Narcissism was first identified as a mental disorder by Havelock Ellis in 1898. The disorder is named after the mythological Narcissus, who fell in love with his own reflection. According to Sigmund Freud, narcissism is a normal stage in children’s development, but it is considered a disorder when it occurs after puberty.
Narcissism is a less extreme version of Narcissistic Personality Disorder. Individuals having Narcissistic Personality Disorder believe that the world revolves around them. They lack an ability to empathize with others and have intense desire to keep a focus on them all the time. This personality disorder is characterized by arrogant behavior and a need for admiration, which is consistently evident at work and in relationships. Individuals with this disorder have cockiness, manipulativeness, selfishness, power motives, and vanity (especially, a love of mirrors).
Narcissists rate themselves as having high self-esteem. Normally, people, who have high self-esteem, are humble, whereas narcissists rarely are. It is generally thought that narcissists behave so because they are actually insecure deep down, but latest evidence indicates that they are actually secure deep down too. They have a sense of grandiosity. When their self-esteem is threatened e.g. being ridiculed, they can turn aggressive.
Signs of narcissistic personality disorder – Such people:
Have a sense of grandiosity – The persons with narcissistic personality disorder (NPD) exaggerate achievements and talents; they expect to be recognized as superior though they don’t possess commensurate talents.
Require excessive admiration – They expect excessive admiration from others, failing which they feel bad and develop ill feelings toward those, who don’t admire them.
Believe that they are special – They harbor the belief that they are special and unique; they think that they can only be understood by people who are special and have high status.
Always fantasize – Most of the time, they are preoccupied with fantasies of unlimited success, power, beauty or ideal love.
Lack empathy – They are unable or unwilling to recognize or identify with the feelings or needs of others.
Have a sense of entitlement – They have unreasonable expectations of favorable treatments from others. Similarly, they expect that others should comply with as they wish them, failing which they tend to develop animosity toward them.
Exploit others – They are always prepared to take advantage of others to achieve their own ends.
Are envious of others – They are often envious of others but, on the other hand, believe that others are envious of them.
Are arrogant – They mostly show arrogant and haughty behavior toward others.
Devalue others – They devalue the contributions and achievements of others, particularly when those people have received acknowledgement or praise for their accomplishments.
Causes of narcissistic personality disorder – The experts can’t define the exact cause of the disorder, but many theories have been floated by scientists that are noteworthy. Two important causes are as follows:
Bio-psycho-social cause – This includes biological, genetic and social factors. Biological and genetic factors are hereditary, whereas social factors – such as how a person interacts in one’s early development with one’s family, friends and other children – contribute to modify the disorder.
Psychological cause – This includes factors – such as individual personality, environmental effects on one’s learning skills, and mismatch in parent-child relationship with either excessive pampering or excessive criticism.
Matter-of-factly, no single factor is responsible for the disorder. There is intertwining of all these factors that may lead to the disorder. Generally, researchers agree that, in biologically vulnerable children, the parenting styles that overstress the child’s specialness and criticize its failures and fears may be responsible for the disorder to some extent. As a result, the child may build up low self-esteem, which it may hide by developing a superficial sense of perfection and behavior, needing a constant admiration. Research also suggests that there is an increased possibility of the disorder to be passed down to their children by those suffering from it.
Complications – The disorder is fraught with risks of developing some complications as follows:
- Alcohol or drug abuse
- Suicidal thoughts or behavior
- Relationship problems
- Problems at school or work
Management – Long term outpatient care is the choice management that usually involves psychotherapy, medication and lifestyle changes.
Psychotherapy – Psychoanalytical psychotherapy is the mainstay of treatment for such individuals. Besides, group therapy and cognitive behavior therapy (CBT) are also used to treat the disorder. The group therapy usually involves processes, requiring empathy, patience, and an ability to relate and connect to others; all these traits are lacking in persons having narcissistic personality disorder. The studies show that long-term group therapy can benefit patients with narcissism by providing them with a safe haven, in which they can explore boundaries, receive and accept feedback, develop trust, and increase self-awareness.
CBT also has the potential to benefit narcissistic patients. There is a specific form of CBT, known as schema-focused therapy, which centers on repairing narcissistic schemas and the defective moods and coping styles associated with them. Core schemas of narcissism are emotional deprivation and defectiveness, which is a part of lonely child disorder.
Medication – The disorder per se doesn’t require any specific medications. However, symptoms of depression, anxiety or any other condition that may accompany narcissistic personality disorder require appropriate treatment, which will be helpful in managing the disorder.
Lifestyle changes – Apart from above modalities of management, the disorder also requires some important lifestyle modifications that affect seriously the outcome of its management.
- Learn about the disorder – Having a correct knowledge about the disease – signs and symptoms, risk factors and treatments – will help the individual immensely. The parents and others closely associated with the person should also educate themselves about the disorder, because they can also play a helpful role in its management.
- Get treatment for an associated problem – Substance abuse, depression, anxiety or any other illness nourish the disorder; so, the individual should remember that the proper treatment of the concomitant problems and abstinence from substance abuse are of equal importance as the treatment of the disorder itself.
- Learn stress management – Since stress and anxiety nourish the disorder, one should learn stress management techniques – such as meditation, yoga, tai chi in order to reduce stress in life.
- Stay focused – Since recovery from narcissistic personality disorder takes time, the individual should stay focused and patiently follow the advice of the experts about its management.
Summary – The incidence of narcissistic personality disorder is present up to 6.2% in people varying from community to community and 50% to 75% of them are predominantly males. The disorder is characterized by an arrogant behavior and a need for admiration, which is consistently evident at work and in relationships. Individuals with this disorder are selfish, and have power motives, and vanity. They have a strong belief that the world revolves around them. People having the disorder are most likely to have relationship problems with fellow students at school, associates at workplace and family members. They are most prone to develop alcohol and drug addiction; they are also prone to have depression, and suicidal thoughts and behavior.
The management of narcissistic personality disorder includes psychotherapy, medication if any concomitant illness is present and certain lifestyle changes. The management is long term, the outcome of which depends upon good compliance to the expert advice by the patient, and co-operation of the family members and other close associates.