Psych central narcissistic personality disorder

What Is Narcissism and What Causes It?

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

People with narcissistic personality disorder (NPD) are often regarded as self-centered, 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.

Counseling and professional support can sometimes help them find a different way to connect to others and manage the shifts in mood that may characterize this personality disorder.

Help is available if you or someone you love is exploring an NPD diagnosis. You might find this article and the resources listed at the end a good starting point.

NPD is a formal mental health diagnosis and not just a type of personality or a personal choice.

Understanding this difference is key to managing the formal symptoms of narcissism and supporting someone who’s received this diagnosis.

A mental health condition, including a personality disorder, affects how someone feels, thinks, and behaves.

In turn, this can deeply affect day-to-day living and how people function in their relationships, at work, and in general.

Researchers have found that, specifically, someone with NPD may have a lower ability than others to acknowledge and understand how and why they think and behave the way they do.

Similarly, they may have a difficult time relating to what other people feel or do.

As a cluster B personality disorder, NPD is mainly characterized by behaviors that are:

  • dramatic and exaggerated
  • emotional and intense
  • erratic and unpredictable

Not everyone with narcissistic personality behaves in the same way. This is, in part, because there are different types of narcissism.

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

There are many personality traits, such as generosity and discretion, for example. They show to a greater or lesser degree in all of us. The same thing happens with a narcissistic trait.

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 is such that it permanently affects and hurts how they relate to others and themselves.

Narcissism as a personality trait might occasionally appear in some of our behaviors 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 received from your boss when they’re around. Maybe you even give them an unfairly poor review at some point.

But this is an occasional reaction related to this specific co-worker instead of a generalized 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

NPD is one of 10 personality disorders. These are a group of mental health conditions characterized by persistent thoughts, emotions, and behaviors that may be harmful to the person with the disorder or to others.

In general, a mental health professional diagnoses a personality disorder if at least these two criteria are met:

  1. Personality traits make it difficult for that person to relate and connect to other people or themselves. For example, how they control their own behavior or how they respond emotionally to other people.
  2. Pathological personality traits keep showing up and across many different situations.

“Pathological,” in mental health terms, refers to thoughts, emotions, or behaviors that negatively affect how a person sees, relates, and adapts to the world around them.

Pathological may also refer to traits caused by a mental or physical condition that aren’t expected or accepted in the culture they live in.

Not all personality disorders show the same symptoms or pathological personality traits. This is why they’re classified into three different groups, or clusters.

This classification is based on their most representative personality traits:

  • Cluster A: odd and eccentric
  • Cluster B: dramatic and erratic
  • Cluster C: fearful and anxious

NPD is part of the cluster B personality disorders.

More specifically, doctors diagnose narcissism when a person shows five or more specific symptoms.

These NPD symptoms have been established by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association. It’s a handbook mental health professionals use as a classification reference for making accurate diagnoses.

Not everyone with narcissistic personality will have these symptoms in the same degree or intensity, but five of them need to be present over time and across different situations for a diagnosis to be made.

Even though there’s still no consensus, some experts believe that fragility, fear, and low self-esteem could explain some NPD symptoms.

Grandiosity and self-importance

Exaggeration is often the basis for grandiosity. This means that people with NPD tend to have an inflated sense of self-importance. They may feel they’re more powerful, intelligent, capable, and charming than they really are and more than other people in general.

To reaffirm this sense of superiority, someone with narcissistic personality may exaggerate or lie about their accomplishments, skills, and talents.

For some people with NPD, this sense of superiority isn’t as evident in how they behave. Some may be shy or withdrawn, but they may still firmly believe they’re superior in one or many aspects compared to other people.

Fantasies of perfection and superiority

People with narcissistic personality may constantly fantasize about having unlimited power, intelligence, beauty, acceptance, or love. They often believe they deserve it more than others.

Sense of specialness and uniqueness

People with NPD may have the need to highlight how special and unique they are in comparison to everyone else.

This also leads them to believe they can only be understood by or associate with other special and unique people and groups.

If someone doesn’t “get them,” it’s because they’re not as smart, special, or unique.

Need for praise and attention

People with narcissistic personality may have a constant need to be admired and praised. They might seek constant attention and might not take well to any form of criticism.

They may also resent others who don’t think what they’re doing and saying is exceptional.

Strong sense of entitlement

Someone with NPD may be convinced they deserve special treatment and have the right to all the available privileges.

Similarly, people with NPD might feel everyone should comply with their expectations and demands.

A tendency to exploit others

Manipulation and exploitation tactics are very common in many people with narcissistic personality. This means they may take advantage of others to achieve their own goals because there’s a need for personal gain above everything else.

People with NPD might also use strategies such as spreading lies about others in order to get ahead.

In many instances, a person with NPD may turn to cruelty when they feel their needs aren’t met, or if someone doesn’t treat them the way they expect.

Lack of empathy

Someone with NPD might be unable to connect with the needs of others or put themselves in someone else’s shoes. This is one of the main reasons why they might behave in a cruel or exploitative way.

This lack of empathy might also show as selfishness, disregard, and lack of compassion for what others are experiencing or feeling.

Jealousy, envy, and distrust

People with this personality disorder usually believe others are competing with them or are envious of who they are. In the same way, they may often compete with others or feel envious of their accomplishments.

Arrogance and scorn

Some people with narcissistic personality may disregard others as worthless, ridiculous, or despicable. This belief may lead them to display an attitude of arrogance and scorn.

It’s now accepted that there are different levels and types of narcissism.

Mainly, experts focus on two different subtypes of NPD.

Overt narcissism

This subtype of narcissism, also called grandiose narcissism, is the most recognized. It’s mainly characterized by attitudes and behaviors that are:

  • arrogant
  • pretentious
  • dominant
  • exhibitionist
  • aggressive
  • self-assured

Covert narcissism

This other subtype of narcissism refers to people whose attitudes and behaviors are more typically:

  • anxious
  • overly sensitive, particularly in regard to criticism
  • insecure
  • defensive
  • depressive
  • withdrawn

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

Narcissistic personality is one of the least studied personality disorders. This makes understanding its causes and treatment options more difficult.

There’s little agreement within the medical community regarding what really causes someone to develop NPD.

Most researchers believe NPD is a response to a combination of two or more of these factors:

  • environmental and cultural influences
  • early life experiences and the parent-child bond
  • genetics

In other words, someone may have developed narcissistic traits as a response to the specific situations they’ve experienced since very early in life, like:

  • a traumatic event
  • negligence and abandonment
  • excessive criticism from a loved one
  • living with a parent or guardian with a mental health condition
  • abuse of any kind
  • discrimination
  • excessive pampering and praising
  • a medical history of NPD in the family
  • growing up in an individualistic culture

Not everyone will respond in the same way to these events. That’s why it’s difficult for researchers to determine the exact causes of a personality disorder.

Also, these same reasons might lead someone to behave in a certain way that may be perceived as narcissistic, even if it’s not NPD.

The diagnosis of NPD should be left to a mental health professional only.

It might be tempting to evaluate someone you know based on this information, but in reality, narcissism goes far beyond a few behaviors or attitudes. It’s impossible for someone not formally trained and educated to make a proper diagnosis.

A psychiatrist, psychologist, or another mental health professional typically makes an NPD diagnosis after having direct access to the person and their medical history.

Even for a mental health professional, it might not be as easy in some instances to diagnose NPD. This is because it’s rare for someone with NPD to commit to seeking help, openly talk about their thoughts, or even attend a therapy session.

A mental health professional might follow the DSM-5 model to diagnose NPD. They’ll then observe and measure the following:

  • individual personality traits
  • how the person functions in the world (relationships, jobs, etc.)
  • sense of identity
  • self-esteem and changes related to their self-image over time
  • if the person is capable of empathy

The mental health professional will try to identify five or more of the symptoms of NPD. If they do, they’ll be able to make a diagnosis and recommend treatment accordingly.

Even though teenagers may display early signs of the disorder, NPD is usually diagnosed in adulthood.

This is because children and adolescents are still under constant physical and mental development. These ongoing personality changes at an early age might make it difficult to recognize lasting patterns of behavior.

If an NPD diagnosis is made during adolescence, it’s because there’s a clear pattern of behavior that’s been evident for more than 1 year.

There’s been some controversy regarding how NPD is diagnosed.

This is mostly because many mental health professionals have focused on the most visible interpersonal behaviors of those with NPD and not enough on the inner struggles, vulnerabilities, and challenges they live with. This sometimes leads to judgment instead of understanding.

Experts estimate that about 5.3% of the U.S. population has NPD. It’s an estimate because a diagnosis depends on many factors, including how willing a person is to seek a diagnosis and treatment. This might not be the case for many people with the disorder.

NPD diagnoses are more common among men than women. Fifty to 75% of people diagnosed with NPD are male.

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.

People with NPD are sometimes more likely to develop other mental health conditions, such as:

  • anxiety disorder
  • depression
  • substance use disorder

In many cases, they might seek help to treat these conditions and not NPD itself.

Sometimes, a person with NPD may seek treatment for reasons other than believing they have an issue. For example, when they feel conflicted because their relationships or way of living isn’t up to their own high standards. Or when they feel they’re losing someone’s admiration or interest.

When someone with NPD comes to therapy for these reasons, they’re not aware these difficulties might come from their own personality traits. They might blame others for their issues and may see therapy as a place to vent, not wanting to accept any responsibility.

Even when NPD treatment is sought, clinical case studies suggest people with NPD have difficulty staying in therapy long enough to lead to long-term changes in behavior.

For one, people with NPD may face challenges interacting with other people in general, which shows in the therapist-client setting. Also, they may not often recognize they have a problem.

Sometimes when a person with NPD stays in therapy, they may show slow progress and be reluctant to change because of the disorder’s core personality traits. Since they might not accept responsibility, they may find no valid reason to change.

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 behaviors and attitudes that may lead to conflict with other people
  • develop the ability to prevent and change these behaviors
  • manage reactions to criticism and feedback
  • develop skills to build more intimate and stable relationships
  • develop adaptive coping mechanisms
  • 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.

Many psychotherapy approaches have been used to treat NPD. The most common ones include:

  • psychoanalytic psychotherapy
  • cognitive behavioral therapy
  • schema-focused psychotherapy
  • metacognitive interpersonal psychotherapy
  • dialectical behavior therapy

Whether you or someone you love wants to explore treatment for NPD, many resources are available to help you find support. The following organizations can point you in the right direction:

  • American Psychiatric Association
  • American Psychological Association
  • National Alliance on Mental Illness
  • National Institute of Mental Health
  • U.S. Department of Health & Human Services
  • Project Air

Narcissistic personality disorder (NPD) is a formal mental health diagnosis. It’s not a personal choice of behaviors. It requires a proper diagnosis by a mental health professional.

Although there are different subtypes of NPD, the most common symptoms are a strong sense of entitlement and superiority, need for attention, and lack of empathy.

These symptoms can have a direct impact on how the person relates to others and themselves.

People can manage NPD symptoms when they’re committed to staying in therapy long term. Treatment can help regulate emotions and change hurtful behaviors to healthy ones.

Narcissistic Personality Disorder Quiz | Psych Central

In our selfie-obsessed and self-posting culture, we’ve all likely heard the word narcissism thrown around. Oftentimes, it’s used to describe someone who seems overly vain or full of themselves.

But is that really what narcissism means?

More accurately, narcissism is one of 10 personality disorders. It’s defined as an inflated sense of self. If you’ve had moments of narcissism, don’t worry. You’re not alone.

Each person is narcissistic in some way. We all have moments — whether that’s believing you’re the best person for your job or the best looking person in the room. We can all recognize areas where we feel unique and special.

But if the need to feel special and important becomes excessive, you might be living with symptoms of narcissistic personality disorder.

Narcissistic personality disorder (NPD) is one of 10 personality disorders.

Narcissistic traits can affect how a person thinks, feels, and behaves. In turn, this can affect day-to-day living and how someone functions at work and in their relationships.

People with narcissistic personality disorder often present with five or more specific symptoms, including:

  • grandiosity and self-importance
  • sense of specialness and uniqueness
  • fantasies of perfection and superiority
  • need for praise and attention
  • strong sense of entitlement
  • lack of empathy
  • jealousy, envy, and distrust
  • arrogance and scorn
  • a pattern of manipulating others

Not everyone will have the same symptoms. The condition can present in different ways from person to person.

So, if you have any of these symptoms, does this mean you’re narcissistic?

Not necessarily. Just having or exhibiting these behaviors doesn’t mean that you have narcissistic personality disorder.

Our narcissistic personality test can help you find out if you might benefit from an evaluation by a mental health professional for narcissistic personality disorder. But remember: This test is only a screening tool. Only a mental health professional can accurately diagnose the condition and recommend treatment options, if needed.


Here you’ll find a list of 40 statements. For each statement, choose the one that best matches you (even if it’s not a perfect fit). Complete the quiz on your own and in one sitting, which takes most people about 5 to 10 minutes.

Answer all questions honestly for the most accurate result.

This online screening is not a diagnostic tool. Only a trained medical professional, like a doctor or mental health professional, can help you determine the next best steps for you.

Disclaimer: This quiz is for entertainment purposes only. In no way is this an empirically validated test. The concepts presented aren’t rooted in any known research.

Ready to start therapy? Our Find a Therapist resource may help.

Narcissism - what it is, signs and causes of narcissistic personality disorder

About who people with narcissism are, where it comes from and whether it is always necessary to break off relations with narcissists, says Anna Krymskaya, a clinical psychologist and co-founder of the online psychological help service YouTalk

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?

What is narcissism

Psychologically, narcissism is an exaggerated belief about one's contribution to society or a group, otherwise known as excessive narcissism or even self-centeredness. 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 the narcissistic tendencies are and whether they interfere with life, the spectrum of narcissism can be divided into four parts:

Character and accentuation are options for a healthy manifestation of narcissism, and personality disorder is already a psychiatric diagnosis.

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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.

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.
  • 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.
  • 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.

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 American DSM-5 classification of diseases, in early adulthood, a person must exhibit five or more of the following characteristics of narcissism:

  • Preoccupation with fantasies of unlimited achievement, influence, power, intelligence, beauty, or ideal love.
  • Belief in one's individuality and uniqueness, accompanied by the need to communicate only with people of the highest level.
  • The need for unconditional admiration.
  • Feeling entitled to a reward.
  • Exploitation of others to achieve one's own goals.
  • Lack of empathy.
  • Envy of others and belief that others envy them.
  • Arrogance and haughtiness.
  • In Russia, however, since January 2022 it has become impossible to get a diagnosis of Narcissistic Personality Disorder, because our doctors do not follow the 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.

    Is it worth labeling a person "narcissus"

    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.

    In addition, in psychology there are many different classifications of narcissism that better convey the shades of this phenomenon than one term.

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    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.

    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.

    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.

    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.

    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 enjoy 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.

    Because women are often criticized for being aggressive and authoritarian, they can suppress these narcissistic traits while men do not have to. 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.

    Representatives of psychoanalysis paid particular 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.

    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.

    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.

    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.

    Treatment of narcissism

    Both narcissistic personality disorder and narcissism in the broadest sense 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.

    If your relationship is bad, 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.

    Together 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.

    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? No, it makes sense to think about parting. In the case of an abusive relationship without outside support, this can be very difficult. Psychotherapy can help you find a resource for ending a relationship, as well as understanding the reasons why you ended up and stayed in it so that the scenario does not repeat itself in the future.

      If it seems to you that a person has strong narcissistic inclinations, but at the same time the relationships themselves are built on mutual respect, warmth and sincerity, there is no violence in them in any form, then you should not break off contact just because the person is a “narcissist”.

      Official website of the Minsk City Clinical Center for Psychiatry and Psychotherapy

      Sedach Natalya Andreevna, psychotherapist of the health care institution "City Clinical Psychiatric Dispensary"

      The topic of narcissism has long attracted and still continues to attract the attention of many people. The term narcissism was borrowed from the ancient Greek myth of Narcissus, a young man who fell in love with his own reflection and died of unrequited love for himself.

      All of us in our early childhood development go through the stage of normal narcissism in order to become a more whole person. During this period, the attitude of parents towards us will determine how much narcissism we take with us and how, namely the attitude of "healthy" parents who keep their unhealthy narcissism under reasonable control and are able to develop the individuality of their children and in doing so teach them to appreciate and respect other people.

      Healthy narcissism allows us to laugh at ourselves, our imperfections and shortcomings, go deep within ourselves to create something unique, our own, and leave a trace of our activities in the world. Healthy narcissism speaks of a person's ability to feel emotions in all their diversity, sharing his emotional life with other people, the presence of his wisdom, which allows him to separate truth from fantasy, and at the same time, the ability to dream, along with the ability to confidently go to your goal and rejoice in your own successes, without dwelling on tormenting doubts. Healthy narcissism depends on a person's real self-esteem, which is exactly what is completely absent in people, whom we usually call narcissistic personalities.

      We consider the narcissistic personality unhealthy. This is a person of any age, who, at the same time, has not yet reached his emotional and moral development, l whose personality is organized around maintaining self-respect by receiving confirmation from . Concerned about how he is perceived by others, the narcissistically organized person has a deep feeling that he is deceived and unloved. He lacks a realistic sense of the Self (according to Jung, the Self is the archetype of integrity and the central organizing mental factor; the Self is the root structure, the fundamental principle of personal identity) and an internalized system of values. Instead of an accurate assessment of individual strengths and capabilities, there is a pose of extra importance, completely unrelated to his true achievements and successes. Instead of showing humility towards his inevitable shortcomings, he is overwhelmed by a completely unbearable sense of shame, often carefully disguised. The narcissistic personality is characterized by a lack of ability to appreciate, and even recognize the independent existence of other people or their feelings. The narcissistic personality may be fearsome and even hypnotic, but behind its bombast or charm lies an emotional inferiority combined with the moral development of a child who has just begun to walk. The clinical literature consistently emphasizes shame and envy as the main emotions associated with the narcissistic personality organization. The subjective experience of narcissistic people is imbued with a sense of shame and fear of feeling shame . Narcissistic patients may exhibit addiction traits as they need recognition and worship; they are deeply incapable of dependence due to distrust of others and their depreciation . Analytical investigation reveals an intense oral anger which is central to their psychopathology, as well as an object relationship pathology: an inability to depend on "good" internal objects while expressing relations with "threatening" objects. Modern clients often feel rather subjective empty than overflowing critical internalizations. They are worried that they “do not fit in”, and not because they are betraying their principles. They may incessantly reflect on visible virtues—beauty, fame, wealth—or displays of political trustworthiness, but not on the more hidden aspects of their identity and integrity. "Image" replaces essence, and what Jung (1945) called persona (presenting oneself to the outside world) becomes more alive and reliable than the actual person.

      Sandy Hotchkis called "The Seven Deadly Sins of Narcissism":

      1. shamelessness, 2. magical thinking (a feeling of grandiosity and omnipotence), 3. arrogance, 4. envy along with her sidekick contempt, 5. pretension to possess right and accompanying rage,

      6. exploitation (the desire to use others), 7. weak interpersonal boundaries.

      Sandy Hotchkis called these traits "mortal", because, having penetrated into everyone who comes into contact with them, they destroy the integrity of his personality; and at the same time they are “sinful”, since they destroy the personality of the person himself. The seven deadly sins of narcissism not only cripple and injure others, but also prevent the narcissistic personality itself from developing its true Self.

      Shame is one of the most unbearable feelings of a person, regardless of his age and life situation. Unlike guilt, it does not indicate a mistake, but the suffering associated with a common personality flaw. To ensure the normal development of the child's brain, parents must do what the child's brain cannot itself - soothe the child, relieving him of the shame that they themselves have caused. If the parents do not reassure the child to rid him of the shame they have caused, the children develop their own means of compensating for shame - they "shake off" the unbearable feeling and resort to fantasy to hide from the monster, leaving it behind the wall. They cling to their own self-image, believing they are special, powerful, and significant. The shame of the narcissistic personality turns out to be so unbearable that such means, which were developed in childhood, no longer help her. What psychologists call “bypass shame” looks like shamelessness or shamelessness hiding behind a protective barrier of denial, coldness, condemnation or rage. Since there are no healthy internal mental mechanisms capable of processing this painful feeling, shame is directed outward, away from the Self. It will never become "my flaw". Shame is a feeling that is always hidden in unhealthy narcissism, and failure to deal with it in healthy ways - fighting it, neutralizing it, and then doing what normal people do, leads to postures, attitudes and behaviors, characteristic of a narcissistic personality.

      Magical thinking, exploitative idealization and devaluation of other people through the shifting of shame and humiliation are all attempts by narcissistic personalities to avoid feelings of inferiority and worthlessness. At best, this creates barriers to intimacy and acceptance. In a relationship with a narcissistic person, you never know what it means to be loved and valued by him - just the way you are. At worst, endless distortions and transfers will make you feel confused and lower your self-esteem.

      Behind the mask of arrogance of the narcissistic personality lies a self-esteem balloon ready to deflate, which is never satisfied with the fact that such a person is considered good or even very good. If he is not considered "better than ...", then he is useless. From this perspective, if the value of someone else goes up, the value of the narcissistic person goes down accordingly. Conversely, if the narcissistic person feels “deflated”, energetically depleted, then she can again achieve her usual sense of superiority by humiliating, devaluing or insulting the other person. This is why narcissistic personalities often exhibit domineering, perfectionistic behavior, showing an undisguised lust for power.

      For a narcissistic personality, any competition is a way to once again assert their superiority, although many of them enter into competitive relations only when they foresee a favorable ending for themselves. Feeling the burning shame of defeat, such people tend to choose a field of action where they can shine without taking too much risk and effort, and when they succeed, they can become obsessive in their pursuit of excellence. All this time they crave worship and adoration from those around them. This desire for admiration in narcissistic personalities usually arises from the fact that they feel somewhat insecure and need some emotional nourishment. It is absolutely unacceptable for them if they are considered ordinary or average, because when they cannot be the best, they are nothing. Narcissistic individuals can rarely maintain their own sense of superiority on their own, so they are drawn to where they would be in the spotlight, they need praise, applause, recognition from others who would support their sense of superiority. It is important for them to recognize how smart, unique they are. and unique. The attitude of arrogance and superiority serves as a protective barrier that isolates them from the intolerable sense of shame associated with their inferiority. Inside themselves, they are under the critical, shaming gaze of the parent, from which they need to hide at all costs. So when you face the arrogance of a narcissistic person, what you see is not true pride, but a deep and irrational fear of your worthlessness. The only way to somehow cope with this fear is to feel important and significant and, as it turns out, more important and significant than everyone around.

      Narcissistic envy, fueled by a desperate hope of superiority, is unconscious or even denied, which makes it even more dangerous. Unaware of their envy or need for superiority, narcissistic personalities may feel only self-satisfied contempt, signifying hatred.

      People who pretend to be respected by others but do not respect others, or expect rewards and encouragement without making any effort, or desire to live without experiencing discomfort, are deprived of the energy that they could have to determine your own destiny. When what they expect does not happen in reality, they feel powerless. Claiming their right, they thereby demand for themselves life in the fantasy world of a one-year-old baby. Therefore, one should not be surprised at their attacks of rage.

      The claim to entitlement and the rage that goes with it is a serious allusion to the retardation in healthy development that is called narcissism.

      Exploitation always involves taking advantage of other people without regard for their feelings or interests. Often the other person finds himself almost in a servile position, when it becomes difficult or even impossible for him to resist.

      The narcissistic personality suffers from a deep characteristic flaw in the development of the sense of the Self. This flaw deprives such people of the ability to recognize the presence of their own boundaries, as well as to perceive other people as separate individuals, and not an extension of their own. Other people either exist to meet the needs of the narcissistic personality or may not exist at all. In the psyche of the narcissistic personality there is no boundary between his own Self and the other person.

      The main fear of a narcissistic personality is to face his insignificance, uselessness. The fear of being unnoticed or insignificant is even stronger than the fear of rejection. All his defenses work to ensure that he can avoid the feeling of inner emptiness and his own alleged insignificance. The narcissist experiences fear in two ways: either he attacks the offender, accusing him of all imaginable and unimaginable sins, or he goes into depression, often accompanied by some kind of psychosomatic illness, during which he receives care and care that helps him heal his spiritual wounds. P. Mollon and G. Perry drew attention to the fact that the “depressive prison” is the only form of protection for the fragile, vulnerable real narcissistic self. The envy and rage inherent in narcissistic personalities are experienced as hopelessness and helplessness.

      There are different points of view in the literature about narcissistic depression, which is characterized by feelings of loss of meaning, emptiness, apathy for no apparent reason.

      A. Beck distinguished between two types of depression: depression associated with deprivation, and depression of defeat (failure to achieve goals). Since defeat, "failure" for narcissistic personalities is "not being the first" (Kernberg O.F., 1975), a tendency to defeat depression is obvious.

      But there are also points of view on narcissistic patients as incapable of depression. O. Kernberg defends it most consistently, emphasizing that what on the surface looks like depression is anger and indignation, a load of vindictive feelings, and not sadness due to a loss. M. Dzhesovich-Gesich and J. Wesel argue that when the object is lost, the narcissistic personality is sad about the loss of the “mirror”, the lack of admiration leads to dysphoria and self-hatred. O. Kernberg also believes that the loss is experienced not of the object, but of the narcissistic provision. The researcher believes that even a slightly expressed capacity for sadness and depression, with elements of guilt, is a favorable prognostic indicator for treatment outcomes. The critical period in the treatment of narcissistic patients is characterized, in the author's opinion, by the emergence of a destructive sense of guilt for all previous aggression against the analyst, for his depreciation and destruction. There is despair over the mistreatment of the analyst and all the significant figures that the patient could love and who loved him. During this stage of treatment, narcissistic patients often have suicidal thoughts. When they pass the critical period, they become capable of love, care and gratitude. Cavalier-Adler describes the fear of crying that is typical of the narcissistic personality. Patients with narcissistic personality disorder constantly reject the fear of being consumed by their own pain. Unshed tears of decades of suppressed pain create an unconscious threat to "drown in your own tears." They experience fear of constant crying in the process of the affect of grief; tears are caused by the horror of losing the object of a fantastic fusion and at the same time the horror of being absorbed by the one with whom you want to merge.

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