness of empathy" (7th sign). The least changed were: “grandness” (1st sign), “need for admiration” (4th sign), “envy” (8th sign). It is these three least changed signs that can be considered the main criteria for pathological narcissism. nine0053
Those six signs that have changed during the course of treatment rather define the "narcissistic state". The reduction of signs, along with treatment, was influenced by significant life events: achievements, new strong relationships, moderate disappointment. Ronningstam and Gunderson question the constructive validity of such a diagnostic category as narcissistic personality disorder.
1 ICD-10 does not include narcissistic personality disorder.
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Find:Narcissism - what it is, signs and causes of narcissistic personality disorder
Anna Krymskaya, a clinical psychologist and co-founder of the YouTalk psychological help online service nine0052
Surely among your acquaintances there is someone about whom you thought “yes, he is a typical narcissist”. Most likely, the description of this person will look like this: self-confident, ambitious, somewhat selfish. Possibly manipulative.
Finished reading here
The term "narcissism" sounds everywhere: in psychological blogs, films, "Tiktok".
There are articles and studies about him. But often in them this phenomenon is simplified and stigmatized. Who are narcissists, should they be avoided, and when can one speak of a narcissistic disorder? nine0053
What is narcissism
Psychologically, narcissism is an exaggerated view of one's contribution to society or a group, otherwise known as excessive narcissism or even egocentrism. This is not a monolithic concept, but a whole spectrum. To some extent, its features are present in many of us, this is normal and even useful in some ways. For example, people with a narcissistic temperament are often ambitious, take care of themselves and achieve great success in their careers.
Depending on how pronounced narcissistic tendencies are and whether they interfere with life, the spectrum of narcissism can be divided into four parts:
- individual features
- character
- accentuation
- personality disorder.
Character and accentuation are variants of a healthy manifestation of narcissism, and a personality disorder is already a psychiatric diagnosis.
Related material
The extreme degree of the norm is the narcissistic accentuation of the personality. This means that the narcissistic qualities of character are so pronounced that in some cases they begin to interfere with a person's life. They can affect his relationships with others or the professional sphere. However, their influence is not so serious as to diagnose a personality disorder. For example, they can lead to conflicts with superiors or prevent a person from sincerely opening up to another, removing the mask of ideality. nine0053
What qualities are considered narcissistic
Based on the Narcissistic Personality Inventory, one of the most popular tools for identifying non-clinical cases of narcissism, the following qualities can be considered narcissistic:
- Demonstration.
It is expressed in the idea of one's own unusualness, uniqueness, physical attractiveness and ability to influence others - Authority. Confidence in possessing leadership qualities, the ability to influence others, power over people, the ability to succeed. nine0004
- Chosenness. The feeling of one's own peculiarity, the expectation of an exceptionally good attitude, respect, recognition of one's merits, submission to one's requirements and desires.
- Vanity. The desire to look good in the eyes of others, the need to confirm one's superiority, the desire to hear flattery from other people.
- Self-sufficiency. Confidence in one's independence from people in achieving results, competence, responsibility for making decisions, confidence in the correctness of one's actions, the ability to live in accordance with one's desires, the ability to become a great person. nine0004
- Excellence. Conviction in the extraordinary and uniqueness of one's personality, the presence of special achievements and talents, the deserving of appropriate recognition from others.
- Operation. Confidence in one's ability to use other people, the ease of manipulating others to achieve one's own goals, the ability to understand others well, influence their behavior, and convince of something.
Along with these traits, there are often such characteristics as increased sensitivity to shame, perfectionism, a feeling of inner emptiness and loneliness. nine0053
People with a narcissistic psychotype are demonized, attributing to them aggressiveness, lack of empathy, a tendency to violence
The traits listed above are manifestations of narcissism as a personality trait, that is, a norm. To be diagnosed with Narcissistic Personality Disorder, according to the DSM-5 American Classification of Diseases, a person must exhibit five or more of the following characteristics of narcissism in early adulthood: nine0004
In Russia, however, since January 2022 it has become impossible to get a diagnosis of Narcissistic Personality Disorder, because our doctors do not follow DSM-5, but the International Classification of Diseases from the World Health Organization. In the latest edition, the division into individual personality disorders was removed: now they look at whether a person has general signs of a personality disorder, the degree of their severity and specific manifestations. This will make the approach more comprehensive and personalized.
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Is it worth labeling a person as "narcissist"
There are two sides to using such labels. They can be a guide, explain individual patterns in their own and others' behavior, feelings and thinking; can help you get the big picture. But they can also become a stigmatizing stigma, if you do not pay attention to the individual characteristics of a person. Unfortunately, in modern culture, this often happens and any people with a narcissistic psychotype are demonized, attributing to them aggressiveness, lack of empathy, a tendency to violence, and offering to avoid any contact with them. But this will not be true for every person with narcissistic traits. Because of such generalizations, even the expression "narcissist" itself has acquired a negative connotation, and its use is considered not entirely ethical. nine0053
In addition, in psychology there are many different classifications of narcissism that better convey the shades of this phenomenon than one term.
Related material
What types of narcissism are distinguished by psychologists
Most often they talk about two types:
Grandiose. Such a person wants to be the best. Faster, higher, stronger than all. Career, appearance, relationships - everything should be perfect. This characteristic fits well with the modern philosophy of success and achievement, so often this type achieves a lot in life. Grandiose narcissists can embellish reality to fit their ideal image if reality falls short. The self-esteem of such people is unstable: from the outside it may seem high or even inflated, but inside they often feel empty and dissatisfied. nine0053
Vulnerable. He is also hidden or thin-skinned.
Clinical psychologist Paul Wink in his work "The Two Faces of Narcissism" described the mental portrait of representatives of this type as prone to introversion, submission, anxiety, vulnerability and always being on the defensive. However, like the grandiose type, they are vain, interested in others, impulsive, and often take risks.
While grandiose narcissists tend to exalt themselves in the eyes of others, vulnerable narcissists may appear to hate themselves. In fact, this is the same idealization, but turned inside out. While grandiose narcissists tend to see themselves as the best, covert narcissists tend to see themselves as the worst, stupidest, most miserable. Keyword: most. nine0053
From the grandiose pole, a person with narcissism can fall into the other extreme: feel like a partner unworthy of love in principle
Some researchers believe that these types are not mutually exclusive, but can change depending on the circumstances of a person's life.
For example, there was a successful period at work: a person exceeded KPI and received praise from his superiors. At this point, he will be inclined to idealize himself, to feel his own exclusivity and superiority, life will seem beautiful. A week later, the partner shares that some aspect of the relationship does not suit him. From the grandiose pole, a person with narcissism can fall into the other extreme: to feel like a disgusting partner, unworthy of love in principle. And at the same time devalue all previous achievements. In this state, a person may impulsively propose a breakup or show aggression, trying to avoid corrosive shame. nine0053
And if the narcissistic disorder is accompanied by features of sociopathy (indifference, aggressiveness, disregard for social norms), one can speak of perverse narcissism. It is this type that is prone to emotional violence and even crime due to a lack of empathy. Perverted narcissists are people who prove their worth and value through the humiliation of others.
It is extremely difficult for them to build a healthy relationship, as they are not able to empathize, lie, manipulate and overly control their partner. This type rarely turns to a psychotherapist, and it is difficult for him to stay in therapy. nine0053
Narcissism in Men and Women
Scientists at the Buffalo Institute reviewed studies of narcissistic personality disorder over the past 30 years and found that it is more common in men and manifests somewhat differently than in women.
First, men are more likely to exploit others and feel entitled to have privileges. Secondly, they show more desire for power and leadership. But in the manifestations of vanity and egocentrism, there was no particular difference. Scientists suggest that such results may be the result of a certain gender socialization - that is, the attitudes broadcast by society about what men and women can and cannot be.
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Since women are often criticized for being aggressive and authoritarian, they can suppress these narcissistic traits, while men do not have to restrain themselves. But the authors note that this topic requires further study.
Causes of narcissism
There are different concepts as to why people develop narcissism. The conducted studies have not proved an unambiguous connection with genetics, so the sociocultural concept remains the main one. nine0053
Representatives of psychoanalysis paid a special attention to the nature of narcissism. For example, Sigmund Freud and Heinz Kohut were of the opinion that at a certain stage in the development of a child, the emergence of narcissism is a natural and healthy phenomenon - this is called primary narcissism.
In infancy, the child has no other needs than his own, and he does not have to make any effort to satisfy them. In fact, he is the center of his own universe. This is a normal developmental stage that everyone goes through. nine0053
However, certain circumstances can lead to secondary narcissism - that is, its unhealthy form. Such a circumstance could be a lack of parental love and acceptance. Moreover, the child did not necessarily encounter excessive severity, cruelty or indifference. It is quite possible that his parents, on the contrary, praised him for any reason and did not forbid anything. Child idealization and permissiveness can also be perceived as dislike and cause secondary narcissism, according to Karen Horney. When only the positive side is seen in a child, ignoring the existence of negative traits, he feels unseen. As if they love not him, but some other person, an image. In both cases, the defensive reaction is the creation of an imaginary ideal "I", designed to deserve the love and attention of others.
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Psychoanalyst Andre Green considers another reason in his article "Dead Mother". He talks about a situation in which the mother was physically alive, but was emotionally unavailable and absent due to depression. For this reason, the child did not receive love, care, support in the proper amount. The researcher believed that the mother's depression becomes a trauma for the child, since the baby, up to a certain age, sees in himself the cause of everything that happens around him and, among other things, blames himself for his mother's condition. nine0053
Lack of communication and warmth leads to the fact that the child tries to "bring the mother back to life", changing behavior, attracting attention. Failures give rise to tremendous anxiety and a feeling of a bottomless hole inside.
Over time, the baby begins to feel the emptiness, which he will later try to fill: with achievements, attention, other people. In this case, those around him can become his narcissistic extension - like an extension of his personality, an attribute to maintain status and high self-esteem. Other consequences are the replacement of emotions with reasoning, a tendency to depression, aggressiveness, the inability to let someone in, to accept and experience love, to build warm trusting relationships. nine0053
Narcissistic trauma
Trauma associated with the narcissistic part of the personality can occur not only in childhood. According to Freud, a narcissistic injury is a situation in which the narcissist feels that his hidden true self has been discovered. Its imperfection is revealed. For example, if he faced failure or his authority was called into question.
Narcissistic trauma can lead to depression or what is known as narcissistic rage, an attempt to regain control and avenge the pain. nine0053
Treatment of narcissism
Both narcissistic personality disorder and narcissism in the broad sense of the word are generally amenable to psychotherapy. It's not exactly a "treatment" in the medical sense of the word. Rather, the process of knowing, accepting and adapting to the characteristics of one's personality.
For therapy to be effective, the person must be interested in it. In many cases, the benefits of narcissistic character traits and the difficulty in recognizing one's own imperfection lead to the fact that a person is not too willing to change something in his life and turn to a psychotherapist. And in a situation where we are talking simply about character traits that do not interfere with the person himself and do not harm others, the therapy of narcissism is, in principle, not needed.
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If you feel bad in a relationship, then whether the person is a narcissist or not, it makes sense to think about parting. Working with the deep structures of personality requires a lot of effort and time. But at the same time, the very arrival of psychotherapy already has a positive effect. The therapeutic relationship is built on trust, acceptance, and recognition of the person in all of his manifestations, and this is exactly the kind of experience that people with narcissistic disorder or pronounced narcissism practically do not have. nine0053Together with the client, the therapist looks for points of support and support. The psychologist is able to endure regular cycles of idealization and devaluation, which allows the relationship to last. Teaches the client to see himself, not to fall into one of the poles of adoration and hatred, to endure his fears, doubts, vulnerability, envy and a constant sense of shame.
See the value of other people in isolation from himself and, if necessary, control his aggression.
Having received the experience of warm acceptance of different aspects of his personality in therapy, a person with narcissism learns to apply this experience in everyday life, to build relationships with the world and himself in a new way. nine0053
How to communicate with a person if you suspect narcissism or NPD
There are two main principles to follow: focus on how you feel in contact with this person and not try to save him. In general, these rules can be applied to any relationship, regardless of the type of person.
It is not so important to recognize how pronounced narcissism is, but to pay attention to the quality of your relationship:
- whether there is disrespect, manipulation, aggression or violence
- Does your self-esteem suffer?
- Do you feel better or worse from being with the person? No, it makes sense to think about parting.
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