Narcissistic Personality Disorder: Unpacking The Traits

The term 'narcissism' was derived from Ovid's, the Roman poet, Metamorphoses Book III in the story of Narcissus and Echo. In Ovid's myth, Narcissus is a charming young man who believes he is too worthy for any maiden. When it came to Echo, a nymph cursed to only mimic the last few words of others, she is rejected by Narcissus. He is then punished by Nemesis, the goddess of vengeance, and his punishment is to fall in love with himself without ever being able to accept that love. Therefore, when he drinks from a pool, he falls in love with his reflection, but realizing he will never be able to love himself, he dies. Narcissism was later used as a psychoanalytic term (Ovid, 8 AD/2004).

Narcissistic Personality Disorder: Exploring the Characteristics

Havelock Ellis was the first psychologist to use the term "Narcissus-like" clinically. Ellis connected Ovid's myth to auto-eroticism, which is the sexual arousal when using your own body as the sexual object, with one of his patients. Sigmund Freud then applied the terms "ego-libido," "self-love," and "narcissistic libido" in his Three Essays on the Theory of Sexuality, similar to Ellis. With both Freud's and Ellis' psychoanalytic narcissism, there was the "self-gratifying sexuality" that is not a part of the clinical definition today (Freud, 1905/2000).

The idea of narcissism then began to include characteristics that were more familiar to personality and social psychologists. Ernest Jones derived narcissism as a character trait which he named the "God-complex." Jones describes the God-complex as self-admiring, self-important, overconfident, with the big need for uniqueness and appraisal by others (Jones, 1913).

In Freud's On Narcissism: An Introduction, he defends narcissism as being something children need as a maturational phase of healthy development, a "complement to the egoism of the instinct for self-preservation" (Freud, 1914/1991). Ralph Wilder published the first case study of someone with a disordered narcissistic personality. Wilder's case study set the definition of how the disorder is now defined. Heinz Kohut, however, proposed the term "narcissistic personality disorder" in 1968 (Kohut, 1968).

Diagnostic Criteria and Traits

According to the DSM-IV-TR, the diagnostic criteria for 301.81 Narcissistic Personality Disorder, someone must have a "pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, by early adulthood." They also need to have five of nine criteria associated with the disorder (American Psychiatric Association, 2000).

A grandiose sense of self-importance, the first criterion, usually comes with being boastful of accomplishments and pretentious. Often being in their own realm of reality where the emphasis is on them, they fantasize that their efforts are valued by others. Being preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love is another trait. They will always believe admiration and privilege are due without much effort and feel highly comparable to privileged famous people.

Those diagnosed with the disorder believe that they are superior, special, and have impeccable uniqueness, which can only be understood by someone as high-status as them. By believing they can only associate with someone as superior as them, they will feed off the "idealized value" believing they have special needs. With the special needs, they feel they must have "la creme de la creme" for everything.

Those with the disorder require excessive admiration from others. With this said, they are very fragile. They become preoccupied with how they are regarded by others, which causes the need for attention and admiration. Like a child, it can be seen as how a child requires attention. They have a sense of entitlement and unreasonably expect to be favored. They feel that their needs are to be catered to, and if denied, they become furious. With this and lacking any sense of empathy towards others, they are interpersonally explosive. They will exploit others. With the need for "la creme de la creme," they will get everything they can out of someone for their own personal benefit. This is often the cause of abusive relationships. The person diagnosed with the disorder creates relationships and friendships with the primary intention of advancing their purpose or enhancing their self-esteem.

Those diagnosed with NPD lack empathy. They have difficulty being able to understand or recognize someone else's desires, subjective experiences, and feelings. With that, it is very hard for them to be concerned with anyone else if it won't in any way advance their status. They tend to express themselves with no signs of interest in the others' feelings or needs. They often word things in a manner that they can hurt someone, yet they are oblivious to the pain that can be inflicted. If the diagnosed, with NPD, recognize someone's feelings, they will see it as a sign of weakness and vulnerability.

Those diagnosed are envious or believe everyone is envious of them. They tend to be arrogant or have a haughty attitude. If they feel they have not been recognized for their value, they will down-talk anyone who has moved forward. They tend to be snobby and have a patronizing attitude. This is the ninth criterion.

Development and Prevalence

Narcissistic traits are often found in adolescents but that does not mean they will ultimately have the disorder in the future. As Freud had expressed in his works, it does seem to happen to children, but he felt it helped with maturation, and they do grow out of it. Infants, children, and adolescents who face abuse or trauma by parents, authority, and even peers are often those who may have the disorder. Only 0.7-1% of the population is diagnosed with narcissistic personality disorder. Of those diagnosed with the disorder, 50% - 75% are male. Those that are diagnosed do have a problem with aging, due to the limitations that come with aging (Ronningstam, 2005).

Treatment Approaches

I could not find a definite treatment plan because the NPD patients have a different character pathology. Some have "episodically troublesome dysphoria to crippling existential emptiness and lack of valued relationships and goals." Therefore, treatment has to be tailored to each individual patient. With that said, there were common treatments that popped up several times. There is the therapy treatment, which is then separated into three subcategories. There is individual therapy, couples therapy, and group therapy. The therapies deal with Kohut and Kernberg's ideas about the disorder (Kernberg, 1975; Kohut, 1971).

**References:**

- American Psychiatric Association. (2000). *Diagnostic and statistical manual of mental disorders* (4th ed., text rev.).
- Freud, S. (1914/1991). On narcissism: An introduction. In *The Freud Reader* (P. Gay, Ed. and Trans.). W. W. Norton.
- Freud, S. (1905/2000). *Three essays on the theory of sexuality*. Basic Books.
- Jones, E. (1913). The God-complex: A contribution to the study of character. *The British Journal of Psychology*, 5(4), 303-313.
- Kernberg, O. F. (1975). *Borderline conditions and pathological narcissism*. Jason Aronson.
- Kohut, H. (1968). The psychoanalytic treatment of narcissistic personality disorders: Outline of a systematic approach. *Psychoanalytic Study of the Child*, 23, 86-113.
- Kohut, H. (1971). *The analysis of the self*. International Universities Press.
- Ovid. (8 AD/2004). *Metamorphoses*. (A. D. Melville, Trans.). Oxford University Press.
- Ronningstam, E. (2005). *Identifying and understanding the narcissistic personality*. Oxford University Press.
- Wilder, R. (Year unknown). Case study on narcissistic personality disorder. [Publisher or journal, if available].