A Study of The Narcissistic Personality Disorder

Narcissistic Personality Disorder

Narcissus is defined as a pervasive pattern of grandiosity, need for admiration, and lack of empathy that begins by early adulthood and is present in a variety of contexts (Frances, 714). Individuals with this disorder have an exaggerated sense of self-importance; they routinely overestimate their abilities and inflate their accomplishments, often appearing boastful and pretentious. Narcissists possess an exaggerated sense of importance concerning themselves and their work. Their work and self come first while other people, especially close, intimate relationships, become less important. Concerned with self-promotion, narcissists show disdain and a lack of consideration for other people, while upgrading themselves.

The following myth first told by one of the greatest Latin poets, Ovid (43 BC-AD 18) “The Story of Echo and Narcissus” retold by Edith Hamilton serves to demonstrate the destructive nature of Narcissism.

Long ago there lived a beautiful lad, whose name was Narcissus. His beauty was so great, all the girls who saw him longed to be his, but he would have none of them. He would pass the loveliest carelessly by, no matter how much she tried to make him look at her. Heartbroken maidens were noting to him. Even the sad case of the fairest of the nymphs, Echo, did not move him. She was the favorite of Artemis, the goddess of woods and wild creatures, but she came under the displeasure of still mightier goddess, Hera herself, who was at her usual occupation of trying to discover what Zeus was about. She suspected that he was in love with one of the nymphs and she went to look them over to try to discover which. However she was immediately diverted from her investigation by Echo’s gay chatter. As she listened amused, the others silently stole away and Hera could come to no conclusion as to where Zeus’s wandering fancy had alighted. With her usual injustice she turned against Echo. That nymph became another unhappy girl whom Hera punished. The goddess condemned her never to use her tongue again except to repeat what was said to her. “You will always have the last word,” Hera said, “but no power to speak first.”

This is very hard, but hardest of all when Echo, too, with the other lovelorn maidens, love Narcissus. She could follow him, but she could not speak to him. How then could she make a youth who never looked at a girl pay attention to her? One day, however it seemed her chance had come. He was calling to his companions. “Is anyone here?” and she called back in rapture, “Here–Here.” She was still hidden by the trees so that he did not see her, and he shouted, “Come!”–just what she long to say to him. She answered joyfully “Come!” and stepped forth from the woods with her arms outstretched. But he turned away in angry disgust. “Not so,” he said; “I will die before I give you power over me.” All she could say was, humbly, entreatingly, “I give you power over me,” but he was gone. She hid her blushes and her shame in a lonely cave, and never could be comforted. Still she lives in places like that, and the say she has so wasted away with longing that only her voice now is left to her.

So Narcissus went on his cruel way, a scorner of love. But at last one of those he wounded prayed a prayer and it was answered by the gods: “May he who loves not others love himself.” The great goddess Nemesis, which means righteous anger, undertook to bring this about. As Narcissus bent over a clear pool for a drink and saw there his own reflection, on the moment he fell in love with it. “Now I know” he cried, “what others have suffered from me, for I burn with love of my own self–and yet how can I reach that loveliness I see mirrored in the water? But I cannot leave it. Only death can set me free.” And so it happened. He pined away, leaning perpetually over the pool, fixed in one log gaze. Echo was near him, but she could do nothing; only when, dying, he called to his image, “Farewell–farewell,” she could repeat the words as a lat good-by to him. They say that when his spirit crossed the river that encircles the world of the dead, it leaned over the boat to catch a final glimpse of itself in the water.

A Brief History of Narcissism

In 1898, Ellis first used the term narcissism in relation to psychology phenomena when he describe a special state of auto-erotism in which sexual feelings become absorbed in self admiration. Freud later incorporated the term into his psychoanalytic theory in his 1914 essay ‘On Narcissism’. Freud considered narcissism a sexual perversion involving a pathological sexual love of one’s own body. These two theories cite developmental problems in childhood as causal factors leading to the development of Narcissistic disorder, while others suggest that society as a whole causes the disorder. Since then several other psychological theories have attempted to explain and treat the disorder. However, the psychodynamic perspective of Narcissism offers the most comprehensive explanation of the disorder.

The Psychodynamic View of Narcissism

Two overlapping schools of thought dominate the psychodynamic model of Narcissism: the self-psychology school represented by Kohut and the object relations’ school represented by Kernberg. Kohut suggests narcissism is a component of everyone’s psyche that we are born with the disorder. Kernberg argues that narcissism represents a fixation in ones of the developmental periods of childhood.

The Self Psychology School

Heinz Kohut believed that narcissism was a natural and normal development from birth to adult. In which a healthy normal person, would be able to transform his or her infant narcissism into adult narcissism. “Transmuting internalization” is a term he used to describe the process in which an infant transforming into an adult would encounter various challenges resulting into some frustration. Having optimal frustrations leads the person to develop a strong internal structure or a strong sense of ones self. This is used to compensate for the lack of external structure or support from others, thus if the narcissist process of transmuting is obstructed. Due to a level of frustration that exceeds the optimal frustration, in which the person experiences. He or she will be stuck in the infantile level, displaying many characteristics of omnipotent and invulnerable child.

The Objects Relations School

Otto Kernberg’s views of narcissism are based on Mahler’s theory of separation. Consisting of an individual process of separation, from infancy to early childhood. The developing child gains a stable self-concept by mastering two major phases, normal autism and symbiosis, along with four other sub phases: differentiation, practicing, rapprochement, and consolidation of separation-individuation. Kernberg argues that an individual is unable to successfully master the rapprochement sub phase and becomes fixed at this level. At age 10 to 14 months begins the development stage, in which the child learns to walk. This ability, gives a whole new perspective for the child thus giving a sense of grandiosity and omnipotence, which resembles a narcissist behavior. At age 14 to 24 months the child enters in the rapprochement sub phase finding that he or she has limits of what he or she can do. If the child is severely frustrated they adapt by refusing or consequently returning to the practicing sub phase. This will be his or her security omnipotence and invulnerability.

Diagnostic Criteria for Narcissistic Personality Disorder

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders identifies nine criteria for diagnosing Narcissistic Personality Disorder. The essential feature of the disorder is a pervasive pattern of grandiosity, need for admiration, and lack of empathy that begins by early adulthood and is present I a variety of contexts as indicated by five or more of the following diagnostic criteria:

The individual has a grandiose sense of self-importance. These individuals routinely overestimate their abilities and inflate their accomplishments. They often exaggerate their achievements and talents, and fully expect to be recognized as superior without the corresponding achievement. They will often be surprised when the praise they expect and feel they deserve does not come. They also tend to underestimate or devalue the contributions of others in order to raise their own contribution in the eyes of others.

Those suffering from Narcissistic Personality Disorder are often preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love. They often think or fantasize for long periods about getting the admiration of others.

A Narcissist will believe he or she is “special” and unique and can only be understood by other special people. They also believe they should associate with other special or famous people. A Narcissist may insist on having the best lawyer represent him, or a famous doctor care for an illness.

A Narcissist requires excessive admiration. Since their self-esteem is usually vary fragile, they may be preoccupied with how well they are doing and how favorably others regard them. This often takes the form of a need for constant attention and admiration to the point of expecting their arrival to be greeted by great fanfare.

A Narcissist often has an unreasonable expectation of especially favorable treatment or automatic compliance with his or her expectations. They expect to be catered to and sometimes will become furious when they do not receive such treatment.

A Narcissist will take advantage of others to achieve his or her own ends. They will expect to be given what ever they want or feel they need regardless of the impact it will have on others. They will often take special privileges and extra resources they believe they deserve because they are so special.

A Narcissist is completely unwilling to recognize or identify with the feelings and needs of others. In other words they lack the capacity for empathy, which is essential for mature relationships. They assume everyone is totally concerned about their welfare, and will most likely become impatient with others who talk about their own problems.

A Narcissist is often envious of others or believes that others are envious of him or her. They might harshly devalue the contributions of others, particularly when those individuals have received acknowledgment or praise for accomplishments.

Finally, a Narcissist will display snobbish, arrogant, and disdainful or patronizing attitudes towards others that have received acknowledgement or are perceived in a higher status than them.

Types of Narcissism

Like most personality disorders, narcissism occurs to different degrees in different people and can reveal itself in many ways. Many highly successful individuals may display personality traits that might be considered Narcissistic. So, a small amount of narcissism might be beneficial. For example, many of today’s business leaders and politicians exhibit many of the traits associated with Narcissism. However, excessive Narcissistic behavior can lead to insatiability and disaster.

A narcissist can develop in one of two directions. One of them is the exhibitionist narcissist in which the environment supports his or her grandiosity but feelings are ignored in which he or she continues the cycle thus, trying to restore his or her feelings. This would include the need for attention or attention-seeking tactics like working with charity, voluntary, not-for-profit sector. In most case these are women who want to demonstrate to the world that they are wonderful, kind, caring, compassionate person. Other ways could be playing up an injury or fabricating hate crimes. Another example would be Munchausen syndrome. It is usually a mother, who deliberately harms her child in the intention, of gaining attention from the medical staff. Sometimes the narcissist will work as a nurse or in nursing homes causing death to some and being not detected.

The second type of narcissist is the closet narcissist in which the individual suppress himself from expressing this grandiosity. This narcissist will only reveal his or her feelings of grandiosity when such revelations will be safe and not in public. This could mean having a relationship with someone just to fulfill his needs. He or she would resort to sex. Narcissist partners would be considered his or her objects, not as desire. In this case it is element of conquest and must switch partners very often. Some narcissists like complicated situations such as virgins, married women or men, the more difficult the catch the better. A narcissist might seem to loose interest in sex and in all his sexual partners. The frequency would dwindle to a few times a week to a few times a year. A Narcissist might avoid his spouse and pursue sports, politics or volunteering for anything but sex in order to punish him or her for something, or just because they feel confined to him or her or has lost their freedom.

There are three levels of Narcissism. The extreme level in which there is no separation between the self and the object. The object is seen as an extension of narcissist. An example could be if a narcissist sees himself as unattractive, he would seek someone attractive to fill the need as one. Level two is when a narcissist acknowledges the separation of the object, but still views the object as similar to him or her, sharing the same psychological makeup. Level three is when the narcissist perceives both separate and psychological difference but is unable to appreciate the object as a separate person.

Causes of Narcissism

Medical data showing early mistreatment of individuals from physical, sexual, or emotional have negative effects on brain development. Brain wave abnormalities were present in histories of such early traumas and were at twice the rate compared to non-abused patients. The left side of EEG also showed abnormalities and diminishing development of the left hemisphere. The MRI showed the left hippocampus of abused patients was much smaller compared to non-abused. Studies also showed, that abused children showed deficits of verbal memory. These alterations can increase the risk of depression and many other disorders, including Narcissistic Personality Disorder.

Investigations on verbal abuse also show increase risks for personality disorders. Offspring who experienced maternal verbal abuse were three times more likely to have borderline, narcissist, obsessive compulsive, and paranoid personality disorders, during adolescence or early adulthood. These associations remained significant. Also which showed the disorders to be elevated in adulthood.

There may be a link, between Obsessive Compulsive Disorders and Narcissist Disorders. Thus being a superficial function, to hold on to the self-object. Causing loss of the bond would experience loss of self.

ADHD may also be associated with the narcissistic disorder. Children who suffer from ADHD are unlikely to develop the attachment necessary. Thus the narcissistic disorder occurs, due to regression or adaptation. Another hypothesis could be the linkage of autistic disorders to Narcissism.

Treatment of Narcissism

Most narcissists reject the idea they are mentally disturbed. The level or degree of Narcissism can improve, but rarely will an individual suffering from the disease be cured because of the life long, irreplaceable and indispensable emotional investment in their disorder. Narcissists are attached to one thing their disorder.

Treatment of narcissist revolves around the transference of relationship. The analyst remains silent and invisible, there to listen, echo and interpret the actions of the Narcissist. The therapist remains emphatic to the needs of his patient by becoming a mirror for the Narcissistic to confront his or her alter ego. According to Grunberger, “the patient should enjoy complete narcissistic freedom in the sense that he should always be the only active party. The analyst has no real existence of his own in relation to the analyzed,” the analyst does not have to be good or bad or even exist at all. Analysis is not dialogue; it is a monologue for two voices, one speaking and the other echoing, repeating, clarifying, and interpreting correctly. According to Grunberger, the analyst has to remain a faithful and untarnished mirror.

Once the therapeutic relationship is established, the narcissist mirror transference and self-object transference emerge. This will only happen when the therapist can provide a strong sense of validation to the narcissist allowing the narcissist to recall his injured child. The level of reflecting back to the injured child will depend on the three types mentioned previously. The merger transference will perceive the therapist to be a virtual extension of them. If the therapist should slightly vary from the needs or opinions of the narcissist, the patient will respond by withdrawing. Under the second type, the narcissist perceives the therapist to be separate but alike. It is necessary that the narcissist view the therapist as just like me and be maintained. The third type the therapist must be able to bolster the narcissist’s insecure self. Thus the only interest in the narcissist is to reflect his or her grandiosity.

Utilizing the transference enables the narcissist to heal his or her low self-esteem and restate the damaged grandiosity. To heal the false self, the therapist must take advantage of the narcissist’s emotional state. Making the narcissist focus toward his or her inner feelings at that time. Another approach could be hands-off type. By letting the narcissist take control of the sessions in therapy. It is up to the therapist to recognize the narcissist injury and discover the cause of injury. Once the injury is discovered the therapist must explore the issue with out threatening the narcissist.

Summary

Individual suffering from Narcissistic Personality Disorder usually overestimate their abilities and inflate their accomplishments. They appear boastful and pretentious underestimating and devaluing the achievement and accomplishment of others. Narcissists sometimes fraudulently claim to have qualifications or experiences, which they don’t have.

Fragile self-esteem is another issue for the narcissist. The need for constant attention, admiration, complements, along with superior entitlement, and expecting others to defer to them help their fragile self-esteem. Greed another trait, expecting to receive instead of give and using any means around them for advancement, to include sexual relations.

Narcissist lack of sensitivity has difficulty in recognizing the needs and feelings of others. They are dismissive, contemptuous and impatient when others share or discuss concerns or problems. To conclude the narcissist is oblivious to the hurtfulness of their remarks or behavior, arrogant, disdainful and patronizing attitude, showing envy, emotional coldness and lack of interest and is quick to blame and criticize others when their needs and expectations are not met.

In today’s society Narcissism is all around us. From the time we awake to the time we fall asleep. The children of today are more self-centered then generations ago. Could the parents be spoiling them too much? Thus by giving them, everything they want, with out some level of frustrations, could possibly lead to narcissistic behavior. We see it on television and think it is normal. Television shows, of men and women trying to be gorgeous and the center of attention, such as the Miss America Pageant. Another show, Survivor, in which there is only one person standing at the end. Other factors, may include material items such as cars, houses, that must be grander then others, shows object relations to narcissism. Eventually narcissism may be a part of everyday life and not be considered a disorder in the years to come.

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