Narcissism is a term many of us have come across. It has become widely used in recent years, perhaps overly-so. This article will try to demystify this complex and interesting topic.
Narcissistic Personality Disorder (NPD; narcissism) is the full term and it describes a mental health disorder that is one of several types of personality disorder. Personality disorders are patterns of behaviour and thinking that are maladaptive and dysfunctional, causing suffering for the individual and others. NPD is characterised by excessive feelings of self-importance and a need for recognition & praise. It usually involves an inability to empathise and have genuine concern for others. It may be over-simplified as a pattern of excessively self-centred and selfish behaviour.
Other characteristics include a tendency to down-play the merit and achievements of others. Anger and rage, often in response to a perceived challenge to competence and merit, is another common trait.
NPD is thought to be partly genetic/inherited and partly a result of childhood and early-life experiences. Classically and most-commonly there is a lack of emotional attachment to parents (unconditional parental love is considered critical in the development of a sound but also realistic sense of self-worth). The resulting self-doubt and insecurity is thought to be at the heart of the issue for most narcissists -the narcissist’s response to this self-doubt is to inflate their own sense of self-importance and to defend this at all costs (whereas the healthier response would be to understand the scenario on an intellectual and emotional level and to then start healing mentally) . As can be seen, the importance of genetics and parenting in the causality of narcissism can, most-unfortunately, lead to families where several generations display narcissistic tendencies.
There is some debate and complexity around the precise diagnosis of NPD. Some experts believe it to be over-diagnosed and some feel it is too broad a diagnosis, which lacks precision. As things stand it is an accepted psychological diagnosis that is reached through the clinical assessment of psychologists and or psychiatrists. It is important to note that NPD is commonly associated with other mental health problems such as depression and substance abuse. The treatment of NPD focusses on psychotherapy/counselling, with medications seemingly unhelpful except for associated conditions such as depression. The results of treatment are mixed and the fact that most patients are “resistant” to treatment (their inflated sense of self-worth persuades them that there is no problem and or they are excessively afraid of being labelled or criticised as “nutty”) tends to lead to poorer outcomes. NPD is thought to affect up to 5% of adults, although this is not well understood as yet. A major focus tends to be on the family situation, where the children (and other family members as well as friends and associates) of narcissists can be helped to understand the situation and to develop more balanced and healthy feelings about themselves, hopefully breaking the cycle. There is a huge ammount of self-help and popular-culture material, most of it online, available on these topics. Some caution is advised here: while much of this material is well intended and much of it sound and helpful, there is also quite a lot of pseudo-science and several unqualified people offering advice in this filed. Readers are advised to seek online information and advice by all means, but to look into the actual qualifications and experience of those offering such.
Narcissism and Narcissistic Personality Disorder is an important mental health condition that causes huge suffering for the patient and those close to the patient. There is a trend for NPD to run in families, for genetic and early-life-experience reasons. This cycle can be very damaging for all involved. Treatment is challenging and the best approaches are found in psychotherapy.
Written by Dr Colin Burns