Narcissistic Personality Disorder : An Overview

INTRODUCTION

Oxford Dictionaries this year announced their “Word of the Year” to be “selfie”. The word selfie has been creating a lot of buzz especially with social networking sites becoming popular. This word means nothing but “photograph that one has taken of oneself”. However a closer look at the very fact that such a word has had so much impact gets us thinking at a deeper level and therefore as a result we probed in to the phenomenon of narcissism. To simply put it in simple terms narcissism is self love. When an individual loves oneself above everybody else it is known as being narcissistic.

Legend has it that according to Greek mythology, Echo a woodland nymph fell in love with Narcissus, a handsome young man. However narcissus refused to accept the love of Echo and rejected her expressions of love. This lead her to feel extremely miserable and hopeless and she succumbed to this ill feeling and eventually died. The Greek God Apollo was angered by this behaviour and thought of punishing narcissus for his pride and self satisfaction and therefore narcissus was condemned to die without knowing what love is. One day when narcissus was feeling thirsty and went to drink water he ends up falling in love with his own reflection and eventually dies as he can never be united with the person he loves and this self absorption kills him.

Narcissistic personality disorder is experienced by 2 to 16 percent of the clinical population and less than one percent of the general population. It is more common among the men rather than women. We all are narcissistic to a certain extent but pathological narcissism is considered unhealthy. Before getting into narcissistic personality disorder it is important to understand what personality disorder is. Personality disorder is considered a mental illness in which the person suffering has trouble in perceiving and relating to situations and people. Interpersonal relations are hampered. The individual tends to have a rigid a pattern of thinking which does not correlate well with the rest of the society. Narcissistic personality disorder is usually found to be present with other personality disorders such as borderline, histrionic or anti social.

DSM – IV – Narcissistic Personality Disorder - Diagnostic criteria

A pervasive pattern of grandiosity (in fantasy or behaviour), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

(1) Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)

(2) Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love

(3) 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)

(4) Requires excessive admiration

(5) Has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations

(6) Is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends

(7) Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others

(8) Is often envious of others or believes that others are envious of him or her

(9) Shows arrogant, haughty behaviours or attitudes

The WHO’s International classification of disease (ICD-10) regards narcissistic personality disorder as a personality disorder that does not fit any other specified personality disorder criteria and falls under the “other specific personality disorders” label.

To understand NPD there are further subtypes through which it is easier to know them:

· Craving narcissists are those who are emotionally needy and therefore mat appear clingy.

· Paranoid narcissists are those who have severe contempt for themselves and project it onto others, they are hypercritical and jealous.

· Manipulative narcissists are those who enjoy lying and manipulating with others.

· Phallic Narcissists are those, generally men who like to show off their masculinity.

CAUSAL FACTORS:

· Family disturbances

· Inadequate parenting

· Inadequate idolization and mirroring

· Influence of media

· Need for social approval

· Social trends

· Abuse or neglect

· Pampering and dysfunctional childhood

TREATMENT:

· Hospitalization in extreme cases – individuals who tend to become impulsive, violent and may cause self harm must be kept and treated in a safe environment

· Psychosocial treatment – client often have ideal images in their mind and often have poor psychological wellbeing, psychosocial treatment in an important way for holistically treating the client

· Individual therapy – address the issue head on and helps the client with his/her problem

· Group therapy – leads to acceptance of disorder and decreasing of defective coping mechanisms

· Counselling to help insight – most people do not accept the presence of the disorder and remain in denial, acceptance is the key to rehabilitation and getting better

· Cognitive behavioural therapy – maladaptive thinking can be replaced with more adaptive and effective ones

· Family therapy – helps both the family and client deal well with the disorder

FAMOUS PERSONALITIES WITH NARCISSISTIC PERSONALITY DISORDER

In world history, there are three names that bring about a chill in your spine. Their sheer charisma and political power changed the world. They were known for their cruelty, manipulations and sadistic attitude. Probably very few know that they were malignant narcissists. Those three great men were none other than Hitler, Stalin and Saddam Hussein. There were common characteristics among them such as grandiosity, self centeredness, oversensitive to criticism and unable to feel empathy. It is believed that their inflated self image was a cover up of their insecurities and fears.

Charlie Chaplin is famous for his slapstick histrionics and he is easily the first person to be an established actor, producer and director. Film critic Richard Schikel described Chaplin as unquestionably the great narcissist in history. He regarded himself as the greatest object of contemplation.Pablo Picasso who was one of the greatest artists was also a hard core narcissist who demanded adoration and in return dominated, manipulated and betrayed. Any friend who was less obedient did not last. His famous painting “Girl before the Mirror” is believed to express his narcissistic character (Picture below)

Narcissism is more in the present times especially among celebrities. The paparazzi, VIP treatment and fan following just adds on to their need for adoration and need for control. A lot of starts who are believed to be lot more narcissistic are Charlie Sheen, Paris Hilton, Madonna, Tom Cruise, and Kim Kardashian. Lance Armstrong is another person believed to be highly narcissistic as he thinks greatly about himself and has a grandiose personality.

The video shows explains narcissism with reference to the movie "The social network".

NARCISSISTIC PERSONALITY DISORDER QUIZ

1) Oxford dictionary’s word of the year:

(a) Photo (b) Kolaveri (c) Selfie (d) Fail

2) Origins of the word narcissism lie in which civilization:

(a) Greek (b) Roman (c) Egyptian (d) Chinese

3) Famous dictator who suffered from narcissism:

(a) Gaddafi (b) Mussolini (c) Kim Jong Un (d) Hitler

4) In the general population it is seen as:

(a) Less that 1% (b) Around 10% (c) More than 15% (d) 50%

5) Meaning of the term “Narcissism”:

(a) Mirror (b) Self love (c) Arrogance (d) Obsessed with others

NARCISSISM TESTING

The narcissism personality inventory is 40-item self report inventory that is used to assess narcissistic traits in an individual. It is not a formal diagnostic tool but has been used to sub-clinical narcissism. The person must choose the statement he best agrees with from the 40 pairs and usually completes it within 5 minutes.

You could take the online version of the test here –

http://personalitytesting.info/tests/NPI.php

The narcissistic personality disorders test too is not a formal test of narcissism but can be used as a screening test for further diagnosis and treatment by a mental health professional. It consists of 12 questions and responses are to be given on a five point Likert scale.

You can take the test’s online version here -http://psymed.info/default.aspx?m=Test&id=89&l=3

PUBLIC OPINION

I think the family in which you are brought up is significant in narcissism. One reason is probably if you were neglected as a child (especially if u have brothers and sisters) u feel the need for attention and to be appreciated in general as u never got it before. I’m not sure but even kids are spoilt by their parents can be narcissistic not spoiled in terms of material stuff but more in terms of getting over appreciated or too much attention for something. so the person wouldn’t be receiving any objective opinions on anything and would probably be given a false sense of the future. so any negative opinions that u get are taken too hard. And I’m not sure about this either but maybe the competitive world that people are brought up in can lead to narcissism. Because of this whole survival of the fittest people might become more and more selfish in nature and think less about others in general. as far as solutions go i really don’t know how u can treat this but in general u can conduct group exercises that forces people to put themselves second to the whole group – Keshav Sundar, Student

People who have Narcissistic PD are essentially attention seekers. The major difference between them and Histrionics are these people look for satisfaction of this need within themselves. They are preoccupied with how they look etc. I'd like to agree with the above post that parenting and home environment plays a very important part. It could one of the possible triggers. The fact that they are so focused on themselves indicates that they probably have had very neglected childhood. In some senses it could be a sort of a defense mechanism that they use against the way are/were treated and brought up. I'm really not sure about this, but in some cases there could also be a possibility of abuse. This again, isn't generalized and I'm not sure of how often this occurs.... but could be a possibility – Varsha Suresh, Student

There may be many genetic and social factors at interplay here as the cause of narcissistic personality disorder. One can never say if it was nature or nurture, or both that affect personality and consequently personality disorders- biggest ongoing debate ever! A person with this personality disorder may have a genetic predisposition such as their temperament which is triggered or reinforced in the symptoms stemming due to deep seated inferiority and a feeling of not being loved- manifested in their grandeur in behaviour, their attention seeking, their arrogance and their desire and expectation to be treated specially. They could be using their "superiority" as a defense mechanism against some feeling of shame or inferiority in some relationship or in general. As important as the cause is, it needs to be managed if not treated. I guess medicines as well as therapy that helps the person realise their situation and condition, and probably come to terms with and manage family or relationship issues or gain closure on past events would be helpful in management – Alekha Acharya, Student

I think it's extreme self indulgence. I think to much consciousness and involvement in one’s own self. It can be associated to extreme admiration and selfishness – Malavika Rao, Student

I think that it’s sort of post-traumatic medical condition, trauma meaning, people aren't born narcissistic, they change into an narcissist because they find a strong reason or a lesson in life which leads them to believe there is no point in thinking about others and they are much better off prioritising themselves. And sometimes, it’s just the way they were brought up....they are made to feel like the centre of the universe since they were too small – Anurag Mulpuri, Student.

POSITIVE NARCISSISM

Narcissism today is being capitalized among all the other things. It is not looked down upon today as much as earlier times probably the changing value system is responsible for this. With increasing competition and globalization there is a need for a larger than life leader and this kind of personality is what Freud dubbed as narcissism. Throughout history there have been narcissistic figures that have inspired people and shaped their futures. However there is a dark side to it. Narcissists are emotionally isolated and distrustful. Achievements can lead to them have feelings of grandiosity. Yet narcissism can be useful and moreover necessary and can be channelized in a proper direction to achieve desired goals. Productive narcissists are risk takers who get their jobs done as well as are charmers who appeal people with their charisma. Their grand vision also helps in establishing huge revolutions in whichever field they choose to. As long as they do not indulge in self destruction and other such behaviour narcissists are a great asset to the society.

https://www.youtube.com/watch?v=dS0Jp_Eu6a8 - This Tedx video shows another way of looking at narcissism.

MIRROR| RORRIM

Bound by a label,
and referred to as disabled.

Know everything about yourself they said,

All I am trying to do is love myself.

What is wrong in loving myself?,

If I don't, then who will?

The world outside is quiet and alone,

I look at myself and it seems time has flown.

Everyone's life seems to be getting clearer,

Only mine seems to blur when I look at the mirror.

I believe in nobody but me,