Online Resource for Victims of Psychopaths and Narcissists

Narcissistic Personality Disorder

One wonders, of course, if this article is not describing the sub-criminal psychopath? Almost everyone has some narcissistic traits, but being conceited, argumentative, or selfish sometimes (or even all the time) doesn't amount to a personality disorder.

While grandiosity is the diagnostic hallmark of pathological narcissism, there is research evidence that pathological narcissism occurs in two forms, (a) a grandiose state of mind in young adults that can be corrected by life experiences, and (b) the stable disorder described in DSM-IV, which is defined less by grandiosity than by severely disturbed interpersonal relations.

The preferred theory seems to be that narcissism is caused by very early affective deprivation, yet the clinical material tends to describe narcissists as unwilling rather than unable, thus treating narcissistic behaviors as volitional -- that is, narcissism is termed a personality disorder, but it tends to be discussed as a character disorder. This distinction is important to prognosis and treatment possibilities. If NPD is caused by infantile damage and consequent developmental short-circuits, it probably represents an irremediable condition. On the other hand, if narcissism is a behavior pattern that's learned, then there is some hope, however tenuous, that it's a behavior pattern that can be unlearned. The clinical literature on NPD is highly theoretical, abstract, and general, with sparse case material, suggesting that clinical writers have little experience with narcissism in the flesh. There are several reasons for this to be so:

-- The incidence of NPD is estimated at 1% in the general population, though I haven't been able to discover the basis of this estimate.

-- Narcissists rarely enter treatment and, once in treatment, progress very slowly. We're talking about two or more years of frequent sessions before the narcissist can acknowledge even that the therapist is sometimes helpful. It's difficult to keep narcissists in treatment long enough for improvement to be made -- and few people, narcissists or not, have the motivation or the money to pursue treatment that produces so little so late.

-- Because of the influence of third-party payers (insurance companies), there has been a strong trend towards short-term therapy that concentrates on ameliorating acute troubles, such as depression, rather than delving into underlying chronic problems. Narcissists are very reluctant to open up and trust, so it's possible that their NPD is not even recognized by therapists in short-term treatment. Purely anecdotal evidence from correspondents and from observations of people I know indicates that selective serotonin-reuptake inhibitors, such as Prozac, aggravate narcissists' grandiosity and lack of social inhibition. It has also been suggested that self-help literature about bolstering self-esteem and getting what you want out of life or that encourages the feeling of victimization has aggravating effects on NPD thinking and behavior.

-- Most clinical writers seem unaware that narcissists' self-reports are unreliable. This is troubling, considering that lying is the most common complaint about narcissists and that, in many instances, defects of empathy lead narcissists to wildly inaccurate misinterpretations of other people's speech and actions, so that they may believe that they are liked and respected despite a history of callous and exploitative personal interactions.

[from Diagnostic and Statistical Manual of Mental Disorders, 4th edition, 1994, commonly referred to as DSM-IV, of the American Psychiatric Association. European countries use the diagnostic criteria of the World Health Organization.]

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy.[jma: NPD first appeared in DSM-III in 1980; before that time there had been no formal diagnostic description. Additionally, there is considerable overlap between personality disorders and clinicians tend to diagnose mixes of two or more.

Grandiosity is a special case, but lack of empathy and exploitative interpersonal relations are not unique to NPD, nor is the need to be seen as special or unique. The differential diagnosis of NPD is made on the absence of specific gross behaviors. Borderline Personality Disorder has several conspicuous similarities to NPD, but BPD is characterized by self-injury and threatened or attempted suicide, whereas narcissists are rarely self-harming in this way.

BPD may include psychotic breaks, and these are uncharacteristic of NPD but not unknown. The need for constant attention is also found in Histrionic Personality Disorder, but HPD and BPD are both strongly oriented towards relationships, whereas NPD is characterized by aloofness and avoidance of intimacy.

Grandiosity is unique to NPD among personality disorders, but it is found in other psychiatric illnesses.

Psychopaths display pathological narcissism, including grandiosity, but psychopathy is differentiated from NPD by psychopaths' willingness to use physical violence to get what they want, whereas narcissists rarely commit crimes; the narcissists I've known personally are, in fact, averse to physical contact with others, though they will occasionally strike out in an impulse of rage.

It has been found that court-ordered psychotherapy for psychopaths actually increases their recidivism rate; apparently treatment teaches psychopaths new ways to exploit other people.

Bipolar illness also contains strong elements of grandiosity. See more on grandiosity and empathy and its lack below.]The disorder begins by early adulthood and is indicated by at least five of the following:

Translation: Narcissistic Personality Disorder (NPD) is a pattern of self-centered or egotistical behavior that shows up in thinking and behavior in a lot of different situations and activities. People with NPD won't (or can't) change their behavior even when it causes problems at work or when other people complain about the way they act, or when their behavior causes a lot of emotional distress to others (or themselves? none of my narcissists ever admit to being distressed by their own behavior -- they always blame other people for any problems). This pattern of self-centered or egotistical behavior is not caused by current drug or alcohol use, head injury, acute psychotic episodes, or any other illness, but has been going on steadily at least since adolescence or early adulthood.

NPD interferes with people's functioning in their occupations and in their relationships:

Mild impairment when self-centered or egotistical behavior results in occasional minor problems, but the person is generally doing pretty well.

Moderate impairment when self-centered or egotistical behavior results in: (a) missing days from work, household duties, or school, (b) significant performance problems as a wage-earner, homemaker, or student, (c) frequently avoiding or alienating friends, (d) significant risk of harming self or others (frequent suicidal preoccupation; often neglecting family, or frequently abusing others or committing criminal acts).

Severe impairment when self-centered or egotistical behavior results in: (a) staying in bed all day, (b) totally alienating all friends and family, (c) severe risk of harming self or others (failing to maintain personal hygiene; persistent danger of suicide, abuse, or crime).

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

Translation: Grandiosity is the hallmark of narcissism. So what is grandiose?

The simplest everyday way that narcissists show their exaggerated sense of self-importance is by talking about family, work, life in general as if there is nobody else in the picture. Whatever they may be doing, in their own view, they are the star, and they give the impression that they are bearing heroic responsibility for their family or department or company, that they have to take care of everything because their spouses or co-workers are undependable, uncooperative, or otherwise unfit.

They ignore or denigrate the abilities and contributions of others and complain that they receive no help at all; they may inspire your sympathy or admiration for their stoicism in the face of hardship or unstinting self-sacrifice for the good of (undeserving) others. But this everyday grandiosity is an aspect of narcissism that you may never catch on to unless you visit the narcissist's home or workplace and see for yourself that others are involved and are pulling their share of the load and, more often than not, are also pulling the narcissist's share as well.

An example is the older woman who told me with a sigh that she knew she hadn't been a perfect mother but she just never had any help at all -- and she said this despite knowing that I knew that she had worn out and discarded two devoted husbands and had lived in her parents' pocket (and pocketbook) as long as they lived, quickly blowing her substantial inheritance on flaky business schemes.

Another example is claiming unusual benefits or spectacular results from ordinary effort and investment, giving the impression that somehow the narcissist's time and money are worth more than other people's. [Here is an article about recognizing and coping with narcissism in the workplace; it is rather heavy on management jargon and psychobabble, but worth reading. "The Impact of Narcissism on Leadership and Sustainability" by Bruce Gregory, Ph.D. "When the narcissistic defense is operating in an interpersonal or group setting, the grandiose part does not show its face in public. In public it presents a front of patience, congeniality, and confident reasonableness."]

In popular usage, the terms narcissism, narcissist, and narcissistic denote absurd vanity and are applied to people whose ambitions and aspirations are much grander than their evident talents. Sometimes these terms are applied to people who are simply full of themselves -- even when their real achievements are spectacular. Outstanding performers are not always modest, but they aren't grandiose if their self-assessments are realistic; e.g., Muhammad Ali, then Cassius Clay, was notorious for boasting "I am the greatest!" and also pointing out that he was the prettiest, but he was the greatest and the prettiest for a number of years, so his self-assessments weren't grandiose.

Some narcissists are flamboyantly boastful and self-aggrandizing, but many are inconspicuous in public, saving their conceit and autocratic opinions for their nearest and dearest. Common conspicuous grandiose behaviors include expecting special treatment or admiration on the basis of claiming (a) to know important, powerful or famous people or (b) to be extraordinarily intelligent or talented.

As a real-life example, I used to have a neighbor who told his wife that he was the youngest person since Sir Isaac Newton to take a doctorate at Oxford. The neighbor gave no evidence of a world-class education, so I looked up Newton and found out that Newton had completed his baccalaureate at the age of twenty-two (like most people) and spent his entire academic career at Cambridge.

The grandiose claims of narcissists are superficially plausible fabrications, readily punctured by a little critical consideration. The test is performance: do they deliver the goods? (There's also the special situation of a genius who's also strongly narcissistic, as perhaps Frank Lloyd Wright. Just remind yourself that the odds are that you'll meet at least 1000 narcissists for every genius you come across.)

2. Preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love

Translation: Narcissists cultivate solipsistic or "autistic" fantasies, which is to say that they live in their own little worlds (and react with affront when reality dares to intrude).

3. Believes he is "special" and can only be understood by, or should associate with, other special or high-status people (or institutions)

Translation: Narcissists think that everyone who is not special and superior is worthless. By definition, normal, ordinary, and average aren't special and superior, and so, to narcissists, they are worthless.

4. Requires excessive admiration

Translation: Excessive in two ways: they want praise, compliments, deference, and expressions of envy all the time, and they want to be told that everything they do is better than what others can do. Sincerity is not an issue here; all that matter are frequency and volume.

5. Has a sense of entitlement

Translation: They expect automatic compliance with their wishes or especially favorable treatment, such as thinking that they should always be able to go first and that other people should stop whatever they're doing to do what the narcissists want, and may react with hurt or rage when these expectations are frustrated.

6. Selfishly takes advantage of others to achieve his own ends

Translation: Narcissists use other people to get what they want without caring about the cost to the other people.

7. Lacks empathy

Translation: They are unwilling to recognize or sympathize with other people's feelings and needs. They "tune out" when other people want to talk about their own problems.

In clinical terms, empathy is the ability to recognize and interpret other people's emotions. Lack of empathy may take two different directions: (a) accurate interpretation of others' emotions with no concern for others' distress, which is characteristic of psychopaths; and (b) the inability to recognize and accurately interpret other people's emotions, which is the NPD style. This second form of defective empathy may (rarely) go so far as alexithymia, or no words for emotions, and is found with psychosomatic illnesses, i.e., medical conditions in which emotion is experienced somatically rather than psychically.

People with personality disorders don't have the normal body-ego identification and regard their bodies only instrumentally, i.e., as tools to use to get what they want, or, in bad states, as torture chambers that inflict on them meaningless suffering.

Self-described narcissists who've written to me say that they are aware that their feelings are different from other people's, mostly that they feel less, both in strength and variety (and which the narcissists interpret as evidence of their own superiority); some narcissists report "numbness" and the inability to perceive meaning in other people's emotions.

8. Is often envious of others or believes that others are envious of him

Translation: No translation needed.

9. Shows arrogant, haughty, patronizing, or contemptuous behaviors or attitudes

Translation: They treat other people like dirt.

How to Recognize a Narcissist

Never love anything that can't love you back

Life being the way it is, a couple of weeks after I'd drafted this page, but before showing it for comments, I received the following joke in my email. It reminds me of something a wise old woman said: "I don't think the devil looks ugly and frightening. If he did, people wouldn't find him so attractive. The devil must be a handsome man." And the devil's sister is a pretty woman, as often as not.

One bright, beautiful Sunday morning, everyone in tiny Anytown got up early and went to the local church. Before the service started, the townspeople were sitting in their pews and talking about their lives, their families, and so on.

Suddenly, Satan appeared at the front of the church.

Everyone started screaming and running for the front entrance, trampling each other in a frantic effort to get away from evil incarnate. Soon everyone had left the church except for an elderly gentleman who sat calmly in his pew, not moving, seemingly oblivious to the fact that God's ultimate enemy was in his presence.

Now, this confused Satan a bit, so he walked up to the man and said, "Hey! Don't you know who I am?"

The man replied, "Yep, sure do."

Satan asked, "Aren't you afraid of me?"

"Nope, sure ain't," said the man.

Satan was a little perturbed at this and queried, "Why aren't you afraid of me?"

The man calmly replied, "I've been married to your sister for 25 years."

"If it walks like a duck and quacks like a duck...."

To my knowledge, none of the narcissistic individuals I've known personally have had official diagnoses of Narcissistic Personality Disorder; they have not sought help and so haven't been assessed clinically. On the other hand, members of their families have sought help to cope with them -- and I have sought help in understanding every one of them! Thus these pages.

These are field notes -- that is, descriptions and observations to assist in identifying narcissists and also, I hope, to give aid and comfort to others who live and work with narcissists. I'm sorry that I cannot also give hope, but, since a prime characteristic of narcissists is believing that they are always right no matter what, narcissists are extremely resistant to change and, unfortunately, tend to get worse as they get older.

I have also never had to cope with a physically aggressive or sadistic narcissist. The narcissists I've known have pretty much stuck to neglect and verbal and emotional abuse. But lots of people have not been so lucky, and their narcissist parents or partners have been relentlessly interfering and cruel in efforts to reform and re-form their "beloveds," including but not limited to plastic surgery or bleaching and perming little babies' hair to make them more perfectly beautiful blondes. [If you had a narcissist for a parent, you may find some of these books helpful.]

Nearly everyone has some narcissistic traits. It's possible to be arrogant, selfish, conceited, or out of touch without being a narcissist. The practical test, so far as I know, is that with normal people, no matter how difficult, you can get some improvements, at least temporarily, by saying, essentially, "Please have a heart." This doesn't work with narcissists; in fact, it usually makes things worse.

It's impossible to overemphasize the importance of narcissists' lack of empathy. It colors everything about them. I have observed very closely some narcissists I've loved, and their inability to pay attention when someone else is talking is so striking that it has often seemed to me that they have neurological problems that affect their cognitive functioning.

These are educated people with high IQs, who've had ordinary middle-class backgrounds and schooling, and their thinking is not only illogical but weird: with narcissists, you have to know them pretty well to understand their behavior. For instance, they always fill in their gaps (which make up just about the entirety of their visible life) with bits of behavior, ideas, tastes, opinions, etc., borrowed from someone else whom they regard as an authority. Their authoritative sources, as far as I know, are always people they've actually known, not something from a book, for instance, and narcissists' opinions may actually come from someone you know, too, but who is not to you obviously an authority on the matter at hand, so narcissists can seem totally arbitrary, virtually random in their motivations and reasoning.

They are evidently transfixed by a static fantasy image of themselves, like Narcissus gazing at his reflection, and this produces an odd kind of stillness and passivity. Because their inner life is so restricted and essentially dead, it doesn't contain images of how to live a full life -- these things are not important to them, they expect others to look after day-to-day chores, they resent wasting their specialness on common things, they don't put their heart into their work (though they'll tell you how many hours they put into it), they borrow their opinions and preferences and tastes from whomever strikes them as authoritative at the moment.

From my personal experience, and from what I've seen in the clinical literature, narcissists don't talk about their inner life -- memories, dreams, reflections -- much at all. They rarely recount dreams. They seem not to make typical memory associations -- i.e., in the way one thing leads to another, "That reminds me of something that happened when I was...of something I read...of something somebody said...." They don't tell how they learned something about themselves or the world. They don't share their thoughts or feelings or dreams. They don't say, "I have an idea and need some help," or "There's something I've always wanted to do...did you ever want to do that?"

They do not discuss how they've overcome difficulties they've encountered or continuing problems that they're trying to solve (beyond trying to get someone else to do what they want). They often say that they don't remember things from the past, such as childhood events, their schooldays or old friends, and it seems to me that they really don't most of the time.

Anyhow, for all these reasons, I've tried to refrain from speculating about (i.e., novelizing) what goes on in their heads. Writer John Cheever (who recorded having been diagnosed as a narcissist when he went to marriage counseling at his wife's insistence) describes some of his persistent fantasy images -- and, with Cheever, they're very striking, as you'll know if you've read any of his fiction; his characters and plots tend to be narcissistic (i.e., self-obsessed tunnel vision spiraling into nihilism), but his stories often contain memorably glorious set pieces or tableaux, such as the the hunt for the golden Easter egg in one of the Wapshot novels. Cheever also gives unself-conscious expression to the ways in which his obsessive preoccupation with himself (and his penis -- sort of a magic wand in his mind) obstructed his ability to relate to his wife and children, obstructed even his ability to perceive them: to see what they looked like, to pay attention to what they said and did, though with Cheever everything is also soaked with the sorrows of gin.

Alice Adams's novel, Almost Perfect, also gives things from a narcissistic point of view in a way that I found convincing and credible, based on my personal experience of narcissistic individuals. A striking thing about narcissists that you'll notice if you know them for a long time is that their ideas of themselves and the world don't change with experience; the ones I've known have been stalled at a vision that came to them by the age of sixteen.

There are different theories of how narcissists are made. Some psychologists trace NPD to early infantile neglect or abuse, and some blame over-indulgence and indiscriminate praise by parents who don't set limits on what's acceptable from their children. Others say that NPD shows up in adolescence. Some say narcissists tend to peak around middle age and then mellow out. Others say that narcissists stay pretty much the same except they tend to depression as they get older and their grandiose fantasies are not supported, plus they're not as good-looking as they used to be. The narcissists I've known have apparently always been "that way" and they get worse as they get older, with dramatic regression of their personas after the deaths of their parents and other personal authority figures who have previously exerted some control over the narcissists' bad behavior. And, yes, chronic depression gets to be obvious at least by their forties but may have always been present. Depressed narcissists blame the world, of course, and not themselves for their personal disappointments.

Essentially, narcissists are unable or unwilling to trust either the world or other people to meet their needs. Perhaps they were born to parents unable to connect emotionally and, thus, as infants learned not to let another person be essential to them in any way. Perhaps NPD starts later, when intrusive or abusive parents make it dangerous for the child to accept other people's opinions and valuations. Maybe it comes from a childhood environment of being treated like royalty or little gods. Whatever the case, narcissists have made the terrible choice not to love. In their imaginations, they are complete unto themselves, perfect and not in need of anything anyone else can give them. (NB: Narcissists do not count their real lives -- i.e., what they do every day and the people they do it with -- as worth anything.) Their lives are impoverished and sterile; the price they pay for their golden fantasies is high: they'll never share a dream for two.

Now, it is possible to have a relatively smooth relationship with a narcissist, and it's possible to maintain it for a long time. The first requirement for this, though, is distance: this simply cannot be done with a narcissist you live with. Given distance, or only transient and intermittent contact, you can get along with narcissists by treating them as infants: you give them whatever they want or need whenever they ask and do not expect any reciprocation at all, do not expect them to show the slightest interest in you or your life (or even in why you're bothering with them at all), do not expect them to be able to do anything that you need or want, do not expect them to apologize or make amends or show any consideration for your feelings, do not expect them to take ordinary responsibility in any way. But note: they are not infants; infants develop and mature and require this kind of care for only a brief period, after which they are on the road to autonomy and looking after themselves, whereas narcissists never outgrow their demands for dedicated attention to their infantile needs 168 hours a week.

Adult narcissists can be as demanding of your time and energy as little babies but without the gratification of their growing or learning anything from what they suck from you. Babies love you back, but adult narcissists are like vampires: they will take all you can give while giving nothing back, then curse you for running dry and discard you as a waste of their precious time.

It is also essential that you keep emotional distance from narcissists. They're pretty good at maintaining a conventional persona in superficial associations with people who mean absolutely nothing to them, and they'll flatter the hell out of you if you have something they can use or if, for some reason, they perceive you as an authority figure. That is, as long as they think you don't count or they're afraid of you, they'll treat you well enough that you may mistake it for love. But, as soon as you try to get close to them, they'll say that you are too demanding -- and, if you ever say "I love you," they'll presume that you belong to them as a possession or an appendage, and treat you very very badly right away. The abrupt change from decent treatment to outright abuse is very shocking and bewildering, and it's so contrary to normal experience that I was plenty old before I realized that it was actually my expression of affection that triggered the narcissists' nasty reactions.

Once they know you are emotionally attached to them, they expect to be able to use you like an appliance and shove you around like a piece of furniture. If you object, then they'll say that obviously you don't really love them or else you'd let them do whatever they want with you. If you should be so uppity as to express a mind and heart of your own, then they will cut you off -- just like that, sometimes trashing you and all your friends on the way out the door. The narcissist will treat you just like a broken toy or tool or an unruly body part: "If thy hand or thy foot offend thee, cut them off" [Matt. 18:8]. This means you.

So, yes, it's possible to get along with narcissists, but it's probably not worth bothering with. If family members are narcissists, you have my deep sympathy. If people you work with are narcissists, you will be wise to keep an eye on them, if just for your own protection, because they don't think very well, no matter what their IQs, they feel that the rules (of anything) don't apply to them, and they will always cut corners and cheat wherever they think they can get away with it, not to mention alienating co-workers, clients, and customers by their arrogance, lies, malice, and off-the-wall griping. Narcissists are threatened and enraged by trivial disagreements, mistakes, and misunderstandings, plus they have evil mouths and will say ANYTHING, so if you continue to live or work with narcissists, expect to have to clean up after them, expect to lose friends over them, expect big trouble sooner or later.

If you're reading this because of problems with someone you know now, the chances are excellent that one or both of your parents was a narcissist. Narcissists are so much trouble that only people with special prior training (i.e., who were raised by narcissists) get seriously involved with them.

Sometimes narcissists' children become narcissists, too, but this is by no means inevitable, provided stable love was given by someone, such as the non-narcissist parent or grandparents. Beyond that, a happy marriage will heal many old wounds for the narcissist's child.

But, even though children of narcissists don't automatically become narcissists themselves and can survive with enough intact psychically to lead happy and productive lives away from their narcissistic parents, because we all love our parents whether they can love us back or not, children of narcissists are kind of bent -- "You can't get blood out of a stone," but children of narcissists keep trying, as if by bonding with new narcissists we could somehow cure our narcissistic parents by finding the key to their heart. Thus, we've been trained to keep loving people who can't love us back, and we will often tolerate or actively work to maintain connections with narcissistic individuals whom others, lacking our special training, find alienating and repellent from first contact, setting ourselves up to be hurt yet again in the same old way.

Once narcissists know that you care for them, they'll suck you dry -- demand all your time, be more work than a newborn babe -- and they'll test your love by outrageous demands and power moves. In their world, love is a weakness and saying "I love you" is asking to be hurt, so be careful: they'll hurt you out of a sort of sacred duty. They can't or won't trust, so they will test your total devotion. If you won't submit to their tyranny, then you will be discarded as "no good," "a waste of time," "you don't really love me or you'd do whatever I ask," "I give up on you." (Note: In many instances, narcissists' demands are not only outrageous but also impossible to fulfill even if you want to please them. Plus if you actually want to do what they want you to do, that would be too much like sharing, so they won't want it anymore.)

If you've had a narcissist for a parent, you are probably not afraid of dying and going to hell -- you have lived hell on Earth. Narcissists cannot be satisfied and do a tremendous amount of damage to their children and partners in their relentless demand for a perfect outer appearance to reflect the perfect inner image that obsesses them. Kyrie eleison.

 


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